The Fourth Wave of the Opioid Crisis: What You Need to Know

fourth wave of the opioid crisis

The opioid epidemic has taken a devastating toll on individuals, families, and communities across the United States. Now entering its fourth wave, this crisis is more complex and dangerous than ever. With synthetic opioids like fentanyl being mixed with non-opioid drugs such as methamphetamine, cocaine, and counterfeit pills, the risks of overdose and addiction have escalated dramatically.

At New Heights Recovery, we are dedicated to addressing the ever-changing challenges of addiction and providing hope and healing for those affected by this crisis. Through our comprehensive addiction programs and evidence-based therapies, we are helping individuals reclaim their lives.

The Evolution of the Opioid Epidemic: A Timeline of Destruction

The opioid epidemic has devastated millions of lives over the past three decades, evolving through distinct stages, each more complex and deadly than the last. Understanding this timeline is crucial to addressing the current challenges.

  1. The First Wave (1990s): Prescription Opioids
    The roots of the opioid epidemic trace back to the 1990s when pharmaceutical companies assured healthcare providers that prescription opioids like oxycodone and hydrocodone were safe and non-addictive. Over prescription led to widespread misuse, dependency, and overdose deaths, sparking the first wave.
  2. The Second Wave (2010s): Heroin
    As access to prescription opioids became restricted, many individuals turned to heroin, a cheaper and more accessible alternative. This shift led to a dramatic increase in heroin-related overdose deaths during the second wave.
  3. The Third Wave (Mid-2010s): Synthetic Opioids
    The emergence of fentanyl, a synthetic opioid 50-100 times more potent than morphine, marked the third wave. Initially developed for medical purposes, fentanyl infiltrated the illicit drug market, leading to a surge in fatal overdoses.
  4. The Fourth Wave (Present): Polysubstance Use
    The current wave is defined by the mixing of synthetic opioids like fentanyl with non-opioid substances, such as methamphetamine, cocaine, and counterfeit pills. This polysubstance use has created unprecedented challenges, including more complex overdoses and heightened addiction risks.

The Dangers of the Fourth Wave

The fourth wave of the opioid crisis presents unique and deadly risks. While previous waves primarily involved opioids, this phase introduces a more complex drug landscape due to polysubstance use.

1. Unintentional Overdose

Many people unknowingly consume fentanyl-laced drugs like methamphetamine or cocaine, leading to fatal overdoses. Even a small amount of fentanyl can be deadly.

2. Difficulty in Overdose Reversal

Naloxone (Narcan) can reverse opioid overdoses, but it is less effective in cases involving multiple substances. Polysubstance overdoses complicate emergency responses, putting lives at greater risk.

3. Increased Addiction Severity

Using multiple substances simultaneously intensifies addiction’s physical and psychological grip. This combination also raises the likelihood of co-occurring mental health disorders, further complicating recovery.

4. The Emergence of “Zombie Drugs”

Substances like xylazine, a veterinary sedative often mixed with fentanyl, are making the crisis even more dangerous. Known as “tranq,” xylazine causes severe tissue damage and cannot be reversed with naloxone, increasing the risk of fatal outcomes.

The Fourth Wave’s Impact: By the Numbers

The fourth wave is not just an evolving crisis—it’s a public health emergency. The statistics reveal the devastating scope of the epidemic:

  • Over 100,000 people in the U.S. died from drug overdoses in 2022, with synthetic opioids like fentanyl responsible for the majority.
  • Nearly 70% of all drug overdoses now involve fentanyl, highlighting its dominance in the illicit drug market.
  • Polysubstance use accounts for 50% of stimulant-related overdoses, often involving fentanyl mixed with methamphetamine or cocaine.
  • Young adults aged 18-45 are disproportionately affected, with fentanyl now the leading cause of death in this age group.
  • The DEA has seized enough fentanyl in recent years to kill the entire U.S. population several times over, showcasing the drug’s alarming prevalence.

opioid crisis in the United States

Why Addressing Polysubstance Use Requires Specialized Care

Polysubstance use often requires a multi-faceted approach to treatment. At New Heights Recovery, we focus on:

  • Medical Detoxification: Safely managing withdrawal symptoms under medical supervision.
  • Dual Diagnosis Treatment: Addressing co-occurring mental health disorders, such as anxiety or depression, alongside addiction.
  • Family Support: Educating and involving families in the recovery process to rebuild trust and communication.
  • Relapse Prevention: Equipping individuals with the skills and resources to maintain sobriety long-term.

The Role of Polysubstance Use in the Fourth Wave

The fourth wave of the opioid crisis is defined by the dangerous trend of polysubstance use, where individuals consume multiple drugs simultaneously, often unknowingly. This development has significantly complicated the epidemic, making overdoses more frequent and difficult to treat.

1. What is Polysubstance Use?

Polysubstance use involves taking more than one drug at the same time or within a short period. In the context of the fourth wave, fentanyl—a synthetic opioid—is often mixed with stimulants such as methamphetamine or cocaine. These combinations are sold as counterfeit pills, powdered substances, or adulterated drugs, exposing individuals to substances they may not have intended to consume.

2. Why is Polysubstance Use Increasing?

The prevalence of fentanyl in the drug supply has made it nearly impossible for users to know exactly what they’re consuming. Dealers often mix fentanyl into other drugs to enhance potency or profit margins, leading to unintentional polysubstance use. This has created a particularly lethal drug environment.

3. The Risks of Polysubstance Use

Polysubstance use increases the likelihood of severe consequences, including:

  • Unpredictable Drug Interactions: The combination of opioids and stimulants (e.g., fentanyl and methamphetamine) puts extreme strain on the body, leading to life-threatening cardiovascular and respiratory issues.
  • Harder-to-Treat Overdoses: Naloxone (Narcan) is effective for reversing opioid overdoses but may not address the effects of stimulants or other substances.
  • Increased Addiction Severity: Using multiple substances simultaneously can intensify addiction, creating a more challenging path to recovery.

The Impact of the Fourth Wave on Mental Health

The fourth wave of the opioid crisis doesn’t only affect physical health—it also has profound implications for mental well-being. The combination of substance use and the challenges of recovery often leads to the development or worsening of mental health disorders.

1. The Connection Between Addiction and Mental Health

Substance use often coexists with mental health conditions such as depression, anxiety, or post-traumatic stress disorder (PTSD). Polysubstance use exacerbates this connection, as individuals may use stimulants to counteract the sedative effects of opioids or vice versa, creating a dangerous cycle of self-medication.

2. The Emotional Toll of the Fourth Wave

For individuals caught in the grip of addiction, the fourth wave can bring additional emotional challenges, including:

  • Increased Stress and Anxiety: Fear of unintentional fentanyl exposure creates constant worry for those struggling with substance use.
  • Trauma from Overdose Events: Witnessing or surviving an overdose can lead to PTSD, further complicating the recovery process.
  • Feelings of Isolation: Stigma around addiction, especially polysubstance use, often leaves individuals feeling alone and unsupported.

3. The Importance of Dual Diagnosis Treatment

Addressing both mental health and addiction simultaneously is essential for long-term recovery. At New Heights Recovery, we offer Dual Diagnosis Treatment, integrating mental health services with addiction care. Our approach includes:

  • Cognitive-Behavioral Therapy (CBT): Helping patients identify and change harmful

thought patterns that contribute to both addiction and mental health struggles.

  • Dialectical Behavior Therapy (DBT): Teaching skills to manage intense emotions, reduce self-destructive behaviors, and improve interpersonal relationships.
  • Trauma-Informed Care: Providing a safe, supportive environment for individuals with a history of trauma, ensuring they feel understood and respected throughout their recovery journey.

How New Heights Recovery in Columbus, Ohio, Can Help

At New Heights Recovery, we are committed to combating the fourth wave of the opioid crisis with compassionate care and evidence-based treatment. Our Addiction Treatment Center in Columbus, Ohio, provides a range of programs tailored to meet the unique challenges of opioid and polysubstance addiction.

1. Comprehensive Addiction Program

Our holistic Addiction Program addresses the root causes of substance use disorders, combining medical, psychological, and social support. Each treatment plan is personalized to meet the individual needs of our patients.

2. Partial Hospitalization Program (PHP)

For those requiring structured support, our Partial Hospitalization Program offers intensive therapy during the day, allowing patients to return home at night. This program is ideal for individuals transitioning from inpatient care or needing a higher level of treatment.

3. Intensive Outpatient Program (IOP)

Our Intensive Outpatient Program provides flexible care, allowing individuals to continue working, attending school, or managing family responsibilities while receiving treatment. Regular therapy sessions focus on relapse prevention, coping skills, and emotional resilience.

4. Alcohol and Drug Treatment

We specialize in treating a wide range of substance use disorders, including alcohol and drug addiction. Our evidence-based approaches, such as Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), empower individuals to overcome cravings and develop healthier habits.

5. Polysubstance Abuse Treatment

Addressing the complexities of polysubstance use requires a multi-faceted approach. Our services include:

  • Medical Detoxification: Managing withdrawal symptoms under 24/7 medical supervision.
  • Dual Diagnosis Treatment: Treating co-occurring mental health disorders alongside addiction.
  • Relapse Prevention Planning: Equipping patients with tools and strategies to maintain sobriety.
  • Family Support Programs: Involving loved ones in the recovery process to rebuild trust and communication.

Fighting the Fourth Wave Together

The fourth wave of the opioid crisis is a public health emergency that demands immediate action. At New Heights Recovery, we are here to help individuals and families navigate this challenging time with compassion, expertise, and hope.

If you or a loved one is struggling with addiction, don’t wait. The sooner you seek help, the better the chances of achieving lasting recovery. Contact New Heights Recovery in Columbus, Ohio, today to learn more about our Addiction Program, Partial Hospitalization Program, Intensive Outpatient Program, and other services. Together, we can break the cycle of addiction and build a healthier, brighter future. If you or a loved one would like to find out more, you can contact us here, or call us at (614) 858-8826.

FAQs on Fourth Wave of the Opioid Crisis

What is the fourth wave of the opioid crisis?

The fourth wave refers to the current phase of the opioid epidemic, characterized by the mixing of synthetic opioids like fentanyl with other substances such as methamphetamine, cocaine, and counterfeit pills. This trend has led to more complex and dangerous overdoses.

Why is the fourth wave more dangerous than earlier waves?

The fourth wave is more dangerous because of polysubstance use, where fentanyl is mixed with non-opioid drugs. This creates unpredictable and often deadly drug combinations, making overdoses harder to prevent and treat.

How can naloxone (Narcan) help during the fourth wave?

Naloxone can reverse opioid overdoses caused by drugs like fentanyl. However, it may not address the effects of other substances mixed with fentanyl, such as methamphetamine or xylazine, complicating overdose treatment.

What treatment options are available for polysubstance use?

At New Heights Recovery, we offer comprehensive treatment programs, including Addiction Programs, Partial Hospitalization Programs, and Intensive Outpatient Programs. These programs address both the physical and psychological aspects of addiction, including polysubstance use.

Why is fentanyl so dangerous?

Fentanyl is 50-100 times more potent than morphine, and even a tiny amount can cause a fatal overdose. Its presence in counterfeit pills and other substances makes it especially deadly.