Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention

J Urban Health. 2019 Feb;96(1):49-54. doi: 10.1007/s11524-018-00343-z.


After remaining stable from 2010 to 2014, the rate of cocaine-involved overdose death increased sharply from 2015 to 2016. This study aims to determine the contribution of opioids, and fentanyl in particular, to the increase in cocaine-involved overdose death from 2015 to 2016. Using New York City death certificate data linked to medical examiner toxicology data, we identified all overdose deaths where post-mortem toxicology results were positive for cocaine from 2010 to 2016. We analyzed cocaine-involved overdose deaths by co-occurring substances. Age-adjusted rates per 100,000 residents were calculated for 6-month intervals from 2010 to 2016. Data suggest that increased deaths involving opioids, specifically fentanyl, accounted for most of the increase in cocaine-involved deaths from 2015 to 2016.

Keywords: Cocaine; Fentanyl; Heroin; Opioid; Overdose.

MeSH terms

  • Adult
  • Analgesics, Opioid / poisoning*
  • Cause of Death / trends*
  • Cocaine / poisoning*
  • Drug Overdose / epidemiology*
  • Drug Overdose / mortality*
  • Drug Overdose / prevention & control*
  • Female
  • Fentanyl / poisoning*
  • Forecasting
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • New York City / epidemiology


  • Analgesics, Opioid
  • Cocaine
  • Fentanyl