Stimulant overdoses rise as opioid deaths fall, but treatment lags

Stimulant overdoses are rising across the US, according to new CDC data, even as opioid-related deaths decline, but experts say these overdoses are harder for bystanders to recognize and treat than opioid cases. While fentanyl deaths fell to pre-pandemic levels in 2025, cocaine fatalities rose in 13 states and methamphetamine deaths in eight, with Arizona hitting record non-fatal stimulant overdoses. Unlike opioid overdoses, which show clear signs like slowed breathing and respond to naloxone, stimulant overdoses vary widely and can cause heart attacks, strokes, or seizures requiring immediate 911 calls. Experts recommend learning stroke signs like the Be Fast mnemonic, keeping stimulant users hydrated to prevent hyperthermia, and calming patients before EMS arrives to avoid altercations. Most fatal stimulant overdoses involve other substances, but older men with heart problems face the highest risk from stimulants alone.