Declines in stimulant-involved overdose mortality occurred only with fentanyl co-involvement, United States, 2023-2024.

Authors

Daniel A Busch

Published in

Drug and alcohol dependence. Volume 288. Pages 113314. Aug 12, 2026. Epub Aug 12, 2026.

Abstract

Between 2023 and 2024, overdose mortality in the United States declined substantially. It is unclear whether declines in stimulant-involved overdose mortality reflect changes in stimulant-related mortality independent of fentanyl co-involvement.
We analyzed U.S. overdose mortality data from CDC WONDER for 2023 and 2024, stratifying stimulant-, cocaine-, psychostimulant-, and non-fentanyl opioid-involved deaths by fentanyl co-involvement (assigned ICD-10 multiple-cause code T40.4). Mortality rate ratios comparing 2024 with 2023 were calculated.
The decline in stimulant-involved overdose mortality was observed only among deaths with fentanyl co-involvement. Similar patterns were observed for both cocaine- and psychostimulant-involved mortality. In contrast, non-fentanyl opioid-involved mortality declined both with and without fentanyl co-involvement, but the overall decline was predominantly associated with deaths with fentanyl co-involvement.
The recent decline in stimulant-involved overdose mortality was confined to deaths with fentanyl co-involvement. Non-fentanyl opioid-involved mortality declined in both strata, but the overall decline was predominantly associated with deaths with fentanyl co-involvement. These findings underscore the importance of stratifying category-specific overdose mortality by fentanyl co-involvement.

PMID:
42830002
Bibliographic data and abstract were imported from PubMed on 05 Oct 2026.

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