MMWR

Stimulant overdose deaths surge, driven by opioid co-use

September 3, 2025

Between January 2018 and June 2024, stimulant-involved overdose deaths rose sharply in the U.S., with 59% of all overdose deaths involving stimulants. Most (73%) also involved opioids, especially fentanyl. Methamphetamine and cocaine were the primary stimulants implicated. Deaths involving stimulants without opioids were more common among older adults (≥45 years) and those with CV disease.

From 2018 to 2023, stimulant-related death rates nearly doubled: cocaine deaths rose from 4.5 to 8.6 per 100,000 and psychostimulants (mainly methamphetamine) from 3.9 to 10.4. The steepest increases occurred among non-Hispanic American Indian/Alaska Native (methamphetamine: 11.0 to 32.9) and non-Hispanic Black individuals (cocaine: 9.1 to 24.3).

These trends underscore the need to expand access to evidence-based treatments for stimulant use disorder, evaluate medication-based therapies, and engage populations not reached by opioid-focused interventions. Clinicians should be alert to cardiovascular comorbidities and consider tailored approaches for older adults and racially impacted communities.

Source:

Tanz LJ, et al. (2025, August 28). MMWR Morb Mortal Wkly Rep. Drug Overdose Deaths Involving Stimulants - United States, January 2018-June 2024. https://pubmed.ncbi.nlm.nih.gov/40875496/