Trends in co-exposures of heroin, cocaine, and methamphetamine with fentanyl. The prevalence of co-exposure of fentanyl involving heroin increased between 2015 and 2021 from 3.0% to 7.8% (p< 0.001), as did the prevalence of co-exposure involving cocaine (increasing from 1.5% to 7.3%, p= 0.001), and methamphetamine (increasing from 1.1% to 8.7%, p= .004).