June 8, 2023

New Research Finds Strong Association Between Psychostimulant Prescriptions and Fatal Overdoses

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These findings raise a need for reforming harm reduction education to include information about stimulant use.

The Bottom Line

New research is among the first to show a correlation between fatal psychostimulant-related overdoses and access to prescriptions for psychostimulants in the year preceding death.


Prescription psychostimulants — like amphetamine, amphetamine/dextroamphetamine, and methylphenidate — are commonly prescribed for ADHD or narcolepsy. In recent years, prescription psychostimulant use has doubled in the U.S. At the same time, the overdose crisis in the U.S. has been exacerbated by the increased presence of stimulants in illicit drug markets, as well as the increased access via prescriptions. According to 2020 research, between 2012 and 2019, while the rate of overdose deaths involving cocaine increased by three-fold and those involving psychostimulants increased by six-fold.  

Study Objective

To determine if there is a significant correlation between prescribing psychostimulants and psychostimulant-related overdose deaths.

The Details

Brown University, Rhode Island Department of Health and Boston Medical Center conducted a population-based case-control study using linked, state level databases from the Rhode Island Department of Health. Researchers looked at Rhode Island residents who experienced a fatal drug overdose involving a psychostimulant and compared that to cases involving a fatal overdose that didn’t involve psychostimulants. Additionally, researchers looked at Rhode Island’s prescription monitoring program to determine whether or not those residents had obtained a psychostimulant prescription before their death.


Researchers found that those residents who experienced a psychostimulant-related overdose death were 4.1 times more likely to have received a psychostimulant prescription in the year preceding their death. Researchers did note that in 90% of all deaths opioids, particularly fentanyl, was also involved. In the wake of these findings, researchers strongly urge an expansion of current harm reduction efforts to include psychostimulant overdose training including expanding the education of naloxone and fentanyl test strips so that individuals using psychostimulants can test their drugs for fentanyl or revive a friend in distress.

Pull Quote

“Moreover, psychostimulant/opioid combination use and overdose represents a pressing public health challenge. For example, psychostimulants may mask symptoms of opioid overdose, thereby reducing the likelihood of bystander intervention and naloxone administration and increasing the rate of overdose.”


Macmadu A, Banks A, Hallowell B, Scagos R, Hadland S, Chambers L, Marshall B (2023). ” Receipt of Prescription Psychostimulants and Stimulant-Involved Fatal Overdose: A Population-Based Case-Control Study.” Substance Use & Misuse.

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