Evidence mapPaperPMID 41238695Full record

ArticleNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2026

Polydrug overdose mortality caused by synthetic opioids and stimulants: current sex- and age-specific trajectories in United States national data for 2018-2024.

Eduardo R Butelman, Yuefeng Huang, Siri Shastry, Alex F Manini, Rita Z Goldstein, Nelly Alia-Klein

Abstract read
In one paragraph

Article in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2026. 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

6 authors.

Eduardo R ButelmanNeuropsychoimaging of Addictions and Related Conditions, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. eduardo.butelman@mssm.edu.ORCID http://orcid.org/0009-0006-9298-7798
Yuefeng HuangNeuropsychoimaging of Addictions and Related Conditions, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Siri ShastryDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Alex F ManiniDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Rita Z GoldsteinNeuropsychoimaging of Addictions and Related Conditions, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID http://orcid.org/0000-0002-1680-229X
Nelly Alia-KleinNeuropsychoimaging of Addictions and Related Conditions, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA) 1R01DA060914U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA) 2R01DA048009U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA) 2R01DA048009-06U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA) 5R01DA049547U.S. Department of Health & Human Services | NIH | National Institute on Drug Abuse (NIDA) 5R01DA049547-02
6 · The paper itself

Abstract

Recent years have shown increases in overdose (OD) mortality caused by polydrug exposure to synthetic opioids such as fentanyl and stimulants such as methamphetamine or cocaine. The goal of this study is to understand the recent trajectory in this polydrug OD mortality, especially as associated with decedents' sex and age. We carried out a cross-sectional analysis of national data for persons aged 15-74, from CDC WONDER for 2018-2024 (data for 2024 are considered provisional at the time of analysis). The outcome measure was OD mortality/100,000 population; annual data for 2018-2024 were analyzed with joinpoint regression, and the most recent years (2023-2024) were analyzed with ANOVA and multiple linear regression. Males had greater polydrug OD mortality caused by synthetic opioids and stimulants compared to females, across 2018-2024. Sex-specific joinpoint regressions detected increases in these polydrug OD after 2018, then decreases from 2023 in males, and from 2022 in females. For these polydrug OD, the mean annual percent change (APC) in 2024 versus 2023 was -36% and -31% in males and females, respectively. For synthetic opioids without stimulants, OD trends in 2024 versus 2023 were similar to those for polydrug OD (-42% and -39% APC in males and females, respectively). However, OD for stimulants without synthetic opioids showed relatively smaller changes (-3% and -2% APC in males and females, respectively). Stratification into 10-year age groups for polydrug OD revealed that mortality peaked at age 35-44 and then declined at older ages. Recent decreases in polydrug OD mortality were observed across age groups, with joinpoints detected in 2022 or 2023. These findings indicate that after increases from 2018 onward, polydrug OD mortality caused by synthetic opioids and stimulants exhibited substantial decreases in both males and females in the most recent data for 2024, across a broad age range. Because relatively smaller changes were observed in OD mortality caused by stimulants without synthetic opioids in this time period, the decreases in polydrug OD mortality are more likely to be caused by changes in exposure, prevention or intervention strategies focused on opioids rather than on stimulants. While this polydrug OD mortality has decreased in 2024, it remains at concerning levels.

Indexed as

Analgesics, OpioidCentral Nervous System StimulantsDrug OverdoseAdolescentAdultAgedAge FactorsCross-Sectional StudiesFemaleHumansMaleMiddle AgedSex FactorsUnited StatesYoung AdultAnalgesics, OpioidCentral Nervous System Stimulants

Identifiers

PMID41238695
PMCPMC13013711

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.