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A “silent epidemic” of stimulant use is shadowing the most recent opioid epidemic

Recent waves of drug-related deaths involve opioids and stimulants—but public awareness is limited.

2025-07-16
(Press-News.org)  Many people might be aware of an ongoing opioid epidemic, with thousands of people dying every year from overdoses. But many who are misusing opioids are also using—and dying from—stimulant drugs as well, according to a study published July 2 in the open access journal PLOS Mental Health by Yutong Li from the University of Alberta, Canada, and colleagues.

 In 2021, more than 88,000 people passed away from opiate-related deaths in the United States and Canada—the latest in three major waves of opiate deaths. But many opioid users also use stimulants—82 percent have been exposed to stimulants and 22 percent are regular amphetamine users. To better understand how opioid and stimulant deaths might be connected, the authors of this study examined data from the United States National Institute on Drug Abuse for both intentional and unintentional deaths in the United States between 1999 and 2021, as well as the Public Health Agency of Canada and the Alberta Substance Use Surveillance System between 2016 and 2021. They also looked at Google Trends in the same time span, to gain some insight into how aware the public may be of deaths involving both opioid- and stimulant use. 

The authors found four distinct surges in opioid-related deaths, with the biggest increase in deaths between 2019 and 2021, and three surges in stimulant-related deaths between 1999 and 2021, with the biggest increase between 2013 and 2021. There were two major jumps in the number of deaths involving both opioids and stimulants, with the largest between 2013 and 2021. But while Google Trends for opiates showed peaks during increases in opioid-related deaths, searches for stimulants remained low, indicating a lack of public awareness. While the authors did not have access to data, which included the use of other substances such as alcohol, and most of the data was centered in the United States, their findings nonetheless indicate that the surge in stimulant-related deaths along with opiate-related deaths is occurring in the shadows, with a lack of public awareness potentially impeding interventions.

 

In your coverage please use this URL to provide access to the freely available article in PLOS Mental Health: https://plos.io/468jZp7

Citation: Li Y, Pierce DV, Vik S, Dong K, Patten S, Zhang Y, et al. (2025) Co-involvement of stimulants with opioids in North America: A 'silent epidemic'. PLOS Ment Health 2(7): e0000319. https://doi.org/10.1371/journal.pmen.0000319

Author Countries: Canada

Funding: This work was supported by the Canadian Institutes of Health Research (grant awarded to Yutong Li) and by Alberta Innovates (grants awarded to Yutong Li and Bo Cao). Additional funding was provided to Bo Cao by the Canada Research Chairs program, the Institute for Advancements in Mental Health, Mental Health Foundation, Mental Health Research Canada, the MITACS Accelerate program, the Simon & Martina Sochatsky Fund for Mental Health, the Howard Berger Memorial Schizophrenia Research Fund, the Abraham & Freda Berger Memorial Endowment Fund, the Alberta Synergies in Alzheimer's and Related Disorders (SynAD) program, the University Hospital Foundation, and the University of Alberta.

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[Press-News.org] A “silent epidemic” of stimulant use is shadowing the most recent opioid epidemic
Recent waves of drug-related deaths involve opioids and stimulants—but public awareness is limited.