Deaths from stimulant use rose sharply in the past decade
Mortality from stimulants, including cocaine and methamphetamine, rose faster than deaths from opioids from 2010 to 2017, according to data from the National Center for Health Statistics.
A study showed an increase in mortality involving stimulants, many of which saw a doubling in the mortality rate every four years.
Researchers used the Drug Involved Mortality database from the National Center for Health Statistics, which tallied drug-related terms mentioned on every U.S. death certificate from 2010 to 2017, to review demographics, multisubstance deaths, and mortality rates for all stimulants, including illicit stimulants such as cocaine and medical stimulants such as methylphenidate. Deaths from multiple drugs were counted in each of the groups. Results of the study were published as a research letter by JAMA Internal Medicine on Feb. 1.
Of the 1,220,143 deaths due to drugs, 130,560 (10.7% of all decedents) involved stimulants. Among stimulant-involved deaths, 93,689 decedents (71.8%) were men, the median age was 45 years, and 98,635 (75.5%) were White. Of the stimulant deaths, 120,803 certificates (92.5%) listed only illicit stimulants, 5,544 (4.2%) listed only medical stimulants, and 3,524 listed both types (2.7%).
Among illicit stimulants, 77,013 deaths (61.9%) involved cocaine, 49,602 (39.9%) involved methamphetamine, and 817 (0.7%) involved 3,4 methylenedioxymethamphetamine. Among medical stimulants, 8,240 deaths (90.9%) involved amphetamine, 295 (0.3%) involved methylphenidate, and 615 (0.7%) involved pseudoephedrine.
The mortality rate involving all stimulants increased from 2.913 deaths per 100,000 population in 2010 to 9.690 in 2017. Annual rate ratios (ARRs) for mortality increased for all medical stimulants (ARR, 1.226; 95% CI, 1.202 to 1.250), amphetamine (ARR, 1.118; 95% CI, 1.082 to 1.155), cocaine (ARR, 1.234; 95% CI, 1.222 to 1.245), and methamphetamine (ARR, 1.278; 95% CI, 1.261 to 1.295).
The study authors noted that the increase in mortality due to stimulants is concerning for several reasons, including that there are no reversal agents for these drugs. “Opioid-involved mortality in 2000 had a similar rate (approximately 3 deaths per 100,000 population) and rose more slowly than our results have shown for stimulant-involved mortality. A notable difference is that stimulant-involved mortality predominantly stems from illicit drugs. These results should be a call to address stimulant-associated use before mortality reaches epidemic levels,” they wrote.