Latest reporting
Minnesota's Opioid Deaths Fell Again. The Stimulant Deaths Don't Have an Antidote Waiting.
Minnesota's 2025 data shows opioid deaths falling for a third year while stimulant overdoses climb. Naloxone does nothing for meth or cocaine. Here is what does.
"Being Sober Is Payment Enough." Why a Gift Card Works on Meth Anyway
A woman in a Maine rewards program said sobriety was payment enough. Why contingency management still works for meth and cocaine, what stimulant craving and flat, joyless weeks feel like, and what the evidence does and does not prove.
The Overdose Decline Has a Hole in It, and Meth Is Standing in It
Minnesota's 2025 overdose deaths rose 3% while opioid deaths held flat and stimulant deaths climbed. Kentucky's meth deaths fell and meth still became the most common drug found. What providers and people who use can do this week.
Through eight lenses
Science
Monoamine release/reuptake (DA, NE, serotonin) — cocaine blocks; meth releases.
Three Hundred and Seventy-One Trials Later, There Is Still No Approved Drug for Meth or Cocaine. The Best Treatment We Have Is a Gift Card.
Oct 5A Breakthrough Badge Isn't a Treatment. Meth Patients Need the One That Already Works.
Sep 29No Drug Treats Stimulant Addiction Yet. The FDA Just Fast-Tracked a Device That Might.
Sep 23
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).
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.
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.
Harm Reduction
Sleep, hydration, avoiding mixing with depressants, safer-use supplies, drug checking.