Deaths Involving Stimulants in the US, 2021-2024

"Types of stimulants involved. Among 309,274 overdose deaths during January 2021–June 2024 in 49 states and DC,††† 59.0% involved any stimulant, 31.2% involved methamphetamine, and 30.0% involved cocaine; 3.8% involved both methamphetamine and cocaine (Figure 1). Prescription stimulants (1.6%), synthetic cathinones (0.7%), and 3,4-methylenedioxymethamphetamine (MDMA)/3,4-methylenedioxyamphetamine (MDA) (0.4%) were rarely involved. Most (73.0%) stimulant-involved overdose deaths co-involved opioids, including 79.1% of cocaine-involved and 68.8% of methamphetamine-involved deaths; 14.5% of deaths involved only stimulants.

"Characteristics of stimulant-involved overdose deaths. Overall, 182,502 (59.0%) overdose deaths involved stimulants, 133,293 (43.1%) co-involved stimulants and opioids, and 49,209 (15.9%) involved stimulants and no opioids (Table). Across stimulant and opioid groups, approximately 70% of decedents were male, and 30% were female. A higher percentage of persons who died of overdoses involving stimulants and no opioids was aged ≥45 years (66.5%) than of those who died of overdoses co-involving stimulants and opioids (44.2%).

"Among 46 states and DC§§§ with sufficient circumstance data,¶¶¶ higher percentages of persons who died of overdoses involving stimulants and no opioids had a known history of cardiovascular disease (CVD) compared with those who died of overdoses co-involving stimulants and opioids (38.7% versus 21.2%) and were seen in the emergency department (ED) for the fatal overdose (33.1% versus 18.4%). Lower percentages of persons who died of overdoses involving stimulants and no opioids, compared with those co-involving stimulants and opioids, had evidence of opioid use history (11.6% versus 35.8%) and of ever receiving treatment for mental health or substance use disorders (SUDs) (14.9% versus 23.4%). For deaths specifically involving cocaine or methamphetamine, with or without opioid co-involvement, patterns were comparable to those for deaths involving any stimulant."