• Tonazzina H Sauda, R Andrew Yockey, Sofia B Marin, and Rachel A Hoopsick.
• Department of Health and Kinesiology, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
• Am J Prev Med. 2024 Oct 25.

IntroductionPre-pandemic data suggests that methamphetamine-related mortality and opioid co-involvement have been increasing in the United States (US). However, there was a staggering number of US drug overdose deaths in 2020 and 2021, particularly among males. An updated examination of sex-specific trends in methamphetamine-related mortality, the extent to which these deaths may be driven by the heroin and fentanyl co-involvement, and whether this co-involvement might explain the disproportionate number of male methamphetamine deaths is warranted.MethodsWe leveraged final and provisional data from the CDC WONDER multiple causes of death database to examine deaths involving methamphetamine (i.e., psychostimulants with abuse potential, ICD-10 code T43.6) and methamphetamine-related deaths that co-involved heroin and/or synthetic opioids excluding methadone (ICD-10 code T40.4; e.g., fentanyl) among US residents aged 15 - 74 years. We plotted age-adjusted methamphetamine mortality rates by sex and year and quantified the proportion of deaths with heroin/synthetic opioid co-involvement. Finally, we used joinpoint regression models to quantify sex-specific trends in methamphetamine mortality and the proportion of deaths with heroin and/or synthetic opioid co-involvement.ResultsFrom 1999 to 2021, the methamphetamine-related mortality rate increased 58.8-fold among males (0.33 per 100,000 to 19.74 per 100,000) and 65.3-fold among females (0.12 per 100,000 to 7.96 per 100,000), with the greatest increases occurring between 2019 and 2021. The proportion of these deaths that co-involved heroin and/or synthetic opioids increased among both males (13.1% to 61.5%) and females (7.7% to 63.1%) from 1999 to 2021.ConclusionsIncreasing methamphetamine-related mortality among males and females has been accompanied by a dramatic increase in the proportion of heroin and/or synthetic opioid co-involvement among both sexes. Robust harm reduction efforts are needed to mitigate these increases, particularly for people who co-use stimulants and opioids.Copyright © 2024. Published by Elsevier Inc.

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