Fentanyl and other opioid involvement in methamphetamine-related deaths

ABSTRACT

Background: Methamphetamine-related deaths have been rising along with those involving synthetic opioids, mostly fentanyl and fentanyl analogs (FAs). However, the extent to which methamphetamine involvement in deaths differs from those changes occurring in synthetic opioid involvement is unknown.

Objectives: To determine the patterns and temporal changes in methamphetamine-related deaths with and without other drug involvement.

Methods: Data from all methamphetamine-related deaths in West Virginia from 2013 to 2018 were analyzed. Quasi-Poisson regression analyses over time were conducted to compare the rates of change in death counts among methamphetamine and fentanyl//FA subgroups.

Results: A total of 815 methamphetamine-related deaths were analyzed; 572 (70.2%) were male and 527 (64.7%) involved an opioid. The proportion of methamphetamine only deaths stayed relatively flat over time although the actual numbers of deaths increased. Combined fentanyl/FAs and methamphetamine were involved in 337 deaths (41.3%) and constituted the largest increase from 2013 to 2018. The modeling of monthly death counts in 2017–2018 found that the average number of deaths involving fentanyl without methamphetamine significantly declined (rate of change −0.025, p < .001), while concomitant fentanyl with methamphetamine and methamphetamine only death counts increased significantly (rate of change 0.056 and 0.057, respectively, p < .001).

Conclusions: Fentanyl and FAs played an increasingly significant role in methamphetamine-related deaths. The accelerating number of deaths involving fentanyl/FAs and methamphetamine indicates the importance of stimulants and opioids in unintentional deaths. Comprehensive surveillance efforts should continue to track substance use patterns to ensure that appropriate prevention programs are undertaken.

KEYWORDS:

• Methamphetamine
• fentanyl
• opioid
• death

Disclosure statement

No conflict declared.

Contributors

ZD, MA and GS formulated the research question, designed the study, and drafted the initial manuscript. ZD, CG, and MA revised the manuscript according to reviewers’ comments. ZD conducted the main statistical analyses, and CG provided statistical expertise on regression. MA, ZD, and CG designed the tables and ZD incorporated suggestions from all co-authors. MA, GS, TR, JK and AK contributed to the conception of the analyses, interpretation of the results and manuscript writing. All authors had full access to all of the data and approved the final manuscript.

Data availability statements

The data that support the findings of this study are available from the corresponding authors, [ZD& MA], upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported in part by the following awards: National Institute of General Medical Sciences [2U54GM104942-02.; National Institute of Drug Abuse [1R21DA040187 and 1UG3DA044825].