ArticleDrug and alcohol dependence2023
Prevalence of fentanyl in methamphetamine and cocaine samples collected by community-based drug checking services.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers.
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Who cites it
66 citing papers in PubMed, 96 citations in OpenAlex.
- Community-Based Cluster-Randomized Trial to Reduce Opioid Overdose Deaths.The New England journal of medicine · 2024Trial
- Interpol review of forensic drug chemistry, 2022-2025.Forensic science international. Synergy · 2026Review
- An evaluation of N-acetylcysteine in a sequential oxycodone and cocaine rat self-administration model.Experimental and clinical psychopharmacology · 2026Article
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Evaluation of illicit drug contaminants in seized cannabis in Arizona and California, 2023-2024.Journal of forensic sciences · 2026Article
- Polysubstance use disorders among US adults.Molecular psychiatry · 2026Article
- Cocaine-Induced Ocular Toxicity.Diseases (Basel, Switzerland) · 2026Review
- Medications for opioid use disorder, recovery supports, and overdose risk -- a database linkage study of a rural cohort of people who inject drugs and use opioids.BMC public health · 2026Article
- Trauma Profiles and Cocaine Use Among Formerly Incarcerated Black Men Who Co-Use Opioids and Stimulants.The Journal of black psychology · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Xylazine in Ohio: Insights from individuals with criminal legal system involvement and a history of illicit stimulant use.Drug and alcohol dependence reports · 2026Article
- Length of Stay of Emergency Department Patients with Stimulant Intoxication Receiving Intravenous Fluid.The western journal of emergency medicine · 2026Article
- Crack/cocaine use to manage xylazine exposure in fentanyl in Connecticut: findings from a convergent mixed methods study.Harm reduction journal · 2026Article
- The changing contribution of fentanyl use to non-fatal overdose among a cohort of people who inject drugs in San Diego, California: A longitudinal assessment.Drug and alcohol dependence · 2026Article
- Probability of fentanyl adulteration in cocaine selectively decreases cocaine demand.Experimental and clinical psychopharmacology · 2026Article
- Risk reduction behaviours following the detection of unexpected drugs through community drug checking: a cross-sectional study.Harm reduction journal · 2026Article
- Characterizing patterns of opioid and stimulant use by route and associations with non-fatal overdose and xylazine use in people who have injected drugs from Baltimore, MD, 2023-2024.Drug and alcohol dependence reports · 2026Article
- Mechanisms of overdose from unintentional fentanyl use when intending to use stimulants: a qualitative study of people who use stimulants and avoid opioids.Research square · 2026Article
- Assessing working musicians' perspectives of need and barriers regarding lay harm reduction efforts for substance-related harm in South Carolina.Harm reduction journal · 2026Article
- What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles.The International journal on drug policy · 2026Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundOverdose deaths involving stimulants and opioids simultaneously have raised the specter of widespread contamination of the stimulant supply with fentanyl.
methodsWe quantified prevalence of fentanyl in street methamphetamine and cocaine, stratified by crystalline texture, analyzing samples sent voluntarily to a public mail-in drug checking service (May 2021-June 2023). Samples from 77 harm reduction programs and clinics originated in 25 US states. Sample donors reported expected drug and physical descriptions. Substances were identified by gas chromatography-mass spectrometry. Negative binomial models were used to calculate fentanyl prevalence, adjusting for potential confounders related to sample selection. We also examined if xylazine changed donors' accuracy of detecting fentanyl.
resultsWe analyzed 718 lab-confirmed samples of methamphetamine (64%) and cocaine (36%). The adjusted prevalence of fentanyl was 12.5% (95% CI: 2.2%, 22.9%) in powder methamphetamine and 14.8% (2.3%, 27.2%) in powder cocaine, with notable geographic variation. Crystalline forms of both methamphetamine (Chisq=57, p<0.001) and cocaine (Chisq=18, p<0.001) were less likely to contain fentanyl: less than 1% of crystal methamphetamine (2/276) and no crack cocaine (0/53). Heroin was present in 6.6% of powder cocaine samples. Xylazine reduced donors' ability to detect fentanyl, with correct classification dropping from 92% to 42%.
conclusionsFentanyl was detected primarily in powder forms of methamphetamine and cocaine. Recommended interventions include expanding community-based drug checking, naloxone and fentanyl test strip distribution for people who use stimulants , and supervised drug consumption sites. New strategies to dampen variability in street drug composition are needed to reduce inadvertent fentanyl exposure.
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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.