At the Intersection of Methamphetamine and Fentanyl: Trends in Use Patterns, Morbidity and Mortality in the US Stimulant/Opioid Syndemic

This panel presents three analyses of trends in polysubstance use, changes in morbidity, and the relationship between drug supply and mortality.
The first analyses follows Trends and Topics in Discussions of Stimulants in Reddit Opioid Forums. Methods included natural Language Information Extraction of discussions, temporal trends, and qualitative thematic analysis. Discussions about fentanyl and methamphetamine increased from 2016 to 2020, while discussions about cocaine started decreasing after 2018. Key themes included polysubstance use (e.g., “speedballs” and “goofballs”), concern about purported stimulants containing fentanyl and potentially protective effects of methamphetamine against fatal overdoses involving fentanyl.

The second analyses focused on National Trends in Stimulant-Related Hospitalization. Methods included numbers and rates for stimulant-related hospitalization (NIS, 2016-2018) were calculated using ICD-10 diagnoses and the NIS complex study design to create national estimates and changes over time. In 2016, there were 28,389 stimulant-related admissions increasing to 36,099 in 2018 (21% increase). Rates were highest among 18–44-year-olds and males. The presentation will detail the co-morbid health conditions associated with stimulant-related admissions.

The final analyses focuses on if the Rapid Rise of Methamphetamine in Ohio a Response to an Increasingly Dangerous Illicit Drug Risk Environment. Multivariate regression analysis of the relationship between current overdose mortality rates and illicit drug prevalence, utilizing Ohio BCI’s crime lab data (2010-2020). Contemporaneous overdose mortality is negatively related to contemporaneous methamphetamine prevalence. The prevalence of fentanyl and carfentanil predict statistically significant higher methamphetamine prevalence 9 to 12 months later, indicating that methamphetamine prevalence may be partially explained as a response to a more dangerous illicit drug risk environment.