Antecedents of Fentanyl Coinvolvement in Deaths Attributed to Stimulant Poisoning in San Francisco, CA

Our findings add to existing evidence that fentanyl-stimulant deaths are markedly different than stimulant-no-opioid deaths. The association of opioid-related emergency department history with fentanyl involvement in death reinforces a potential touch point for overdose prevention efforts (eg, naloxone, medications for opioid use disorder). Our finding of cardiac conditions being associated with lower odds of fentanyl involvement in death supports the hypothesis that stimulant-no-opioid deaths may be driven by cardiovascular conditions.