Stimulant Summit: Fentanyl Looms, but Stimulants Pose Increasing Threat in Northeast

Fentanyl remains the No. 1 illicit substance threat in the state of Vermont, but multiple trends point to cocaine and methamphetamine becoming increasingly prevalent within the state, drug intelligence officer James Downes, MS, and public health analyst Stephanie Thompson, MPA of the Vermont Intelligence Center told Cocaine, Meth & Stimulant Summit attendees in a session presented Friday.

Downes and Thompson serve in the New England High Intensity Drug Trafficking Area program, one the 33 HIDTA programs that serve 600 counties across the U.S. The New England HIDTA’s Overdose Response Strategy aims to reduce overdoses and develop harm-reduction strategies by analyzing data regarding both supply of and demand for illicit substances within the state.

Among the findings shared during Friday’s session:

• In Vermont, seizures of opioids by law enforcement have steadily trended slightly upward since 2011, Downes said. Stimulant seizures, meanwhile, have increased significantly since 2016, especially within the past two years. As seizures of illicit stimulants have increases, so too has demand for prescription stimulant medications. Prescriptions for stimulant medications increased 90% between 2010 and 2018, and have held steady from 2017 to 2019, Thompson noted. Misuse of stimulants, both with and without a prescription, by young adults ages 18 to 25 increased from 2016 to 2018.
• Opioid overdose deaths more than tripled from 2010 to 2018, and after a decrease in 2019, are on pace to increase again for 2020. Rules around prescribing opioids for both chronic and acute pain, enacted in 2015 and 2017, have helped curb opioid-involved deaths in which prescription medications were a contributing substance—prescription opioids were a contributing substance in about 90% of opioid overdose deaths in 2010 vs. less than 30% in 2019—but the rise of fentanyl kept opioid-involved deaths climbing in the state throughout the 2010s. At the start of the decade, fentanyl accounted for just over 10% of opioid overdose deaths. It is now a contributing substance in nearly 90%. Heroin-involved deaths have started to drop after peaking in 2018. Cocaine has also become a factor, as it was found to be involved in 43% of opioid-related fatalities in 2019, following the trend of cocaine seizures by law enforcement within the state.

Felony arrest notifications

Downes and Thompson also highlighted felony arrest notifications tracked by the New England HIDTA. Such arrests include trafficking, possession with intent to distribute and felony possession of illicit drugs. Tracking types of drugs in a region’s supply can provide an early warning to public health and public safety officials about the substances posing the greatest risk to the area, Downes said.

In 2019, heroin, followed by cocaine and crack cocaine were the most frequently seized illicit substances. Fentanyl, which contributes to over 80% of overdose deaths, was the next most commonly seized illicit substance. The least frequently seized substance in 2019 was methamphetamine, but early signs suggest that will change this year, Downes said. Cocaine and crack cocaine have become the top two illicit substances seized through the first two quarters of 2020.

“We’re concerned about what we’re seeing with stimulants here in Vermont,” he said. “We have particular pockets of the state that suggest methamphetamine may be increasing.”

Poly-substance use could also be on the rise. In 2019, 72% of felony arrest notifications within the state involved a single drug, but Downes said he expects poly-drug seizures and felony drug arrests to increase in 2020.