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 As of 2016, 27% of cocaine overdoses and 14% of stimulant overdoses
treated in U.S. emergency rooms also involved an opioid, researchers
report in the journal Addiction. And, in 2017, almost 75% of
overdose deaths involving cocaine and half involving stimulants also
involved at least one opioid.
"Since opioids are driving increases in some stimulant overdoses,
expanding opioid overdose prevention and reversal efforts through
risk reduction services and access to medication-assisted treatment
is critical for people who use stimulants," said study leader Brooke
Hoots of the Centers for Disease Control and Prevention in Atlanta.
"Increases in stimulant overdoses without opioids also draws
attention to the need for new, evidence-based interventions to
address the evolving drug overdose crisis," Hoots said by email.
Previous studies have documented the trend of fatal overdoses
increasingly involving a cocktail of opioids and other drugs like
stimulants and cocaine, but the current analysis offers fresh
evidence that it holds true for nonfatal overdoses, too, the study
team notes.
Hoots' team examined data on nonfatal overdoses from 2006 to 2016
and fatal overdoses from 2006 to 2017 involving cocaine,
psychostimulants and opioids.
Death rates from stimulant overdoses involving opioids climbed by
about 29% from 2010 to 2015, with a dramatic annual increase of 51%
from 2015 to 2017. Stimulant overdoses without opioids climbed 23%
from 2008 to 2017.
These increases occurred across a broad range of demographic groups
and geographic areas, underscoring the escalating nature of the
overdose crisis in the United States, the study team writes.
Mixing stimulants and opioids may make overdoses more likely, Hoots
said.
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Signs and symptoms of stimulant overdose include chest pain, high
body temperature, rapid heart rate, difficult or labored breathing,
agitation, paranoia, and hallucinations, Hoots said. A severe
stimulant overdose can cause seizures, heart attack or stroke.
"Mixing a stimulant and an opioid sends the body conflicting signals
and can mask the effect of either drug, making an individual more
likely to overdose," Hoots added.
One limitation of the study is that comprehensive toxicology tests
are rarely done for patients who have overdoses, making it
impossible to confirm the exact drugs they might have been using,
the study team notes. Often, overdose records list drugs that
patients report using, which might miss situations where people use
stimulants they don't realize have been blended with other drugs.
It's also not clear whether overdoses are rising because more people
are using stimulants or because stimulants are becoming more potent,
or both, said Brendan Saloner, a researcher at the Johns Hopkins
Bloomberg School of Public Health in Baltimore who wasn't involved
in the study.
"We as a country are very opioid-focused right now, and it means
that we have neglected other drugs," Saloner said by email. "The
really scary thing about stimulants is that we don't have really
great treatment or harm reduction strategies compared to what we
have for opioids, so it's very possible that we could contain the
opioid crisis and still see rising stimulant deaths."
SOURCE: https://bit.ly/2GAeAKk Addiction, online January 7, 2020.
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