Key findings Data from the National Vital Statistics System, Mortality From 2009 through 2019, the rate of overdose deaths involving both cocaine and opioids increased at a faster pace than the rate of overdose deaths with cocaine but no opioids. In 2019, 76% of overdose deaths involving cocaine also involved an opioid; the percentage varied by region, from 83% in the Northeast to 63% in the West. From 2009 through 2016, the rate of overdose deaths involving psychostimulants but no opioids was higher than the rate for deaths involving both drugs; from 2017 through 2019, the pattern reversed with a higher rate for deaths involving both psychostimulants and opioids. In 2019, 54% of overdose deaths involving psychostimulants also involved an opioid; the percentage varied by region, from 80% in the Northeast to 44% in the West.