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Increasing Overdose Deaths Related to Cocaine and Other Stimulants: Guidance from the New York State Office of Addiction Services and Supports, Medical Advisory Panel

Posted 9/1/2020 (updated 3/29/2024)

Recently, there have been reports of increasing overdose deaths related to cocaine and other stimulants, both nationally and in New York State (NYS) and New York City (NYC). There are data to suggest that rates of cocaine and other stimulant use are increasing, particularly in certain demographic groups and geographic areas. While overdose deaths related to cocaine and/or other stimulants alone are increasing, there are also data to suggest that most of the increase in overdose deaths related to cocaine and other stimulants is related to opioids – particularly high potency synthetic opioids such as fentanyl and analogues – being mixed with cocaine and other stimulants. This “mixing” can occur in two ways – individuals can intentionally use cocaine/stimulants along with or near the same time as opioids (and highly potent opioids may be included in the intentionally used opioids, and the person using may or may not be aware of their presence), or the opioids can be combined with the cocaine/stimulants without the individual using knowing of their presence.

The NYS Office of Addiction Services and Supports (OASAS) Medical Advisory Panel convened a meeting to discuss this burgeoning overdose crisis on October 16, 2019, and offers the following guidance to clinical providers and local public health and mental hygiene authorities in NY.