{"id":2449,"date":"2024-02-21T10:37:05","date_gmt":"2024-02-21T10:37:05","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=2449"},"modified":"2024-02-21T10:37:09","modified_gmt":"2024-02-21T10:37:09","slug":"fourth-wave-of-opioid-epidemic-crashes-ashore-propelled-by-fentanyl-and-meth","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=2449","title":{"rendered":"\u2018Fourth Wave\u2019 of Opioid Epidemic Crashes Ashore, Propelled by Fentanyl and Meth"},"content":{"rendered":"

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The United States is knee-deep in what some experts call the opioid epidemic\u2019s \u201cfourth wave,\u201d which is not only placing drug users at greater risk but is also complicating efforts to address the nation\u2019s drug problem.<\/p>\n

These waves, according to a report out today<\/a> from Millennium Health, began with the crisis in prescription opioid use, followed by a significant jump in heroin use, then an increase in the use of synthetic opioids like fentanyl.<\/p>\n

The latest wave involves using multiple substances at the same time, combining fentanyl mainly with either methamphetamine or cocaine, the report found. \u201cAnd I\u2019ve yet to see a peak,\u201d said one of the co-authors, Eric Dawson<\/a>, vice president of clinical affairs at Millennium Health<\/a>, a specialty laboratory that provides drug testing services to monitor use of prescription medications and illicit drugs.<\/p>\n

The report, which takes a deep dive into the nation\u2019s drug trends and breaks usage patterns down by region, is based on 4.1 million urine samples collected from January 2013 to December 2023 from people receiving some kind of drug addiction care.<\/p>\n

Its findings offer staggering statistics and insights. Its major finding: how common polysubstance use has become. According to the report, an overwhelming majority of fentanyl-positive urine samples \u2014 nearly 93% \u2014 contained additional substances. \u201cAnd that is huge,\u201d said Nora Volkow<\/a>, director of the National Institute on Drug Abuse at the National Institutes of Health.<\/p>\n

The most concerning, she and other addiction experts said, is the dramatic increase in the combination of meth and fentanyl use. Methamphetamine, a highly addictive drug<\/a> often in powder form that poses several serious cardiovascular and psychiatric risks, was found in 60% of fentanyl-positive tests last year. That is an 875% increase since 2015.<\/p>\n

\u201cI never, ever would have thought this,\u201d Volkow said.<\/p>\n

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Among the report\u2019s other key findings:<\/p>\n
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The nationwide spike in methamphetamine use alongside fentanyl marks a change in drug use patterns.<\/li>\n
Polydrug use trends complicate overdose treatments. For instance, though naloxone, an opioid-overdose reversal medication<\/a>, is widely available, there isn\u2019t an FDA-approved medication for stimulant overdose.<\/li>\n
Both heroin and prescribed opioid use alongside fentanyl have dipped. Heroin detected in fentanyl-positive tests dropped by 75% since peaking in 2016. Prescription opioids were found at historic low rates in fentanyl-positive tests in 2023, down 89% since 2013.<\/li>\n<\/ul>\n
But Jarratt Pytell<\/a>, an addiction medicine specialist and assistant professor at the University of Colorado\u2019s School of Medicine, warned these declines shouldn\u2019t be interpreted as a silver lining.<\/p>\n
A lower level of heroin use \u201cjust says that fentanyl is everywhere,\u201d Pytell said, \u201cand that we have officially been pushed by our drug supply to the most dangerous opioids that we have available right now.\u201d<\/p>\n
\u201cWhenever a drug network is destabilizing and the product changes, it puts the people who use the drugs at the greatest risk,\u201d he said. \u201cThat same bag or pill that they have been buying for the last several months now is coming from a different place, a different supplier, and is possibly a different potency.\u201d<\/p>\n
In the illicit drug industry, suppliers are the controllers. It may not be that people are seeking out methamphetamine and fentanyl but rather that they\u2019re what drug suppliers have found to be the easiest and most lucrative product to sell.<\/p>\n
\u201cI think drug cartels are kind of realizing that it\u2019s a lot easier to have a 500-square-foot lab than it is to have 500 acres of whatever it takes to grow cocaine,\u201d Pytell said.<\/p>\n
Dawson said the report\u2019s drug use data, unlike that of some other studies, is based on sample analysis with a quick turnaround \u2014 a day or two.<\/p>\n
Sometimes researchers face a months-long wait to receive death reports from coroners. Under those circumstances, you are often \u201cstaring at today but relying on data sources that are a year or more in the past,\u201d said Dawson.<\/p>\n
Self-reported surveys of drug users, another method often used to track drug use, also have long lag times and \u201coften miss people who are active for substance use disorders,\u201d said Jonathan Caulkins, a professor at Carnegie Mellon University\u2019s Heinz College. Urine tests \u201care based on a biology standard\u201d and are good at detecting when someone has been using two or more drugs, he said.<\/p>\n
But using data from urine samples also comes with limitations.<\/p>\n
For starters, the tests don\u2019t reveal users\u2019 intent.<\/p>\n
\u201cYou don\u2019t know whether or not there was one bag of powder that had both fentanyl and meth in it, or whether there were two bags of powder, one with fentanyl in it and one with meth and they took both,\u201d Caulkins said. It can also be unclear, he said, if people intentionally combined the two drugs for an extra high or if they thought they were using only one, not knowing it contained the other.<\/p>\n
Volkow said she is interested in learning more about the demographics of polysubstance drug users. \u201cIs this pattern the same for men and women, and is this pattern the same for middle-age or younger people? Because again, having a better understanding of the characteristics allows you to tailor and personalize interventions.\u201d<\/p>\n
All the while, the nation\u2019s crisis continues. According to the Centers for Disease Control and Prevention, more than 107,000 people died<\/a> in the U.S. in 2021 from drug overdoses, most because of fentanyl.<\/p>\n
Caulkins said he\u2019s hesitant to view drug use patterns as waves because that would imply people are transitioning from one to the next.<\/p>\n
\u201cAre we looking at people whose first substance use disorder was an opioid use disorder, who have now gotten to the point where they\u2019re polydrug users?\u201d he said. Or, are people now starting substance use disorders with methamphetamine and fentanyl, he asked.<\/p>\n
One point was clear, Dawson said: \u201cWe\u2019re just losing too many lives.\u201d<\/p>\n
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