Methamphetamine use is no longer a problem confined to the West Coast or specific subcultures. Across the United States, meth is increasingly intertwined with the fentanyl crisis, creating a dangerous and often deadly drug landscape that looks very different from past decades.
This pairing, sometimes referred to as synthetic speedballing, combines a powerful stimulant (methamphetamine) with an ultra-potent opioid (fentanyl). While speedballing historically referred to cocaine and heroin, today’s version is far more unpredictable and far more lethal.
A Growing National Trend
Recent overdose data highlight just how widespread and dangerous this combination has become:
- –Nearly 1 in 3 overdose deaths since 2021 involved methamphetamine
- –Almost 75% of meth-related deaths also involved opioids
- –In 2023, roughly 60% of fatal fentanyl overdoses involved stimulants
These numbers reflect a fundamental shift in the drug supply. Unlike earlier eras dominated by plant-based drugs like heroin or cocaine, today’s market is largely synthetic. Meth and fentanyl are inexpensive to produce, extremely potent, and increasingly mixed together—sometimes intentionally, and sometimes without the user’s knowledge.
Why This Combination Is So Dangerous
Meth and fentanyl place opposing stresses on the body. Methamphetamine stimulates the central nervous system, increasing heart rate, blood pressure, and alertness. Fentanyl, on the other hand, depresses breathing and slows the body down.
When used together, the stimulant effects of meth can mask early signs of opioid overdose, delaying recognition and response. As the meth wears off, fentanyl’s respiratory-depressing effects can suddenly dominate, leading to fatal outcomes even hours after use.
Even more concerning: many people who believe they are using only meth may unknowingly be exposed to fentanyl due to contamination in the drug supply. This means individuals without opioid tolerance face an especially high risk of overdose.
Naloxone Saves Lives—Even When Meth Is Involved
Although naloxone (Narcan) does not reverse methamphetamine toxicity, it can reverse the opioid effects of fentanyl. Because fentanyl is so commonly present in meth supplies, experts recommend administering naloxone whenever an overdose is suspected, regardless of what substance someone believes they used.
Carrying naloxone, knowing how to use it, and calling emergency services can be lifesaving steps.
Treatment Challenges and Recovery Support
There is currently no FDA-approved medication specifically for methamphetamine overdose or meth use disorder. Treatment typically involves:
- Emergency medical care during overdose
- Evidence-based behavioral therapies such as Cognitive Behavioral Therapy (CBT) and Contingency Management
- Long-term recovery supports, including peer services and mental health care
Because stimulant and opioid use increasingly overlap, integrated treatment approaches are critical.
Safe Storage Saves Lives
Safe storage is a proven harm-reduction strategy that helps prevent accidental overdose, poisoning, and unintended exposure: especially among children, teens, and others in the household.
If substances are present in the home, they should be:
- Stored in locked containers or lockboxes
- Kept out of sight and out of reach
- Never shared or left unattended
- Properly disposed of when no longer needed
Naloxone should be stored in an easily accessible location, and everyone in the household should know where it is and how to use it. Safe storage does not encourage drug use—it reduces preventable harm and saves lives.
Moving Forward
The rise of meth and fentanyl together represents one of the most urgent public health challenges of our time. Understanding the risks, carrying naloxone, practicing safe storage, and expanding access to treatment and education are all essential steps in reducing overdose deaths.
To learn more about this trend, visit Methamphetamine Use Is Growing Among Fentanyl Users on Psychology Today.
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