It Is No Longer Just an Opioid Problem: Polysubstance Misuse and the Fourth Wave of the Overdose Crisis

The drug overdose crisis in the United States began in the 1990s. This crisis was fueled by a growth in opioid prescriptions by healthcare providers and is referred to as the “first wave.” The first wave was followed by a second wave, driven by a rise in heroin use. A third wave followed, which was highlighted by the use of synthetic opioids. Now, a fourth wave has emerged in the opioid overdose crisis. This wave is marked by polysubstance misuse involving the use of fentanyl combined with stimulants. These waves have caused a progressively higher number of drug overdose deaths in the United States. This activity reviews the distinctive features of each wave of the drug overdose crisis and the increasing role of polysubstance misuse in the fourth wave. It also discusses the successes and failures of regulatory and public policy decisions that have been applied to combating this drug overdose crisis and the dangers and risks of stimulant misuse. This is a General course for Florida and Michigan.