The American Society of Addiction Medicine recently flagged several pieces of research. Here are three, checked directly against the original study text, and the clearest thread running through them is that stimulant overdose deaths are moving in the opposite direction from the rest of the overdose crisis.

1. Stimulant Overdose Deaths Kept Rising in 2024, Even as Overall Deaths Fell

US overdose death rates peaked in 2022 at 36.9 per 100,000 and fell to 25.6 per 100,000 by 2024, a 27.9% decline, driven mainly by a 38.3% drop in fentanyl-involved deaths.

But stimulant overdose deaths without any opioid present moved the opposite way between 2023 and 2024: cocaine-without-opioids deaths rose 1.7% (166 additional deaths) and methamphetamine-without-opioids deaths rose 2.4% (476 additional deaths). Neither national increase reached statistical significance on its own (p=0.288 for cocaine, p=0.080 for methamphetamine), but the researchers describe these methamphetamine and cocaine overdose trends as an epidemiologically meaningful signal because of where the increases concentrated.

The regional and demographic breakdown was uneven. In the Midwest, methamphetamine-without-opioids deaths rose 135.2% among American Indian/Alaska Native populations, the largest subgroup increase found anywhere in the study, while deaths declined sharply among Hispanic populations in the same region. In the Northeast, which saw the largest overall regional increase in stimulant overdose deaths, methamphetamine-without-opioids deaths rose 26.7%, including a 45.7% rise among White adults 55 and older. In the South, methamphetamine-without-opioids deaths rose 61.2% among AIAN adults 55 and older and 23.6% among Hispanic adults in the same age group. The study’s authors argue this represents a distinct toxicity crisis from opioids, since naloxone doesn’t reverse a stimulant overdose, and call for prevention strategies built specifically around stimulants.

2. Cannabis Was Detected in 1 in 5 Overdose Deaths, Concentrated in Teens

Using CDC’s State Unintentional Drug Overdose Reporting System, covering 31 states and Washington DC, researchers examined 209,166 overdose deaths between January 2021 and June 2025. Cannabis was detected in 43,880 of them, 21.0%, a share that stayed stable over the full period. Cannabis was recorded as the actual cause of death in only 0.8% of cases (1,687 deaths), and was the only substance present in just nine deaths total.

The clearest pattern was by age. Among decedents aged 12 to 17, cannabis was detected in 42.7% of overdose deaths, more than double the rate in any older group. That rate within the teen group dipped from 49.2% in 2021 to 35.9% in 2024, then rose again to 44.6% in the first half of 2025. Adults 50 and older had the lowest detection rate, 16.7%, though even that ticked up from 14.8% to 18.1% over the same window.

What stood out most: among all deaths where cannabis was detected, 73.5% also involved illegally manufactured fentanyl and 60.4% also involved stimulants, tying this finding directly back to the same stimulant overdose deaths trend seen nationally. Among just the 12-to-17 age group, those co-involvement rates climbed to 88.6% for fentanyl and 69.0% for stimulants. The CDC frames cannabis detection as a marker of high-risk polysubstance use among young people rather than a direct cause of overdose death.

3. A Care Navigator With Incentives Improved Engagement, Not Treatment Access

This randomized trial at Denver Health enrolled 192 adults who’d had a methamphetamine-related encounter in an acute care setting, between April 2023 and September 2024. Participants were mostly male (81.3%), with a median age of 39, and the group was heavily marginalized: 84.9% were unstably housed, 82.3% were unemployed, and 49.0% had no regular access to a working phone.

The trial matters directly to the stimulant overdose deaths picture above, since methamphetamine remains the primary driver of stimulant-involved mortality, and there is still no FDA-approved medication for methamphetamine use disorder. Half the group (96 people) was randomized to a care navigation intervention that layered in contingency management, small cash rewards and a prize wheel (48% chance of a motivational quote, 52% chance of a cash prize between $5 and $50) for engaging with the navigator. The other 96 received usual care.

The intervention group engaged more: 62.5% attended two or more navigation sessions, and completion of the 90-day study visit was higher in the intervention arm (49.0%) than in the control arm (38.5%). But the primary outcome, actual linkage to substance use treatment, showed no meaningful difference. At 30 days, both arms were identical at 25.0% (risk ratio 1.00). At 90 days, 33.3% of the intervention group had linked to treatment versus 25.0% of the control group, a gap that did not reach statistical significance (risk ratio 1.33, 95% CI 0.85 to 2.09). Contingency management, despite being the best-evidenced approach available for reducing stimulant overdose deaths, is used in fewer than 10% of US addiction treatment programs.

The Bigger Picture

Across all three studies, stimulant overdose deaths, whether from methamphetamine or cocaine, stand out as the part of the overdose crisis that hasn’t followed the national decline. Cannabis detection data reinforces the same trend, showing stimulants present in the majority of teen overdose deaths where cannabis also appeared. And the treatment trial underscores why: with no approved medication and limited access to the interventions that do work, methamphetamine and cocaine overdose trends look set to keep diverging from the broader progress on opioids.

Source: dbrecoveryresources