Current wave of opioid crisis run by fentanyl combinations

The fourth wave of the opioid crisis continues to grow increasingly complex, dominated by “fentanyl plus” combinations of drugs that, in some cases, predictably follow historical patterns, and in others, turn logic on its ear. A leading national researcher on drug‐using behavior told ADAW that unlike fentanyl's original imposition into the drug supply, many of the combinations that have emerged since then appear to be demand‐driven, though the “why” of the demand is often hard to pinpoint.