As the United States battles an ongoing epidemic of opioid abuse and deaths, new data shows that fatalities tied to cocaine and methamphetamines are also surging.
In fact, of the more than 70 000 lives lost to drug overdoses in 2017, "nearly a third involved cocaine, psychostimulants or both", reports a team led by researcher Mbabazi Kariisa, of the US Centers for Disease Control and Prevention.
A troubling trend
Psychostimulants include drugs such as methamphetamines (meth), the "club drug" MDMA, Ritalin, and even caffeine.
National vital statistics data on causes of death found that in 2017, one in five drug overdose deaths (nearly 14 000 cases) involved cocaine, representing "a 34.4% increase from 2016", Kariisa and colleagues reported.
Similarly, nearly 15% of all fatal drug ODs for 2017 (about 10 000 cases) involved psychostimulants, a jump upwards of 37% over the previous year.
These numbers reflect a recent, troubling trend: The CDC team noted that between 2015 and 2016, rates of drug overdose deaths involving cocaine, psychostimulants or both had already risen by 42.4%.
Why have coke, meth and the like become even more deadly? According to the researchers, in many cases, deaths also involved the use of opioids, including super-potent drugs such as fentanyl.
"Nearly three-quarters of cocaine-involved deaths in 2017 also involved opioids," they reported, as did about half of deaths involving psychostimulants such as meth. Synthetic opioids – fentanyl, most prominently – often played a key and deadly role.
An emergency physician on the front line of the drug overdose epidemic wasn't surprised by the numbers.
"While much attention continues to focus on addressing opioid abuse and misuse, it's vital that we don't ignore the dangers that cocaine and other psychostimulants present," said Dr Robert Glatter, who practices at Lenox Hill Hospital in New York City.
In many cases, drug abusers may not even know that the substances they are using are laced with fentanyl or other drugs, he added. The trend "could be partly related to people unaware of the tainted product they were using," Glatter said.
But even used alone, cocaine raises a person's odds for death, he said.
"Cocaine use elevates blood pressure, weakens the heart muscle, promotes formation of plaque in the coronary arteries, thereby increasing the risk of heart attack," Glatter explained. "It also may precipitate a stroke by virtue of its effects on plaque formation in blood vessels that supply the brain."
The CDC team found that some demographics are being hit harder by the resurgence of cocaine and psychostimulant abuse than others.
When it comes to gender and age, the upward trend in fatalities was most pronounced for young women aged 15 to 24, although young men were similarly affected. Cocaine-related deaths were most common in the Midwest, while the West had the highest rate of fatal overdoses involving psychostimulants, the CDC researchers said.
The data suggests an increasingly complex "poly-substance landscape" of drug abuse across America, Kariisa's group said.
"Drug overdoses continue to evolve along with emerging threats, changes in the drug supply, mixing of substances with or without the user's knowledge, and poly-substance abuse," they wrote. More can and must be done to provide addicts with "tailored and effective prevention and response strategies" to help curb these trends, the researchers said.
The new report was published in the CDC journal Morbidity and Mortality Weekly Report.
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