{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:04:38Z","timestamp":1787853878306,"version":"build-2784847793"},"reference-count":23,"publisher":"American Public Health Association","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p> Objectives. To examine the state-level history of US overdose deaths involving stimulants with and without opioids from 1999 to 2020. <\/jats:p><jats:p> Methods. We used death certificate data from the National Center for Health Statistics to categorize deaths into 4 groups of interest: cocaine with and without opioids, and psychostimulants with and without opioids. We used a Bayesian multiple change point model to describe the timing and magnitude of changes in overdose death rates involving stimulants for each state and year. <\/jats:p><jats:p> Results. There was little change in the death rates of cocaine without opioids. Death rates involving cocaine and opioids sharply increased around 2015, particularly in the Northeast and Mid-Atlantic. We also observed steady increases in deaths involving psychostimulants without opioids just before 2010, particularly in states in the West and South. Deaths involving psychostimulants with opioids increased around 2015 with largest increases concentrated in Appalachian states. <\/jats:p><jats:p> Conclusions. There is significant geographic heterogeneity in the co-involvement of stimulants in the US overdose crisis. Results can inform public health efforts to inform state-level overdose efforts such as naloxone distribution. (Am J Public Health. 2023;113(9):991\u2013999. https:\/\/doi.org\/10.2105\/AJPH.2023.307337 ) <\/jats:p>","DOI":"10.2105\/ajph.2023.307337","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T20:04:47Z","timestamp":1694030687000},"page":"991-999","source":"Crossref","is-referenced-by-count":18,"title":["State-Level History of Overdose Deaths Involving Stimulants in the United States, 1999\u20122020"],"prefix":"10.2105","volume":"113","author":[{"given":"David","family":"Kline","sequence":"first","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. Bunting, Ariadne Rivera-Aguirre, Noa Krawczyk, and Magdalena Cerda are with the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Langone School of Medicine, New York, NY. Staci A. Hepler is with the Department of Statistical Sciences, Wake Forest University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Bunting","sequence":"additional","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. Bunting, Ariadne Rivera-Aguirre, Noa Krawczyk, and Magdalena Cerda are with the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Langone School of Medicine, New York, NY. Staci A. Hepler is with the Department of Statistical Sciences, Wake Forest University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staci A.","family":"Hepler","sequence":"additional","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. Bunting, Ariadne Rivera-Aguirre, Noa Krawczyk, and Magdalena Cerda are with the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Langone School of Medicine, New York, NY. Staci A. Hepler is with the Department of Statistical Sciences, Wake Forest University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadne","family":"Rivera-Aguirre","sequence":"additional","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. Bunting, Ariadne Rivera-Aguirre, Noa Krawczyk, and Magdalena Cerda are with the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Langone School of Medicine, New York, NY. Staci A. Hepler is with the Department of Statistical Sciences, Wake Forest University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noa","family":"Krawczyk","sequence":"additional","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. Bunting, Ariadne Rivera-Aguirre, Noa Krawczyk, and Magdalena Cerda are with the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University (NYU) Langone School of Medicine, New York, NY. Staci A. Hepler is with the Department of Statistical Sciences, Wake Forest University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Cerda","sequence":"additional","affiliation":[{"name":"David Kline is with the Department of Biostatistics and Data Science, Wake Forest University (WFU) School of Medicine, Winston-Salem, NC. Amanda M. 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