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'Silent Epidemic' of Stimulant Use Accompanies Latest Wave of Opioid Epidemic, Study Finds
Last reviewed: 27.07.2025
Many people may be aware of the ongoing opioid epidemic, which results in thousands of overdose deaths each year. But according to a study published in the journal PLOS Mental Health by Yutong Li of the University of Alberta in Canada and colleagues, many who abuse opioids also use — and die from — stimulants.
In 2021, more than 88,000 people died from opioid-related deaths in the U.S. and Canada, the latest in three major waves of opioid deaths. However, many opioid users also use stimulants: 82% have been exposed to stimulants, and 22% are regular amphetamine users.
To better understand how opioid and stimulant deaths are linked, the authors of this study analyzed data from the US National Institute on Drug Abuse on intentional and unintentional deaths in the US from 1999 to 2021, as well as data from the Public Health Agency of Canada and the Alberta Substance Use Surveillance System from 2016 to 2021.
They also analyzed Google Trends data over the same period to understand how aware the public is of deaths related to the combined use of opioids and stimulants.
The authors found four distinct waves of opioid-related deaths, with the largest increases in deaths between 2019 and 2021, and three waves of stimulant-related deaths between 1999 and 2021, with the largest increases between 2013 and 2021.
There have been two major spikes in both opioid- and stimulant-related deaths, the largest between 2013 and 2021. However, while Google Trends for opioids showed peaks during periods of increased opioid-related deaths, stimulant searches remained low, suggesting low public awareness.
While the authors did not have access to data that included the use of other substances such as alcohol, and most of the data focused on the United States, their findings nonetheless suggest that the rise in stimulant-related deaths alongside opioid deaths is happening in the shadows, and that a lack of public awareness may be hindering effective interventions.