Evidence map›Paper›PMID 40557272›Full record

ArticleSSM. Qualitative research in health2025

Self-reported pathways through which illicitly manufactured fentanyl enters the stimulant supply: Novel insights from people incarcerated for drug manufacturing and distribution.

Patrick J A Kelly, Stephanie A Vento, Traci C Green, Josiah D Rich, Madeline Noh, Joseph Silcox, Jaclyn M W Hughto

Abstract read
In one paragraph

Article in SSM. Qualitative research in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Patrick J A KellyDepartment of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.ORCID 0000-0003-1462-1150
Stephanie A VentoCenter for Health Promotion and Health Equity, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.ORCID 0009-0001-9876-5620
Traci C GreenCenter of Biomedical Research Excellence on Opioids and Overdose, Rhode Island Hospital, 1125 North Main Street, Providence, RI, 02903, USA.
Josiah D RichCenter of Biomedical Research Excellence on Opioids and Overdose, Rhode Island Hospital, 1125 North Main Street, Providence, RI, 02903, USA.
Madeline NohDepartment of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.ORCID 0000-0001-5134-8021
Joseph SilcoxBrandeis University Opioid Policy Research Collaborative, 415 South Street, Waltham, MA, USA.
Jaclyn M W HughtoDepartment of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.ORCID 0000-0003-4722-8179

Funding

Project 4: Neonatal Abstinence Syndrome (NAS): Fetus to First YearsP20GM125507 · NIGMS · RHODE ISLAND HOSPITAL · PI JOSIAH D RICH · 2018 to 2026
$23.4M
Community and big-data system approaches to identifying and understanding the health impact of xylazineF31DA061593 · NIDA · BROWN UNIVERSITY · PI Patrick John Kelly · 2024 to 2026
$149k
NCIPC CDC HHS R01 CE003353NIDA NIH HHS F31 DA061593NIGMS NIH HHS P20 GM125507
6 · The paper itself

Abstract

Background: The unintentional consumption of stimulants containing fentanyl among people who intend to only use stimulants contributes to overdose mortality in North America. Research exploring how fentanyl appears in the stimulant supply among people who manufacture and/or distribute drugs (PWDD) is critical to understanding supply-side factors that shape stimulant and opioid-involved overdose risk. Methods: From April to July 2023, thirty PWDD incarcerated at the Rhode Island Department of Corrections completed an in-depth interview about stimulant and opioid-involved overdose. Data were thematically analyzed to explore speculated pathways through which fentanyl may appear in stimulants. Results: Participants primarily endorsed unintentional fentanyl contamination pathways, including the accidental mix-up of drugs that look alike and cross-contamination via surfaces containing residual fentanyl where stimulant product is packaged. Congruent with historically contested beliefs about drug cutting and adulteration to induce dependence, some participants speculated that fentanyl may be intentionally added to stimulants to induce fentanyl dependence among people intending to only use stimulants to increase profits, though no participant reported firsthand knowledge of this. Participants extensively familiar with opioid and stimulant drug markets believed intentional contamination at high-level drug trafficking organizations was unlikely to occur as this would mix the drug markets, harming the profitability of maintaining distinct opioid and stimulant markets. Conclusion: Our findings challenge beliefs about the intentional addition of fentanyl in stimulants, showing them to be unsubstantiated. Instead, participants with advanced knowledge of drug manufacturing and distribution reported that fentanyl primarily appears in the stimulant supply unintentionally underscoring the need for targeted strategies to reduce contamination.

Indexed as

Drug contaminationFentanylIncarcerationStimulants

Identifiers

PMID40557272
PMCPMC12186731

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.