AI explains how drug wars are lost

Artificial Intelligence appears at first glance to be an obvious choice for sourcing new strategies to win the war on drugs. AI might have worked in this regard if only drug wars possessed some kind of logical or realistic narrative. Human nature and the arbitrary limits posed by mistaken perceptions about drugs and their use get in the way of predicting exact outcomes.

The U.S. government questioned AI to determine its likelihood for winning drug wars. The feedback has not been encouraging. AI admits the short answer is AI cannot “win” the drug war.

Use of AI can temporarily disrupt drug flows and make public health responses more effective, but the economics of prohibition still rule. Traffickers quickly adapt to AI incursions by using it to protect their own operations. The drug war rapidly becomes a tech arms race between drug smugglers and the governments prosecuting them.

Using a strict prohibitionist model, AI detection, interdiction and predictions of drug smuggling that repress supply networks also intensify the harms of prohibition. There is always a risk to civil liberties since race and class inequalities in drug policing and incarceration still get amplified with action plans. This effect is encountered when a drug like raw opium can become something that benefits people but can also give nations the ability to control supply chains, bend the world, or break foreign leaders to their advantage. This was the case for the first British Opium War occurring between 1839 and 1842 with China. Disputes over the opium trade led to China’s efforts to suppress the business which ultimately resulted in a British military victory over China. The Treaty of Nanking ceded Hong Kong to Britain. It also opened several Chinese ports to foreign trade.

A drug decriminalization or harm reduction model is better aligned with AI for improving drug enforcement results. Decriminalization reduces prohibition harms and improves triage, but the illegal markets and violence persist.

A well-regulated market and health-centered decriminalization model using AI that reduces ODs, disease, and violence is where AI can prove powerful. AI is good at monitoring complex systems, spotting risk, and optimizing health outcomes rather than arrests. No one wins the drug war in this model if their primary aim is to eliminate rather than displace a popular drug from its marketing niche.

The displacement of marijuana through state legalization and federal rescheduling from Schedule I to Schedule III are examples of how a regulated market allows societies to adapt to a drug in ways that eliminate arrests and wars while simultaneously helping to keep drugs out of the hands of children and adolescents. Health concerns are achieved in part by drying up illegal markets while accepting legalized products from sources that can create and provide child protection packaging in addition to selling an uncontaminated, cheaper item; one that replaces, defies, or deters illicit competitors while recognizing any needed marketing or consumer safeguards.

A question remains. If AI doesn’t think it can win a drug war then what possibility do humans have of winning it? Drugs tend to win drug wars, not people. The only things left standing after a major war on the drug market are often a lot of drugs.

Drug victories are also wakeup calls to every opportunistic politician and political appointee who favored strict prohibition as a political cover or as a means of career maintenance and advancement. In the future they might want to follow Bill Clinton’s advice and “make change your friend.” Failing to deconstruct prohibition and its harms means they face serious opposition from future political challengers who are certain to use drug war concerns and AI to defeat them.

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13 Responses to AI explains how drug wars are lost

  1. Pingback: AI explains how drug wars are lost | Drug WarRant – News Conect Inteligencia Digital

  2. Servetus says:

    Psychedelics show promise for treating cocaine use disorder (CUD):

    7-May-2026 — Global cocaine use reached record highs in 2023, with increases during the COVID-19 pandemic and an estimated 25 million people who used cocaine in the past year. Cocaine is more likely to elicit dependence than other substances, and cocaine-related fatal overdoses in the US rose sharply after 2019 before declining in 2024. Whereas pharmacotherapies have been developed for several substance use disorders, medications for stimulant use disorders remain elusive. Although numerous pharmacotherapy candidates have been targeted, only contingency management, a behavioral intervention, is associated with increased abstinence alongside a reduction in mortality.

    Psychedelics have shown efficacy treating numerous mental health conditions. In the 1960s through the early 1970s, lysergic acid diethylamide showed promise in treating substance use disorders. In a recent trial of psilocybin for alcohol use disorder (AUD), the percentage of heavy drinking days was lower in the psilocybin group compared with the placebo group. A subsequent trial of psilocybin for AUD and comorbid depression similarly found greater reductions in drinking with psilocybin compared with a low-dose control. However, another trial randomized those with AUD to psilocybin or placebo following detoxification and found no differences between groups. Brain imaging during drug sessions may have interfered with therapeutic response. Finally, in a study of psilocybin or nicotine patch for smoking cessation, prolonged abstinence rates were 40.5% for the psilocybin group at the 6-month follow-up vs 10% for the nicotine patch group. Despite potential anti-addictive efficacy, no trials have evaluated psychedelics in the treatment of cocaine use disorder (CUD).

    In the current trial, participants received manualized psychotherapy and were randomized to 1 all-day psilocybin session or 1 all-day active placebo session. It was hypothesized that psilocybin would yield a higher percentage of cocaine abstinent days, a greater likelihood of complete abstinence from cocaine, and a greater latency to first cocaine lapse through 180 days after the end of treatment. […]

    The first primary outcome was urinalysis-verified percentage of cocaine abstinent days measured across 6 time periods: in the past 90 days at baseline; during the prescreening period (ie, baseline through the first preparation session); during the preparation period; during the integration period; from the final integration session through day 90; and from day 90 through day 180. The second primary outcome was complete cocaine abstinence, a dichotomous outcome defined as no use of cocaine whatsoever after the all-day drug session through day 180 verified by urinalysis and with participants lost to follow-up coded as nonabstinent. The final primary outcome was time to cocaine lapse, measured as days until first reported cocaine use since the all-day drug session.

    Participants were observed throughout the all-day drug session and specifically queried for any drug-related adverse events (AEs) at the outset of the first integration session. Any new or worsening AEs observed or reported during or after the all-day drug session were deemed related to the intervention based on temporal proximity, participant attribution, and investigators’ judgment; AEs were deemed expected from the intervention based on literature review and investigators’ judgment. […]

    This randomized clinical trial is the first, to our knowledge, to demonstrate that psilocybin coupled with psychotherapy may be safe and efficacious in the treatment of CUD. Psilocybin-treated participants showed significantly greater percentages of cocaine abstinent days, higher rates of complete abstinence from cocaine, and a decreased risk of cocaine lapse over time. These findings are a potentially important advancement in the treatment of CUD, a condition for which there are no approved pharmacotherapies and limited psychosocial interventions.

    The representation of vulnerable populations in psychedelic clinical trials has been a crucial ongoing concern. A recent systematic review found that participants in US-based psychedelic trials typically had higher socioeconomic status than the general population. The present study demonstrates that psilocybin treatment can be feasibly implemented with Black and socioeconomically disadvantaged individuals vulnerable to the adverse impacts of CUD but understudied in psychedelic research. […]

    AAAS Public Science News Release: Psilocybin in the treatment of cocaine use disorder

    JAMA Network: Psilocybin in the Treatment of Cocaine Use Disorder — a Randomized Clinical Trial

  3. Servetus says:

    People over 60 are trying marijuana for the first time:

    8-May-2026 — For adults over 60, cannabis use is increasing faster than in any other demographic.

    But science has yet to keep up with why older adults are using cannabis products, which products they choose, and how they make decisions about which products to use … many older adults start cannabis seeking more effective or non-pharmaceutical options to manage sleep, pain, or mental health, and that many people base their decisions on word of mouth rather than discussions with health care providers. […]

    The researchers interviewed 169 adults over 60 who were about to purchase cannabis for the first time to identify common motivations.

    “Overall, they really wanted better quality of life, reducing their pain, getting better sleep, and being able to enjoy time with family and friends a little bit more,” says Rebecca Delaney, PhD, assistant professor of population health sciences at U of U Health and first author on the study.

    “For the most part, we found that these folks aren’t really interested in getting high. They just want to feel better,” adds Angela Bryan, PhD, professor of psychology and neuroscience at CU Boulder and senior author on the study.

    Many participants had heard positive anecdotes about product usefulness from friends or family members, which tended to influence decisions. “They brought a lot of feedback from other people to inform their opinions,” Delaney says. “Word of mouth has a really big impact.”

    Discussions with medical providers were rarely part of the picture, suggesting that better informational materials for patients and providers could be needed to drive conversations and help people make informed decisions about their health. […]

    Older adults also faced the question of which products to use. Edible cannabis products may contain tetrahydrocannabinol (THC, the main psychoactive component of cannabis), cannabidiol (CBD), or both, and it was unclear what motivated and informed their decisions about which to purchase.

    Many people perceived CBD-only products as therapeutically beneficial, which was often driven by anecdotal claims. People tended to perceive THC as offering benefits like improving mood. But most people chose combination products containing both, seeing them as a “Goldilocks option” that gives the best of both worlds. […]

    AAAS Public Science News Release: Study reveals why older adults are using cannabis edibles

    JAMA Network: Edible Cannabis and Pain, Sleep, and Mental Health Management in Older Adults

    Authors: Rebecca K. Delaney, PhD1; Melissa H. Watt, PhD; Madeline Stanger, BA; Isabelle Hong, BA; Nehal K. Bakshi, BS; Angela Fagerlin, PhD; Angela Bryan, PhD.

  4. Servetus says:

    Smoking drugs in cars is traceable on surfaces and fabrics:

    7-May-2026 — Environmental health experts at Flinders University have found open windows and ventilation can reduce but not completely remove methamphetamine contamination on most hard surfaces of a car after an extended period.

    In a new study, researchers tested various parts of a car’s interior to show concentrations in the air and surfaces exposed to controlled release of methamphetamine smoke. While levels generally dropped over time, the experts warn indirect exposure could still occur, in particular in textile or soft surfaces.

    The latest results, published in the journal Forensic Chemistry, highlight the complexity of managing meth contamination in contained spaces where various fabric types showed differing levels of meth smoke taint – even after eight weeks of ventilation. […]

    Air concentrations ranged from 0.19 to 0.96 micrograms per cubic metre (μg/m3) in the driver area and the rear storage area after three controlled smokes.

    Air testing detected small amounts of methamphetamine in the air. By comparison, tobacco smoke could contain hundreds of thousands of micrograms per cubic metre of airborne particles in indoor environments.

    After the contaminated car’s windows were opened for decontamination purposes, the concentrations in the air and on the surfaces generally decreased after venting for a total of eight weeks after the last smoking event.

    The Flinders University research will help law enforcement agencies, vehicle dealerships, vehicle lenders and owners faced with testing and cleaning contaminated vehicles, in particular stolen or second-hand cars. […]

    AAAS Public Science News Release: Drug contamination traces may linger in cars, even after ventilation — testing on methamphetamine smoke taint under controlled conditions

    Forensic Science: Controlled smoking of methamphetamine in a car and initial remediation by ventilation: Analysing air, surfaces and fabrics

    Authors: Gemma L. Kerry; Kirstin E. Ross; Jackie Wright; G. Stewart Walker.

  5. Servetus says:

    Alcoholism research is funded $2.9 million by the NIH:

    13-May-2026 – …researchers have received a $2.9 million award from the NIH’s National Institute of Alcohol Abuse and Alcoholism to fund their five-year project, “The role of PACAP of the extended amygdala in heavy alcohol drinking. […]

    …alcohol use disorder (AUD) causes substantial harm. AUD affects 29 million individuals and causes more than 140,000 deaths annually in the U.S. alone. […]

    The newly funded project will study a brain signaling system involving pituitary adenylate cyclase-activating polypeptide (PACAP), a molecule that plays an important role in the body’s stress response. The researchers will investigate how PACAP activity in a brain region known as the bed nucleus of the stria terminalis (BNST) may be a driver of excessive alcohol drinking, anxiety-like behaviors and increased sensitivity to pain associated with alcohol addiction.

    “Our goal is to better understand how chronic alcohol exposure changes the brain’s stress circuitry,” said Sabino. “By identifying the molecular and neural mechanisms involved, we hope to uncover new pathways that could then lead to more effective treatments for alcohol use disorder.” […]

    The team will use advanced neuroscience approaches, including pharmacological, molecular, and viral techniques combined with well-established animal models of alcohol dependence and stress-related behaviors. The project also will examine how PACAP interacts with corticotropin-releasing factor (CRF), another key stress-related signaling system in the brain.

    “Stress systems in the brain are increasingly recognized as central drivers of addiction,” said Cottone. “This work will allow us to dissect specific neural circuits that may underlie compulsive drinking and the negative emotional states that accompany addiction.” …the findings could help advance the development of novel medications targeting stress-related neuropeptide systems involved in alcohol addiction and related psychiatric symptoms.

    AAAS Public Science News Release: BU researchers awarded $2.9M to investigate brain mechanisms that drive alcohol use disorder — hope is to identify potential new therapeutic targets for treatment

  6. Servetus says:

    Kratom and its associations with mental health:

    May 13, 2026 — To assess the US lifetime and past-year prevalence of kratom Mitragyna speciosa use and its associations with mental health and DSM-5 substance use disorder … this study examined cross-sectional survey data collected from 169,408 non-institutionalized individuals aged 12 and older in US households between 2021 and 2024. Measures included kratom use, nonmedical use of cannabis, prescription drugs (opioids, sedatives/tranquilizers, stimulants), other drugs, mental health indicators (serious psychological distress, DSM-5 major depression, suicidal ideation), and DSM-5 SUD. […]

    Between 2021 and 2024, lifetime and past-year kratom use were highest among adults aged 21 to 34, 3.40% (95% CI: 3.17–3.65) and 1.01% (95% CI: 0.91–1.13), respectively. Among people who reported prior-to-past-year kratom use, most reported past-year cannabis (65.7%; 95% CI: 60.4–70.3) and had a past-year SUD (52.8%; 95% CI: 50.1–55.4), whereas an estimated 37.8% (95% CI: 37.2–47.3) experienced serious psychological distress. Similar results were observed for those who reported past-year kratom use. Multivariate logistic regression analysis revealed prior-to-past-year and past-year kratom use was associated with increased adjusted odds of past-year SUD (AOR: 4.36; 95% CI: 3.89–4.88 and AOR: 4.81; 95% CI: 3.99–5.80, respectively). Similar results were found for other substance use, DSM-5 major depression, and suicidal ideation. […]

    Over 5 million people in the United States used kratom in their lifetime, with the highest use at ages 21–34 years. Kratom use is increasing and strongly associated among individuals who use cannabis, have a DSM-5 SUD, and experience serious psychological distress. These findings reinforce a profile of individuals who use kratom, many with behavioral health symptoms, and need evidence-based treatment warranting consideration in clinical and policy efforts.

    Journal of Addiction Medicine: Kratom Use and Associations With Mental Health in the United States

    Authors: McCabe, Sean Esteban PhD; Bogan, Ralph C. BA; Dickinson, Kara BS; McCabe, Vita V. MD, MHSA; Menke, Nathan B. MD, PhD; Schepis, Ty S. PhD

  7. Servetus says:

    Primary care physicians are considered potential candidates to treat substance use disorders:

    18-May-2026 – Researchers at the University of Cincinnati found that embedding addiction treatment into primary care training clinics may be a promising approach to addressing substance use disorders (SUDs). […]

    “In traditional training, addiction care is often taught in theory rather than practice,” he said. “We wanted to create a model where treating substance use disorders is integrated into everyday primary care, because that’s where many patients already are.”

    The study evaluated data from the clinic’s first 15 weeks, including both patient care metrics and resident education outcomes. During that period, the clinic recorded 73 patient visits, with opioid use disorder and alcohol use disorder among the most common diagnoses.

    Researchers also surveyed participating residents before and after their rotation. Results from 11 of the 18 residents showed marked improvements in confidence when diagnosing SUDs, interpreting urine drug tests, initiating treatment with and adjusting medication (such as buprenorphine) for opioid use disorder, and providing harm-reduction counseling.

    “For many residents, this was their first time actually starting medications for opioid use disorder or counseling patients on harm reduction,” Binder said. “After just a few weeks, we saw substantial gains in their confidence to do these things independently.” […]

    “Integrating addiction treatment into primary care helps normalize it,” Binder said. “Patients can receive care for substance use disorders in the same place they manage diabetes or hypertension, which can lower barriers and improve engagement.”

    This practical response to gaps in addiction medicine training for physicians augments the training received in residency to meet the growing need for robust clinical experiences in SUD treatment. […]

    AAAS Public Science News Release: Study finds integrating substance use disorder treatment into clinic-based internal medicine expands access to care — new approach also provides hands-on training and boosts physician confidence

    Academic Medicine: Development of an addiction medicine clinic integrated into an internal medicine ambulatory practice

    Authors: Michael C Binder, MD, MPH , Marisa B Brizzi, PharmD , Sally A Santen, MD, PhD , Carolyn A Chan, MD, MHS

  8. Servetus says:

    Anybody who took acid in the 70s most likely took the acid manufactured by none other than Leonard Pickard, who at that time was accused of supplying 90-percent of the LSD-25 consumed in the world. He just got out of a federal supermax prison after 20 years, and after receiving a virtual death sentence for introducing millions to the miracles of psychedelics – a truly remarkable individual:

    YouTube Interview: Psychedelics as Medicine 2025 – Inside the Mind of the LSD King: Conversation with Leonard Pickard

  9. Servetus says:

    Links alleging that cannabis use leads to psychosis in young people are being investigated under a review of previous conflicting research studies:

    May 21, 2026 — Across the 33 studies reviewed, cannabis dose and age at first use appeared to play a role in the risk for psychosis, Jeonghyun Shin, MD, MPH, of Maimonides Medical Center in New York City, said at the American Psychiatric Association annual meeting in San Francisco.

    For example, one study linked daily use of high-potency cannabis (>10% tetrahydrocannabinol [THC]) to a nearly five-fold increase in the odds of developing a psychotic disorder compared with never-users (adjusted OR 4.8, 95% CI 2.5-6.3). Another study tied cannabis use starting by 15 years of age to an earlier onset of psychosis compared with those who started later… other data on state policies legalizing cannabis and psychosis-related outcomes have turned up null results. Shin called this a “critical” research gap that requires further study.

    “There has been emerging evidence showing that there’s a link between cannabis use and the risk of psychosis,” said Shin. “Because there’s been so much rapid change in the policy and this emerging evidence, researchers have started to look into whether these policy changes actually impact psychosis.”

    Some data don’t quite match up with what is being seen in clinical practice, added co-author Jamie Baik, MD, MEd, of Cambridge Health Alliance in Massachusetts. “I’m sure all of us in practice can say something about cannabis making outcomes and symptoms a lot worse, but it’s somehow not being reflected in the data immediately.”

    “The transitional-age youth group that we originally focused on is 15 to 25, but studies are showing that adolescents up until age 18 or 19 were not actually showing a greater use in cannabis after legalization occurred ,” she explained. Instead, “young adults 19 to 25 were disproportionately affected. But when they all get lumped together, you don’t get anything significant.”

    Of the 33 studies included, 11 looked at cannabis use among individuals who had psychosis or who were at high risk for it, and 17 looked at either emergency department visits associated with psychosis or psychosis-related inpatient hospitalizations. […]

    For the next steps, Shin said her team looks forward to extracting the data and making more definitive conclusions regarding different outcomes and different age groups, as well as providing more insights into policy. “The biggest question everyone might have would be … did policy change actually impact psychosis? Our short answer would be that we don’t know as of yet,” she said. “Stay tuned for the final results.” […]

    Medpage Today: Psychosis and Cannabis Legalization: Where’s the Evidence? — As marijuana policy shifts nationwide, researchers are tracking possible link to psychosis

  10. Servetus says:

    Cannabis use does not lower testosterone levels in young men — an increase of about 23-percent is noted:

    28-May-2026 — Some studies suggest that cannabis may reduce sperm count, concentration, and motility. These effects are believed to be linked to the endocannabinoid system—a network of chemical messengers and receptors in the brain and reproductive organs that interacts with sex hormones. However, the findings of studies conducted so far — particularly regarding the impact of cannabis use on testosterone — have often been contradictory.

    To investigate further, a team from the Section of Pharmaceutical Sciences at the UNIGE Faculty of Science, led by Professor Serge Rudaz and in collaboration with SCAHT, conducted an in-depth analysis of steroid hormones — including sex hormones such as androgens, progestogens, and estrogens — in blood plasma samples from Swiss conscripts aged 18 to 23. The cohort included 47 confirmed cannabis users and 47 non-users. The major innovation of this study lies in extending the analysis to hundreds of hormones, whereas previous research focused solely on testosterone. […]

    “Our results show that cannabis use would lead to an increase of about 23% in testosterone in young men,’’ explains Serge Rudaz. ‘‘But by taking a closer look at all male sex hormones — the androgens — we were able to locate the source of this increase specifically in the testes. Androgens produced by the adrenal glands were not affected by this increase.’’ Cannabis therefore appears to have a direct effect on the testes, and more specifically on Leydig cells, which produce testosterone.

    However, this increase in hormone levels among cannabis users should not be interpreted as an indicator of sperm quality. The link between testosterone and fertility remains very complex to decipher. Furthermore, the observed increase could represent a compensatory response by the body to reduced sensitivity of certain androgen receptors in the presence of cannabis. It is also possible that men with naturally higher testosterone levels are more prone to risk-taking behavior and, consequently, more likely to use cannabis. […]

    While cannabis appears to affect certain biological mechanisms related to reproduction, the exact clinical implications for the fertility of young men remain unclear. Further research is needed to determine whether a toxicity threshold exists and to assess potential long-term effects. […]

    AAAS Public Science News Release: Cannabis use does not lower testosterone — A UNIGE study shows that young men who use cannabis tend to have higher levels of male sex hormones, with no clear impact on fertility

    Communications Medicine: Cannabis consumption is associated with altered steroid metabolism in young men

    Auhors: Mathieu Galmiche, Isabel Meister, Fanny Zufferey, Michel F. Rossier, Rita Rahban, Alfred Senn, Serge Nef, Julien Boccard & Serge Rudaz.

  11. Servetus says:

    CBD may be effective in reducing brain inflammation and harmful plaques and debris that are linked to Alzheimer’s Disease:

    May 28, 2026 — Inflammation is part of the body’s natural immune response. In the brain, immune cells normally help protect neurons and clear away harmful debris. But when inflammation becomes chronic, it can begin damaging healthy brain tissue instead. This ongoing immune overactivation, often called neuroinflammation, has been linked to Alzheimer’s disease and several other neurological disorders.

    In a new study published in eNeuro, researchers led by Babak Baban from Augusta University investigated whether CBD could help calm this damaging inflammatory response in the brain.

    The team used a well-established mouse model of Alzheimer’s disease and delivered CBD through inhalation. They then examined how the compound affected immune activity and inflammatory signaling in the central nervous system, which includes the brain and spinal cord. […]

    Using a variety of molecular and genetic tests, the scientists found that CBD lowered the activity of several important regulators involved in neuroinflammation. The treatment was also associated with reduced levels of proinflammatory molecules, which are substances that can worsen inflammation and contribute to tissue damage.

    The researchers also identified specific immune-related pathways that appeared to interact with CBD. These findings suggest the compound may influence multiple biological systems involved in Alzheimer’s disease.

    “Alzheimer’s work has long centered on plaques and tangles,” says Baban. “But our study shows that chronic autoinflammation is also a core driver of the disease. What’s exciting is that CBD not only calms this immune overactivation but, in earlier work, we’ve shown it can also help clear plaques and tangles through a different mechanism. Together, this points to a multitarget approach with real therapeutic potential.” […]

    ScienceDaily: CBD may slow Alzheimer’s by calming the brain’s immune system — CBD may tackle Alzheimer’s on multiple fronts by cooling brain inflammation linked to the disease

    eNeuro: Rethinking Alzheimer’s: Harnessing Cannabidiol to Modulate IDO and cGAS Pathways for Neuroinflammation Control

    Authors: Sahar Emami Naeini, Bidhan Bhandari, Breanna Hill, Nayeli Perez-Morales, Hannah M. Rogers, Hesam Khodadadi, Nancy Young, Lívia Maria Maciel, Jack C. Yu, David C. Hess, John C. Morgan, Évila Lopes Salles, Lei P. Wang, Babak Baban.

  12. Timothythumb says:

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  13. Servetus says:

    Overdose deaths in the U.S. are on the decline:

    2-Jun-2026 — Researchers from the University of California San Diego have found that U.S. overdose death rates declined dramatically between 2023 and 2024, marking the first recorded drop in all four waves of the nation’s overdose crisis. The study, published on June 2, 2026 in the journal Addiction, found that the nationwide decrease was largely driven by falling deaths involving illicit fentanyl, both alone and in combination with stimulants such as methamphetamine and cocaine. Despite the encouraging trend, researchers warn that overdose deaths involving stimulants without fentanyl, as well as xylazine-related deaths, continue to rise and racial disparities remain severe.

    “We are seeing a historic shift in the overdose crisis,” said Joseph Friedman, MD, PhD, MPH, resident physician in the Department of Psychiatry at UC San Diego School of Medicine and the study’s first author. “But this is not the end. The substances involved are changing, some parts of the crisis are still growing, presenting new challenges. We need to avoid interpreting declining national numbers as a sign that the crisis has been solved.” […]

    The study found that the national overdose death rate fell by 24.4% between 2023 and 2024, dropping to 23.7 deaths per 100,000 people. The decline was primarily linked to decreases in fentanyl-related deaths. Deaths involving fentanyl without stimulants fell from 31,193 in 2023 to 19,673 in 2024, while deaths involving fentanyl combined with stimulants dropped from 41,583 to 28,062.

    Researchers describe the U.S. overdose epidemic as unfolding in four waves: prescription opioids, heroin, fentanyl and, most recently, fentanyl combined with stimulants such as methamphetamine or cocaine. The new findings show that the fourth wave — considered especially lethal because of use of multiple substances — declined for the first time in 2024.

    At the same time, the study identified emerging warning signs. Deaths involving stimulants without fentanyl continued increasing, rising from 18,142 deaths in 2023 to 18,907 in 2024. These deaths accounted for 17.3% of overdose fatalities in 2023 but grew to 23.8% in 2024. Xylazine, a veterinary sedative increasingly found in the illicit drug supply, was also implicated in a growing share of fentanyl-related overdose deaths.

    Researchers warn that if these trends continue, stimulants such as methamphetamine and cocaine may soon surpass opioids as the defining addiction-related public health challenge in the U.S. […]

    AAAS Public Science News Release: U.S. overdose deaths dropped in 2024 amid uneven progress, study finds — researchers found racial/ethnic gaps persist and overdose deaths involving only stimulants continued to rise, despite national declines overall

    Addiction: Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement

    Authors: Joseph R. Friedman, Joseph J. Palamar, Daniel Ciccarone, Tommi L. Gaines, Annick Borquez, Chelsea L. Shover, Steffanie A. Strathdee

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