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Stimulant overdose deaths rise in some US states as fentanyl deaths fall
Stimulant-related overdoses are increasing in parts of the United States even as deaths involving fentanyl have fallen, complicating efforts to reduce overdose deaths. Experts say stimulant emergencies can be harder for bystanders to recognise than opioid overdoses, and there is no equivalent to naloxone for treating stimulant-induced heart attacks, strokes or seizures.
Provisional 2025 data show fentanyl-involved deaths fell to pre-pandemic levels nationally, while cocaine deaths rose in 13 states and methamphetamine deaths rose in eight. Symptoms can include chest pain, shortness of breath, seizures and signs of stroke; experts advise calling emergency services, reducing noise and crowds, and using naloxone if the person is unconscious because opioids may also be involved. Heat and dehydration can increase danger, and prolonged stimulant use may lead to psychosis or paranoia.
In short
- Stimulant overdoses are rising in many parts of the US.
- Fentanyl deaths fell, but cocaine and methamphetamine deaths rose in several states.
- Experts advise recognising symptoms and calling emergency services.
Explained simply
Stimulants such as cocaine and methamphetamine speed up activity in the brain and body. In an overdose, they can cause serious problems including heart attacks, strokes and seizures, which may be harder for bystanders to recognise than an opioid overdose.
Fentanyl is a powerful opioid, and naloxone can temporarily reverse its effects. It does not treat the effects of stimulants, though it may still help if opioids are also involved. Stimulant overdoses can therefore require different emergency care.
The different trends matter because efforts to reduce overdose deaths must account for more than one type of drug. Heat and dehydration can add to the risks of stimulant use, and prolonged use may lead to paranoia or psychosis.
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Originally published by The Guardian as “Stimulant overdoses on the rise as opioid deaths decline, but treatment is complex”.