ReviewCurrent opinion in psychiatry2021
The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis.
Review in Current opinion in psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 540 papers, 3 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
540 citing papers in PubMed, 3 syntheses or guidelines pooled it, 901 citations in OpenAlex.
- Pharmacogenetic Evidence in Opioid-Related Toxicity and Death with an Appraisal of Emerging Multi-Omics Studies: A Systematic Review.International journal of molecular sciences · 2026Pooled it
- Precipitants and clinical features of serotonin syndrome: a systematic review with patient-level analysis of published case reports and series.European journal of clinical pharmacology · 2026Pooled it
- Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.Journal of psychopharmacology (Oxford, England) · 2026Guideline
- 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
- Investigating craving as an indicator of early response to buprenorphine treatment among adults with opioid use disorder.Journal of consulting and clinical psychology · 2026Trial
- Local level of social inequity moderates implementation of evidence-based practices tailored to minoritized populations to reduce opioid overdose deaths.Journal of substance use and addiction treatment · 2026Trial
- Reversal of Fentanyl-Induced Respiratory Depression in Healthy Subjects by Intramuscular Nalmefene Administered by Auto-Injector Versus Intranasal Naloxone.Journal of clinical pharmacology · 2025Trial
- Implementation of contingency management with women engaging in polysubstance use.Addiction science & clinical practice · 2025Trial
- Comparative Effectiveness of Buprenorphine/Naloxone and Methadone on Methamphetamine/Amphetamine Use Among People with Opioid Use Disorder in Canada.Substance use & addiction journal · 2025Trial
- US drug overdose deaths involving stimulants without opioids continued to rise in 2024.Addictive behaviors reports · 2026Article
- Would we, could we? Measuring attitudinal and capacity barriers to supporting recovery housing residents on medication for opioid use disorder.Journal of substance use and addiction treatment · 2026Article
- Multilevel drivers and constraints of shifts from injecting to smoking opioids and stimulants: A qualitative study from the San Diego-Tijuana border region.Drug and alcohol dependence · 2026Article
- The neuroimmune-glutamate hypothesis of addiction.Neuroscience and biobehavioral reviews · 2026Review
- An evaluation of N-acetylcysteine in a sequential oxycodone and cocaine rat self-administration model.Experimental and clinical psychopharmacology · 2026Article
- Genetic variation in BDNF is associated with opioid use disorder severity.Human genetics · 2026Article
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- A Series of Aryl-Substituted-(biphenyl)methyl-sulfinylmethylthiazoles as Novel and Atypical Dopamine Transporter Inhibitors.Journal of medicinal chemistry · 2026Article
- Multiyear Wastewater Monitoring of High-Risk Substances Surrounding an Annual Electronic Dance Music Festival, Las Vegas, Nevada, USA, 2023-2025: Surveillance Study.JMIR public health and surveillance · 2026Article
- Comparative Study of Analgesic Therapeutic Index and Addiction Potential of o- and p-Fluorofentanyl.Journal of applied toxicology : JAT · 2026Article
- Investigation of eosin Y as a colorimetric sensor for the detection of fentanyl hydrochloride and fentanyl freebase.Journal of forensic sciences · 2026Article
480 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
1 author at 1 institution in 1 country.
Funding
Abstract
purpose of reviewThis review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment. RECENT
findingsOverdose due to illicit synthetic opioids (e.g. fentanyl and fentanyl analogs) continues to rise in the US both preceding and during the COVID-19 pandemic. Fentanyl-related overdose is rising in new geographic areas e.g. the western USA. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose. Other medical consequences of injection drug use are rising including HIV and hepatitis C infections. Medication approaches to treating opioid use disorder remain the standard of care and there are new promising pharmacological approaches to treating methamphetamine use disorder. SUMMARY: A 'fourth wave' of high mortality involving methamphetamine and cocaine use has been gathering force in the USA. Availability and use of illicit fentanyls are still the major drivers of overdose deaths and the current rise in stimulant-related deaths appears entwined with the ongoing opioid epidemic.
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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.