"In the Seattle area, the increase in methamphetamine use has paralleled an increase in methamphetamine-involved deaths, many of which also involved opioids.35 Although we did not find that people who primarily use goofball were more likely than others to experience an opioid overdose or stimulant overdose/overamp, several behaviors associated with overdose were higher in this group including more frequent injection and injecting alone. Moreover, people who primarily use goofball were the most likely to witness opioid and stimulant overdoses, highlighting the critical importance of engaging this group in overdose prevention services. Fortunately, naloxone possession was also highest in this group, suggesting that these efforts have been successful."
Glick SN, Klein KS, Tinsley J, Golden MR. Increasing Heroin-Methamphetamine (Goofball) Use and Related Morbidity Among Seattle Area People Who Inject Drugs. Am J Addict. 2021;30(2):183-191. doi:10.1111/ajad.13115