Although fentanyl’s contribution to the overdose crisis has dominated the national conversation for over a decade, overdoses involving stimulants—alone and in combination with fentanyl—have increased and are gaining more attention. Because overdose data do not fully capture the scope of illicit stimulant use in the U.S., the analysis of over 1.6 million clinical UDT specimens collected from adults with a substance use disorder (SUD), discussed in this presentation, provides insight into the broader picture of illicit stimulant and fentanyl use—each in total and in combination with one another—between January 2016 and November 2025, and through the first three quarters of 2026.
Learning Objectives:
1. Participants will be able to better understand aspects of the drug use epidemic that are not fully captured by overdose data and highlight the underappreciated contribution of illicit stimulant use to the total burden of drug use among people who have a substance use disorder.
2. Participants will be able to become even more familiar with the changes in information regarding the continued rise of stimulant use, both with and without fentanyl, which suggests that cocaine and methamphetamine are readily available in the illicit drug supply and that demand for these drugs continues to grow—fueling the ongoing “fourth wave” of the overdose crisis.
3. Participants will be able to observe changes in national overdose death rates and delve further into what may be contributing to these changes.
