ArticleSubstance abuse treatment, prevention, and policy2021
'Resurgent', 'twin' or 'silent' epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America.
Article in Substance abuse treatment, prevention, and policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 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
- Methamphetamine use and illicit opioid use during buprenorphine treatment.Journal of substance use and addiction treatment · 2023Trial
- Concurrent chronic methamphetamine exposure may influence behavioral outcomes following repetitive mild traumatic brain injury.Psychopharmacology · 2026Article
- The effects of acute and repeated M1 agonist VU0364572 administration on cocaine-vs-food choice in male and female Sprague-Dawley rats.Drug and alcohol dependence · 2026Article
- Effects of nonpharmacological manipulations and repeated xanomeline treatment on methamphetamine-vs-food choice in Sprague Dawley and Long Evans rats.Drug and alcohol dependence · 2026Article
- The role of polysubstance use in the development, maintenance, and treatment of stimulant use disorders.Pharmacological reviews · 2026Review
- Xanomeline treatment attenuates cocaine self-administration in rats and nonhuman primates.Neuropharmacology · 2025Article
- Substances and substance combinations among accidental substance-related acute toxicity deaths (AATDs) in Canada from 2016 to 2017.BMC public health · 2025Article
- Evaluation of the Characteristics Associated With Methamphetamine Use in Patients With Heroin Use Disorder.Alpha psychiatry · 2025Article
- The impact of sex, species, environmental context, and alternative reinforcers in animal models of cocaine use disorders.Pharmacology, biochemistry, and behavior · 2025Review
- Cocaine self-administration in adult female and male rhesus monkeys: longitudinal comparison with adolescent behavior and role of early life stress.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Article
- Mechanistic and translational insights from preclinical cocaine choice procedures on the economic substitutability of cocaine and nondrug reinforcers.Neuroscience and biobehavioral reviews · 2025Review
- Minority stress and stimulant use among US adult sexual minority men: A systematic review.Drug and alcohol dependence reports · 2025Review
- A longitudinal observational study with ecological momentary assessment and deep learning to predict non-prescribed opioid use, treatment retention, and medication nonadherence among persons receiving medication treatment for opioid use disorder.Journal of substance use and addiction treatment · 2025Observational
- Quantifying the size and characteristics of a population of people who use drugs on the reservation lands of a tribal nation in the southern plains (USA).Harm reduction journal · 2025Article
- Co-involvement of stimulants with opioids in North America: A 'silent epidemic'.PLOS mental health · 2025Article
- The rising burden of drug use disorders in the Americas, 2000-2021.Revista panamericana de salud publica = Pan American journal of public health · 2025Article
- Cross sectional analysis of an addiction consultation service, substance co-use patterns, and receipt of medications for opioid use disorder during hospitalization.Journal of substance use and addiction treatment · 2024Article
- Chronic disease diagnoses and health service use among people who died of illicit drug toxicity in British Columbia, Canada.BMC medicine · 2024Article
- Cognitive performance as a behavioral phenotype associated with cocaine self-administration in female and male socially housed monkeys.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
In the early 2000s, increasing prevalence of psycho-stimulant (e.g., crack/cocaine, methamphetamine) use and related harms, including severe adverse health outcomes, was observed among - mostly marginalized - populations of persons using illicit drugs in North America, underscoring an urgent need for interventions options towards improved prevention and treatment. By about 2010, however, the 'opioid crisis', featuring unprecedented use and public health burden, had accelerated into full force in North America, largely muting attention to the psycho-stimulant issue until recently. Recent surveillance data on drug use and related mortality/morbidity from the present decade has documented a marked resurgence of psycho-stimulant use and harms especially in at-risk populations, commonly in direct combination with opioids, across North America, resulting in a 'twin epidemic' comprised of opioids and psycho-stimulants We briefly review select epidemiological data indicators for these developments from the United States and Canada; in the latter jurisdiction, related evidence has been less prevalent and systematic but corroborating the same trends. Evidently, the (widely ongoing) focus on the 'opioid epidemic' as a 'mono-type' drug problem has become an anachronism that requires urgent and appropriate correction. We then briefly consider existing, evidence-based options for - prevention and treatment - interventions targeting psycho-stimulant use and harms, which are substantially more limited and/or less efficacious than those available for problematic opioid use, while presenting major gaps and challenges. The observed resurgence of psycho-stimulants may, indirectly, relate to recent efforts towards curtailing (medical) opioid availability, thereby accelerating demand and supply for both illicit opioids and psycho-stimulants. The presently unfolding 'twin epidemic' of opioids and psycho-stimulants, combined with limited intervention resources, presents an acute challenge for public health and may crucially undermine actively extensive efforts to reduce opioid-related health harms in North America.
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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.