Latest Articles and News - Jul 15, 2025

Drug involvement variations in overdose death spikes: county-level analysis in Massachusetts.

Communities often experience relatively quiet periods disrupted by sudden surges of drug overdoses, suggesting that the risk of death can change substantially in a short period. Multiple substances are often involved in overdoses, and it is crucial to understand which are more frequently observed in spikes. This study aimed to investigate the involvement of specific substances in overdose spikes at the state and county levels in Massachusetts. We applied a spike detection method to identify daily spikes among 9915 overdose fatalities in Massachusetts from 2020 to 2023. A day was identified as a spike if the number of overdose deaths was over two SDs of the adjusted moving average with a lag of 30 days. We used a general linear mixed model to compare the presence of cocaine, psychostimulants, fentanyl, heroin and prescription opioids in overdose deaths between spike and typical days. Finally, we analysed and compared the results for 8 of the 14 counties in Massachusetts with the highest maximum overdose deaths per day. At the state level from 2020 to 2023, no substances showed significant differences in spike and typical days. Cocaine was more prevalent in multiple counties during spikes. Fentanyl-involved overdose deaths were common on typical days in two counties. Psychostimulants were more prevalent on spike and typical days depending on the county. Heroin and prescription opioids only showed differences in one county each. Our analysis shows high heterogeneity of involved substances in overdose death spikes across counties in Massachusetts. This heterogeneity reinforces the need for localised response strategies. This understanding can guide more targeted local resource allocation and inform strategies to improve public health practices, ultimately aiming to reduce the impact of future overdose spikes.

https://pubmed.ncbi.nlm.nih.gov/40661257/

Rising drug overdose deaths in chronic liver disease in the United States, 2015-2023.

https://pubmed.ncbi.nlm.nih.gov/40660767/

Assessing an ICD-10 code approach for estimating xylazine-involved overdose deaths in the United States.

The prevalence of the veterinary sedative xylazine in US overdose deaths rose between 2018 and 2021. More updated estimates are limited, partially due to the lack of a dedicated ICD-10 code-a primary mechanism used to specify drugs implicated in overdose deaths in the US, including in the CDC WONDER system, which provides public data for download with a 6-month lag. For other emerging substances lacking dedicated codes, over time umbrella codes have come to de facto represent them, yet it has not been demonstrated if this has occurred for xylazine. Overdose deaths in CDC WONDER involving T42.7 ("Antiepileptic and sedative-hypnotic drugs, unspecified") or T46.5 ("Other antihypertensive drugs, not elsewhere classified") were compared to two more specific, albeit delayed, sources: NVSS describing national trends in 2018-2021 and SUDORS describing state-level trends in 2020-2022. This CDC WONDER approach was also used to estimate trends in xylazine-involved deaths through 2024 Q1 by geography, race/ethnicity, substance co-involvement, and demographic categories. At the national level, concordance between CDC WONDER records and previous NVSS estimates improved after 2019 and became highly similar in 2021 (3480 vs 3468 deaths). Concordance was also high for estimates stratified by race, age, and region. At the state-level, across 49 state-year pairs, correlation between CDC WONDER and SUDORS was 0.97. Estimated xylazine-involved deaths doubled between 2021 and 2024 Q1, and estimated racial inequalities widened. T42.7 or T46.5, together, may have become the de facto coding scheme representing xylazine-involved deaths. This approach provides more up-to-date estimates, showing increasing prevalence and worsening racial inequalities in xylazine-involved deaths into 2024.

https://pubmed.ncbi.nlm.nih.gov/40660642/