While opioids have been involved in most of Alaska’s drug overdose deaths, another drug is a frequent contributor to those outcomes: methamphetamine.

A little over half of the fatal overdoses in Alaska from 2017 to 2023 involved methamphetamine use, most commonly in combination with opioids but also sometimes in combination with other types of drugs, said a new bulletin released by the state Department of Health’s epidemiology section.

The contribution of methamphetamine can be overshadowed by effects of opioids like fentanyl, said Riley Fitting, the state epidemiologist who wrote the bulletin.

Overdose deaths in Alaska typically involve acute opioid poisoning, the bulletin noted. But the health deterioration caused by long-term methamphetamine use, with harm to cardiovascular or respiratory systems or other body functions, can exacerbate impacts of opioid use and make people more at risk of fatal overdoses, the bulletin said.

From 2017 to 2023, about 60% of Alaska overdose deaths were among people who were taking more than one drug, according to state statistics.

Fitting said the combination of opioids, methamphetamine and possibly other drugs can make it difficult to pin down exact causes of individual overdose deaths.

“It’s not always clear-cut,” he said.

It is not common for methamphetamine alone to be the cause of overdose deaths, he said. In only about a fifth of the methamphetamine-involved fatal overdoses recorded from 2017 to 2023 was that the sole drug used, he said.

Statistics about mixed drug use hold lessons for health care providers, the bulletin said.

Emergency responders administering naloxone, an overdose-reversal drug, should be aware that the patients they are treating might also be using methamphetamine and can thus “remain agitated, intoxicated or at continued risk of adverse effects,” like heart or respiratory problems or psychological problems. That means close monitoring of patients is warranted even after naloxone is administered, the bulletin said. Naloxone, known under the brand name Narcan, rapidly reverses the effects of opioid overdoses.

Medical providers who are treating people for opioid addiction should also consider the potential complications of methamphetamine, Fitting said. Those extend beyond physical damage to behavioral and psychological concerns as the drug is a stimulant that can cause agitation or other problems, he said.

“If someone comes in for a nonfatal overdose, we can’t just assume that opioids are the only substance that was being abused,” he said.

The percentages of overdoses involving methamphetamine in combination with opioids or other drugs has remained fairly constant over recent years, the bulletin said.

But absolute numbers increased. From 2017 to 2023, Alaska’s rate of methamphetamine-related deaths increased by about 25%, the bulletin said.

Those absolute numbers have recently declined.

Nationally, overdose deaths dropped by about 26% in the most recently available annual statistics, the U.S. Centers for Disease Control and Prevention said.

Declines were reported in almost every state, including Alaska, where overdose deaths hit a record in 2023.

In the 12 months that ended in January, Alaska’s reported overdose death total was more than 10% below the total for the previous 12 months, according to the CDC.

The use of naloxone is one of the factors credited with decreasing overdose deaths nationwide.

The Alaska Beacon is an independent, donor-funded news organization. Alaskabeacon.com.