Millennium Health Signals Report™ Volume 7: Shifting Tides

Data from the Centers for Disease Control and Prevention (CDC) suggest that the seemingly ever-rising tide of fentanyl-fueled overdose deaths may finally be receding after more than a decade. However, these data increasingly point to the co-involvement of stimulants like methamphetamine and cocaine in fentanyl-related deaths, which has been referred to as the “fourth wave” of overdose epidemic. Urine drug testing data have shown corresponding increases in the co-detection of stimulants in specimens that were positive for fentanyl over time and demonstrate that most people who use fentanyl engage in polysubstance use involving a wide range of potentially dangerous drugs. The 7th volume of our Signals Report analyzed more than 1.4 million fentanyl-positive urine drug test results from patients across the U.S. with a substance use disorder diagnosis to evaluate shifts in drug use trends over time. The findings highlight encouraging changes in overdose mortality trends and fentanyl use, capture recent shifts in stimulant, heroin, and prescription opioid use among people who use fentanyl, and generally illustrate the continued evolution of polysubstance use in this group.

Key Takeaway 1: Fatal Drug Overdoses in the U.S. are Falling but Fentanyl-Associated Polysubstance Use Continues to Evolve as the “Fourth Wave” of the Overdose Crisis Rolls On

Key Takeaway 2: Fentanyl-Stimulant Co-Detection Grew in Every Region of the Country Accompanied by a Rising Tide of Heroin Co-Use

Key Takeaway 3: Cocaine and Methamphetamine were Detected in the Population Using Fentanyl More Often than Heroin and Prescription Opioids in Nearly Every State in 2024

Key Takeaway 4: Additional Drugs Were Detected in ~93% of Urine Specimens from the Population that Used Fentanyl in 2024, with Some Regional Variability

Analyses of clinical urine drug testing data offer a rapidly updating and scalable method for monitoring current drug and polysubstance use trends that permit near real-time identification of rapid shifts in drug use that may pose new challenges. It is essential that clinicians, public health officials, and policymakers maintain awareness of current drug use trends to ensure that they are prepared to strategically and meaningfully respond to the next evolutionary stage of the drug use and overdose epidemic.

First Name *

Last Name *

I am a... *

Industry

Company *

Title *

Email *

Phone *

Zip Code *

Comments

By clicking the button above, you are agreeing to receive email communications from Millennium Health and we’ll send you product updates, company news, and marketing content. By doing so, you also agree to our Terms of Service and Privacy Policy.