Latest reporting
The Overdose Numbers Are Falling. Cocaine Is the Exception Nobody's Toasting.
CDC data show overdose deaths falling nationally, but stimulant-only deaths are rising, and Medicaid coverage for the one treatment that works, contingency management, remains rare.
Meth and Cocaine Now Kill More Americans Than Opioids. Medicine Still Has Nothing to Offer.
Meth and cocaine deaths outpaced opioid deaths in 2025 for the first time, per Millennium Health's 8th Signals Report. There is still no FDA-approved medication for stimulant use disorder — and America has run this exact experiment before.
Cocaine Didn't Get More Dangerous. Everything Mixed Into It Did.
CDC data show cocaine-involved overdose deaths rose 85% from 2019 to 2023, driven almost entirely by fentanyl contamination in the stimulant supply — not cocaine itself.
Through eight lenses
Science
Monoamine release/reuptake (DA, NE, serotonin) — cocaine blocks; meth releases.
Biology
Hyperthermia, cardiac strain, neurotoxicity (dopamine terminals with chronic high-dose meth), dental effects ("meth mouth" from dry-mouth + acidic diet, not the drug directly).
There's No Suboxone for Meth. The Reason Is in the Chemistry, Not the Funding.
Sep 9There's Still No Pill for Cocaine. The Treatment That Works Pays You Instead — and Most States Won't Cover It.
Sep 4One in Four Bags of Cocaine Now Carries Fentanyl. There's Still No Medicine for What's Underneath It.
Aug 1
Psychology
The "euphoria gap" after the acute phase, stimulant psychosis in heavy meth use, ADHD/stimulant diagnosis intersection.
Policy
Schedule II (meth, cocaine, Rx stimulants); DEA production quotas; Adderall shortage backstory.
The Overdose Numbers Are Falling. Cocaine Is the Exception Nobody's Toasting.
Sep 14There's Still No Pill for Cocaine. The Treatment That Works Pays You Instead — and Most States Won't Cover It.
Sep 4The Best Treatment for Stimulant Addiction Pays You to Stay Clean. For Forty Years, We Refused to Try It.
Aug 30
Trends
Stimulant-involved deaths hit 57,500 in 2022, ~70% co-involving fentanyl — the fourth wave.
Treatment
NO FDA-approved medication for stimulant UD; contingency management has the strongest evidence (RCTs 2–4× retention); CBT, community reinforcement, matrix model.
Meth and Cocaine Now Kill More Americans Than Opioids. Medicine Still Has Nothing to Offer.
Sep 13There's Still No Pill for Cocaine. The Treatment That Works Pays You Instead — and Most States Won't Cover It.
Sep 4The Best Treatment for Stimulant Addiction Pays You to Stay Clean. For Forty Years, We Refused to Try It.
Aug 30
Harm Reduction
Sleep, hydration, avoiding mixing with depressants, safer-use supplies, drug checking.