{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:57:07Z","timestamp":1793912227213,"version":"4.8.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["1U01DA063078\u201301"],"award-info":[{"award-number":["1U01DA063078\u201301"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA054190"],"award-info":[{"award-number":["R01DA054190"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA057630"],"award-info":[{"award-number":["R01DA057630"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA05771"],"award-info":[{"award-number":["K01DA05771"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R33DA061260"],"award-info":[{"award-number":["R33DA061260"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["DP2DA049295"],"award-info":[{"award-number":["DP2DA049295"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To characterize decreases in overdose death rates in the United States (US) between 2023 and 2024 by race\/ethnicity, and substance involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population\u2010based study of national death records accessed via the Centers for Disease Control and Prevention (CDC) Wide\u2010ranging ONline Data for Epidemiologic Research (WONDER) platform using an underlying cause of death approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants\/cases<\/jats:title>\n                    <jats:p>All individuals who died from drug overdose between January 1999 and December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Annual overdose deaths per 100\u2009000 population. Year of occurrence of overdose death, substance involvement, race\/ethnicity of decedents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>After many years of increases, the US overdose death rate dropped 24.4% between 2023 and 2024. Decreases reflected declining illicit fentanyl\u2010involved deaths (with and without stimulant involvement). The fourth wave of the US overdose crisis\u2014defined by deaths involving fentanyl together with stimulants\u2014declined for the first time in 2024. Despite overall decreases, deaths involving stimulants without fentanyl and deaths involving xylazine continued to represent a growing fraction of overdose fatalities. Non\u2010Hispanic Black and African Americans had the largest decrease in death rates in 2023\u20132024, falling by 29.3% but remaining elevated at 36.0 per 100\u2009000, 1.51 times higher than the national average of 23.7 per 100\u2009000. Non\u2010Hispanic American Indian and Alaska Native individuals had the highest overdose death rates rate in 2024, at 50.8 per 100\u2009000, 2.15 times the national average rate, and experienced a below\u2010average relative decrease of 20.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All four previously defined waves of the US overdose crisis appear to be in decline, as deaths involving illicit fentanyl, with and without stimulants, dropped sharply between 2023 and 2024. Concurrently, the fraction of overdose deaths involving stimulants without fentanyl and those involving xylazine continued to increase. While racial disparities in drug overdose death rates narrowed slightly during this period, large gaps remain, with the highest overdose death rates among American Indian, Alaska Native, and Black individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70472","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:00:37Z","timestamp":1780387237000},"page":"2552-2558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement"],"prefix":"10.1111","volume":"121","author":[{"given":"Joseph R.","family":"Friedman","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J.","family":"Palamar","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ciccarone","sequence":"additional","affiliation":[{"name":"Department of Family Community Medicine University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommi L.","family":"Gaines","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-9837","authenticated-orcid":false,"given":"Annick","family":"Borquez","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0728-4101","authenticated-orcid":false,"given":"Chelsea L.","family":"Shover","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffanie A.","family":"Strathdee","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"U.S. Overdose Deaths Decrease in 2023 First time since 2018[internet]. 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