Table 1.
Combined Fentanyl and Stimulant Exposures Derived From Postmortem Toxicology Testing in the United States
| First Author, Year (Reference No.) |
Data Source | Time Period | Outcome | Key Findings |
|---|---|---|---|---|
| Jones, 2017 (11) | National Vital Statistics System | 2000–2015 | Rate and number of cocaine-involved overdose deaths involving natural or synthetic opioids | Cocaine-related deaths increased significantly from 0.37 (2000) to 1.363 (2015) per 100,000; those not involving opioids declined from 0.89 to 0.78 per 100,000. |
| Jones, 2018 (9) | National Vital Statistics System | 2010–2016 | Rate and number of synthetic opioid-involved overdose deaths | Synthetic opioid involvement in overdose deaths involving illicit drugs or alcohol increased from 7.8% (2010) to 30.5% (2016); synthetic opioid involvement in overdose deaths involving cocaine rose from 4.0% (2010) to 40.3% (2016). |
| Kariisa, 2019 (12) | National Vital Statistics System | 2003–2017 | Rate and number of combined cocaine- and psychostimulant-involved overdose death rates | Death rates increased 34.4% from 3.2 (2016) to 4.3 (2017) per 100,000. In 2017, 72.2% of cocaine and 50.4% of stimulant deaths involved an opioid. |
| Nolan, 2019 (13) | New York City death certificates | 2015–2016 | Contribution of opioids and fentanyl to the increase in cocaine-involved overdose in New York City | Increase in deaths involving fentanyl and cocaine accounted for 90% of the increase in cocaine-related mortality. |
| Hoots, 2020 (10) | Healthcare Cost and Utilization Project’s Nationwide Emergency Department Sample; National Vital Statistics System | 2006–2016 2006–2017 | Trends in nonfatal and fatal overdoses involving stimulants with and without opioids | Emergency department visits involving cocaine with opioids experienced a 14.7% APC increase from 2006–2016; visits involving psychostimulants with opioids experienced a 49.9% APC increase from 2006 to 2011 and then 14.0% APC increase from 2011 to 2016. Among overdose deaths, overdose deaths involving cocaine and opioids decreased 12.0% per year from 2006 to 2010, remained stable from 2010 to 2014, and increased 46.0% per year from 2014 to 2017. For psychostimulants, overdose death rates with opioids remained stable from 2006 to 2010, increased 28.6% per year from 2010 to 2015, and increased 50.5% per year from 2015 to 2017. |
| Wang, 2020 (14) | Florida Drug-Related Outcomes Surveillance and Tracking System | 2016–2018 | Polysubstance-involved deaths with distinction between “co-involved” and “present” drugs | Cocaine-related deaths increased from 1,739 (2016) to 3,027 (2017), and the proportion of these deaths involving fentanyl rose from 32.6% (2016) to 52.4% (2017). |
Abbreviation: APC, annual percent change.