Once considered mostly a local problem in the western United States, methamphetamine-related overdose deaths have now become a nationwide crisis.
A new study shows that these deaths have increased dramatically in every region of the country, with especially sharp rises in the Southeast, including states like Mississippi.
The study was led by Andrew Yockey, a public health professor at the University of Mississippi, and Rachel Hoopsick, a health and kinesiology professor at the University of Illinois at Urbana-Champaign.
Using 19 years of data from the CDC’s WONDER database, they examined what is being called the fourth wave of the U.S. overdose crisis. Their findings were published in the Journal of Addiction Medicine.
The numbers are alarming. Between 1999 and 2023, the number of methamphetamine-related overdose deaths rose from 547 to 34,855 per year. This means deaths have jumped more than 61 times over that period. In their latest study, the researchers also explored where these increases are happening.
They found that the highest death rates are in the Pacific and Mountain regions—including states like California, Alaska, Arizona, Colorado, and Utah—as well as the East South Central division, which includes Mississippi, Alabama, Kentucky, and Tennessee.
Hoopsick explained that knowing where the problem is worse can help experts send support to the right places. That could mean setting up new treatment centers, helping health care workers get trained in addiction treatment, or offering harm-reduction services like clean syringe programs and access to naloxone, the drug that reverses opioid overdoses.
For the past 25 years, the U.S. drug overdose crisis has shifted in waves. The first wave involved prescription opioids. The second wave came with a rise in heroin use. The third wave saw the deadly spread of fentanyl. Now, we are in the fourth wave, which is defined by overdoses involving both opioids and stimulants like methamphetamine.
This mix is especially dangerous. From January 2021 to June 2024, 59% of overdose deaths in the U.S. involved stimulants. In 43% of cases, both stimulants and opioids were involved. Fentanyl is particularly deadly, and when it’s combined with meth, the results can be deadly and unpredictable.
Yockey explained that combining a stimulant like meth with an opioid like fentanyl can trick the body. The stimulant hides the signs of overdose, such as slowed breathing or sedation, making it harder to recognize the danger in time.
Knowing how widespread meth-related overdose deaths are can help health care providers better target their efforts. It can also help local leaders and national policymakers figure out where to spend money, open clinics, and start education or support programs.
The good news is that some areas have shown progress. In regions like New England and the Middle Atlantic, death rates have started to level off between 2020 and 2023. Experts believe that this may be the result of strong public health responses, including harm reduction and community outreach.
However, the researchers warn that even in these areas, the crisis is far from over. “Leveling off” only means the numbers aren’t getting worse—it doesn’t mean the problem is solved.
The findings are a wake-up call. Meth use is no longer limited to one part of the country, and the combination of meth and fentanyl has made the crisis more dangerous than ever. The researchers say that expanding harm-reduction services, increasing access to treatment, and providing community education are all key to saving lives.
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