• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Methamphetamines and Opioid-Related Overdose Risk
Research Update

Methamphetamines and Opioid-Related Overdose Risk

April 1, 2023
Peter J. Farago, MD.
From The Carlat Addiction Treatment Report
Issue Links: Editorial Information | PDF of Issue

Peter J. Farago, MD. Dr. Farago has no financial relationships with companies related to this material.

REVIEW OF: Daniulaityte R et al, Int J Drug Policy 2022;99:103463

STUDY TYPE: Cross-sectional study

Has a patient ever told you that methamphetamines can be used instead of naloxone to reverse an opioid overdose? We’ve all heard the myth, but it’s unknown how widespread this belief actually is. Rigorous research is lacking, but there are two reasons why this practice could be dangerous. First, opioid overdoses are lethal because of hypoxia caused by respiratory cessation; as a vasoconstrictor, stimulants could compound hypoxia by restricting the flow of already oxygen-poor blood to vital organs. Second, fentanyl is commonly mixed with illicit drugs, so someone administering methamphetamines to reverse an overdose might inadvertently be giving additional fentanyl.

To answer the question of how widespread this belief is, and whether it is actually practiced, researchers conducted a qualitative study to understand lay knowledge, attitudes, and behaviors related to methamphetamines and opioids. Structured interviews and urine toxicology were conducted with 41 individuals (mean age 38.3 years, 51% female, 100% non-Hispanic White) in Ohio who reported past 30-day use of methamphetamine and heroin/fentanyl.

Participants described an unpredictable local opioid market saturated by fentanyl and its derivatives, thus substantially increasing overdose risk. Urine toxicology verified their perceptions; all samples were positive for fentanyl, and many were positive for other various fentanyl analogues such as acetyl fentanyl (61.0%), tetrahydrofuran fentanyl (29.3%), and the highly potent carfentanil (12.2%).

Misconceptions about the utility of methamphetamines in opioid overdose were widespread and commonly practiced. Fifty-four percent believed methamphetamines could reduce the risk of overdose, and 60% thought it could reverse an overdose that was already occurring. Nearly half (46%) had personally used methamphetamines either to manage overdose risk or as an alternative to naloxone. Anecdotally, some participants reported success with this strategy, though it’s unknown if they witnessed an actual overdose reversal.

This study gives a distressing glimpse into the current state of the opioid epidemic, albeit through the lens of a relatively small sample size in a particular geographic area. Most importantly, it shows that people believe that stimulants can mitigate or reverse opioid overdoses. These findings emphasize the importance of gauging your patients’ knowledge about overdose reversal; don’t assume that they know not to administer a stimulant or that they know about naloxone. Educate them on the dangers of combining drugs, explain proper overdose reversal techniques, and ensure they leave your appointment with a naloxone prescription.

CARLAT TAKE

The illicit opioid supply is full of dangerous fentanyl and highly potent fentanyl analogues. The misconception that methamphetamines can be used to treat opioid overdoses is widespread. Be sure to educate patients about the dangers of this practice and ensure that they leave your appointment with naloxone and an understanding of how to use it.


Addiction Treatment
KEYWORDS addiction methamphetamines naloxone opioid use disorder overdose
    Peter J. Farago, MD.

    Thiamine Supplementation in Patients With Alcohol Use Disorder

    More from this author
    www.thecarlatreport.com
    Issue Date: April 1, 2023
    SUBSCRIBE NOW
    Table Of Contents
    Learning Objectives,Substance-Induced Depression: Diagnosis and Treatment, CATR, Apr/May/June 2023
    Naltrexone: A Jack of All Trades?
    Recognizing and Treating Substance-Induced Psychosis
    Gabapentin: A Double-Edged Sword
    Methamphetamines and Opioid-Related Overdose Risk
    Are Higher-Potency Cannabis Products Riskier for Mental Illness?
    CME-Post Test, Substance-Induced Depression: Diagnosis and Treatment, CATR, Apr/May/June 2023
    DOWNLOAD NOW
    Featured Book
    • AUDFB1e_CoilBound_Graphic2_transparent_sm.png

      Treating Alcohol Use Disorder: A Fact Book (2023)

      All the tools and information needed to assess and treat your patients who are struggling with...
      READ MORE
    Featured Video
    • therapist_canstockphoto9201097.jpg
      General Psychiatry

      Using SAMe In Clinical Practice with Garrett Rossi, MD

      Read More
    Featured Podcast
    • Substance_Use_Sites.jpeg
      Addiction Treatment

      Supervised Drug Consumption Sites

      Once controversial, research clearly shows the benefit of these sites, and they have started opening in the United States.

      Listen now
    Recommended
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report

    Contact

    info@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.