SynthesisEpidemiologic reviews2020
The Evolving Overdose Epidemic: Synthetic Opioids and Rising Stimulant-Related Harms.
Synthesis in Epidemiologic reviews, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
106 citing papers in PubMed, 2 syntheses or guidelines pooled it, 179 citations in OpenAlex.
- The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data.Substance abuse treatment, prevention, and policy · 2021Pooled it
- Supervised Injection Facilities as Harm Reduction: A Systematic Review.American journal of preventive medicine · 2021Pooled it
- Stimulant use and increased severity of opioid use disorder and mental illness in patients with co-occurring disorders.Journal of substance use and addiction treatment · 2026Trial
- Trial
- Healthcare provider approaches to managing the health harms of xylazine: A qualitative study.Journal of substance use and addiction treatment · 2026Article
- Patterns of polysubstance use among people who use drugs on an American Indian reservation of a southern plains Tribal Nation.Harm reduction journal · 2026Article
- Drug Use After Emergency Department-Initiated Injectable Buprenorphine: A Secondary Analysis of the ED-INNOVATION Ancillary Safety and Feasibility Trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Changing trends in drug overdose mortality in Spain, 2001-2022.Addiction (Abingdon, England) · 2026Observational
- Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats.Drug and alcohol dependence · 2026Article
- Beyond REMS & PDMPs: A Proposed Framework for Next-Generation Opioid Regulation.Therapeutic innovation & regulatory science · 2026Review
- Editorial: Treatment and management of stimulant use disorder and co-occurring disorders.Frontiers in psychiatry · 2026Article
- Atypical contributions of reward decisions to momentary mood in individuals with methamphetamine use disorder.BMC psychiatry · 2025Article
- Use of Illegally Manufactured Fentanyl in the United States: Current Trends.Current addiction reports · 2025Article
- Enhancing Naloxone Distribution for Opioid Users in the USA: A Cost-Utility Analysis of Academic Detailing to Clinicians.Applied health economics and health policy · 2025Article
- Patterns of Drugs Involved in Fatal Overdose and Demographic Correlates: A Latent Class Analysis of Polysubstance-Involved Deaths in the Urban Midwest.Substance use & addiction journal · 2025Article
- Gender differences in opioid and stimulant poisoning in the central region of iran: a cross-sectional study.Scientific reports · 2025Article
- "All it's gonna tell you is if it has fentanyl or not:" Perceptions of fentanyl and drug checking among first responders and people who use drugs.Journal of substance use and addiction treatment · 2025Article
- Trends in Nonfatal Fentanyl Exposures Involving Stimulants in the United States, 2015-2023.American journal of preventive medicine · 2025Article
- Retrospective Urine Metabolomics of Clinical Toxicology Samples Reveals Features Associated with Cocaine Exposure.Metabolites · 2025Article
- Responding to an evolving crisis: Meeting the needs of a growing population who smoke their unregulated substances.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
46 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
The opioid overdose epidemic is typically described as having occurred in 3 waves, with morbidity and mortality accruing over time principally from prescription opioids (1999-2010), heroin (2011-2013), and illicit fentanyl and other synthetic opioids (2014-present). However, the increasing presence of synthetic opioids mixed into the illicit drug supply, including with stimulants such as cocaine and methamphetamine, as well as rising stimulant-related deaths, reflects the rapidly evolving nature of the overdose epidemic, posing urgent and novel public health challenges. We synthesize the evidence underlying these trends, consider key questions such as where and how concomitant exposure to fentanyl and stimulants is occurring, and identify actions for key stakeholders regarding how these emerging threats, and continued evolution of the overdose epidemic, can best be addressed.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.