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The main point: The drug supply and trends in overdose deaths continue to evolve.
- While opioid overdose deaths are on the decline, more Americans are now using and dying from stimulants, particularly cocaine and methamphetamine.
- And new synthetic drugs are being created at a rapid pace.
- The bottom line: The trends underscore that substance use doesn’t just end, it evolves, and people use multiple drugs.
Why it’s important: Drugs are now more complex and likely to be synthetic, adding to the risk of users not fully understanding what is in them. These shifts present challenges to the public health system and public health messaging.
- But the same principles that have led to the recent successes in bringing down opioid overdose deaths can apply.
Go deeper:
- The U.S. spent years building programs to address the opioid crisis, with medications for opioid use disorder (MOUD) and naloxone as key elements. But the same interventions do not exist for stimulants.
- The behavioral treatments that exist for stimulant use disorders are still largely reserved for specialty clinics and are not available in primary care. Access to contingency management through Medicaid and most private insurance is limited, and many policymakers remain opposed to it.
- People who use drugs and their loved ones might not be as likely to recognize the signs and symptoms of a stimulant addiction or overdose.
- Labs are rapidly churning out new synthetic drugs, including not just fentanyl, but also new tranquilizers, stimulants, and cannabinoids. Many are not illegal yet, with the new drugs invented faster than authorities can identify them. Nearly all are harder to trace than conventional drugs, less expensive to produce, much more potent, and far deadlier.
Read more: The cocaine comeback, explained; No Pills or Needles, Just Paper: How Deadly Drugs Are Changing
Published
April 2026