Background: In the US, the number of overdose deaths related to opioids in combination with stimulants has increased, however the Northeast has typically been less impacted by stimulant overdose. Injection drug use (IDU) results in high mortality from overdose and infectious disease. We examined trends in stimulant and opioid IDU using cross-sectional state surveillance data.
Methods: Data came from the CDC’s National HIV Behavioral Surveillance system which includes five waves of data (2005-2018) among adults residing in the Boston, Massachusetts metro area reporting IDU (N=2,250). Outcome measures were type of substance injected in the past 12 months (heroin, prescription opioids, “speedball”, cocaine, crack, and/or methamphetamine).
Results: Participants were 70% male and 58% white. From 2015-2018 there was an over 2-fold increase in injection of methamphetamine (15% vs. 38%; p<0.001). Poly IDU (injecting >1 drug) increased significantly across years compared to single drug injection. Combination heroin and methamphetamine injection increased from 2015 (15%) to 2018 (35%) (p<0.001).
Conclusions: Findings suggest the “twin epidemic” of methamphetamine and opioids extends to Massachusetts. There is an urgent need for enhanced screening of methamphetamine use among those using opioids and increased access and payor coverage of efficacious treatments for stimulant and opioid use disorders.