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The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis.
Ciccarone, Daniel.
  • Ciccarone D; Department of Family and Community Medicine, University of California, San Francisco, California, USA.
Curr Opin Psychiatry ; 34(4): 344-350, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1631191
ABSTRACT
PURPOSE OF REVIEW This review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment. RECENT

FINDINGS:

Overdose due to illicit synthetic opioids (e.g. fentanyl and fentanyl analogs) continues to rise in the US both preceding and during the COVID-19 pandemic. Fentanyl-related overdose is rising in new geographic areas e.g. the western USA. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose. Other medical consequences of injection drug use are rising including HIV and hepatitis C infections. Medication approaches to treating opioid use disorder remain the standard of care and there are new promising pharmacological approaches to treating methamphetamine use disorder.

SUMMARY:

A 'fourth wave' of high mortality involving methamphetamine and cocaine use has been gathering force in the USA. Availability and use of illicit fentanyls are still the major drivers of overdose deaths and the current rise in stimulant-related deaths appears entwined with the ongoing opioid epidemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Fentanyl / Cocaine-Related Disorders / Opioid Epidemic / Opiate Overdose / Central Nervous System Stimulants / Analgesics, Opioid Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Curr Opin Psychiatry Year: 2021 Document Type: Article Affiliation country: YCO.0000000000000717

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fentanyl / Cocaine-Related Disorders / Opioid Epidemic / Opiate Overdose / Central Nervous System Stimulants / Analgesics, Opioid Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Curr Opin Psychiatry Year: 2021 Document Type: Article Affiliation country: YCO.0000000000000717