By Katie Pickles, Health Editor

Published: 19:21 EDT, 26 September 2023 | Updated: 03:06 EDT, 27 September 2023

Overdoses caused by combined fentanyl and stimulants including cocaine and meth have spiked 50-fold in just over a decade.

The rates of fentanyl overdoses that also involve powerful stimulants have grown so precipitously over the years that addiction experts have dubbed this the ‘fourth wave’ of the devastating opioid crisis that still has a stranglehold on the US.

Researchers reported that the proportion of drug overdoses involving both fentanyl and a stimulant rose from less than one percent in 2010 to nearly a third by 2021.

Compounding the tragedy even further, many users unwittingly consume fentanyl – minute doses of which are enough to kill – as it is frequently used as a cutting agent in cocaine and other illicit drugs to extend the supply and the high.

Naloxone has proven a game changer for reversing opioid overdoses in the process, having already saved thousands of lives, but the antidote does nothing to reverse overdoses from other drugs, leaving first responders without an effective stopgap.

As overdose deaths ballooned from around 38,000 in 2010 to more than 106,000 in 2021, the overdose rate involving fentanyl alongside a stimulant climbed.

The percent of overdose deaths in the US involving both fentanyl and stimulants increased from 0.6 percent (235 overdoses) in 2010 to about 32 percent (34,429 overdoses) in 2021, with the sharpest rise starting in 2015.

The researchers combed through a mountain of death records from the Centers for Disease Control and Prevention’s Wide-Ranging Online Database for Epidemiologic Research (WONDER) from 2010 through 2021.

They were then able to measure the annual percentages of overdoses involving fentanyl alone, stimulants alone, fentanyl and stimulants combined, and non-fentanyl or stimulant drugs.

During this time period, overdoses involving fentanyl without any additional stimulant also skyrocketed from slightly over seven percent in 2010 to nearly 36 percent eleven years later. 

Overdoses involving stimulants alone remained relatively stable, though, from nearly 15 percent in 2010 to slightly under 18 percent in 2021.

This ‘fourth wave’ of the opioid addiction epidemic, which had its start in the late 90s with the advent of extremely potent prescription pills like OxyContin, began in earnest in 2015, about two years after fentanyl overtook heroin as the deadliest opioid on the streets.

After the first wave spurred by prescription opioids came the second wave driven by a shift to heroin, followed by the third wave driven by an explosion in demand for and supply of fentanyl.

Dr Joseph Friedman, an addiction researcher at the David Geffen School of Medicine at UCLA said: ‘Fentanyl has ushered in a polysubstance overdose crisis, meaning that people are mixing fentanyl with other drugs, like stimulants, but also countless other synthetic substances. This poses many health risks and new challenges for healthcare providers.

‘We have data and medical expertise about treating opioid use disorders, but comparatively little experience with the combination of opioids and stimulants together, or opioids mixed with other drugs.’

Upon examining the issue closely, Dr Friedman and fellow researchers who authored the study found that the primary stimulant combined with fentanyl in southern and western states was methamphetamine while cocaine was the combination of choice in northeastern states.

In 2021, fentanyl overdoses involving meth were most common in western states including Alaska, California, Hawaii, New Mexico, Oregon, and Washington, as well as West Virginia and Kentucky. 

In a wide swath of northeastern states such as Rhode Island, Vermont, and Massachusetts, meanwhile, cocaine was the most common stimulant involved.

Dr Friedman said: ‘We suspect this pattern reflects the rising availability of, and preference for, low-cost, high-purity methamphetamine throughout the US, and the fact that the Northeast has a well-entrenched pattern of illicit cocaine use that has so far resisted the complete takeover by methamphetamine seen elsewhere in the country.’

The rise of polysubstance overdoses is not monitored in the same way as overdoses attributed to fentanyl alone, as US drug surveillance is limited in how much data it can gather about poisoning involving more than just one drug on its own.

Researchers also warned about the rise of sinister counterfeit pills disguised as prescription drugs sold on the street including Percocet and Xanax.

Many people find out too late that their drugs were laden with fentanyl which can prove deadly at infinitesimal doses – think an amount that would fit on the tip of a pencil.

They said: ‘In recent years, counterfeit pills have grown to represent over a quarter of all illicit fentanyl seizures.

‘Counterfeit pills have the potential to transform overdose risk as they may expand the markets for illicit synthetic drugs to subpopulations, such as adolescents, who may be less likely to consume powder fentanyl products.’

This is not a new problem. In 2018, rapper Mac Miller passed away after an accidental overdose due to a fatal combination of cocaine with pills that dealers who sold to him alleged were oxycodone and Xanax. The pills were actually pressed with fentanyl, enough to kill the young rapper at just 26 years old.

The study by UCLA researchers was published Wednesday in the journal Addiction.

A million US deaths could be averted each year if mortality rates in America were on par with those in other rich countries, a damning report has found.

Researchers looked at the rate of all-cause mortality per population size since the 1930s in nearly two dozen peer nations, including the UK, Canada, Japan, Australia and 17 European countries. 

They found that despite the US being the richest, it has suffered more deaths per capita than any of the 21 other nations since around 1980, which have reached ‘unprecedented levels’ in recent years.

The study noted the opioid and fentanyl epidemic, gun violence, and obesity-related deaths, which have all been exacerbated by the Covid pandemic, are the reason America is an outlier.

The study, published in Proceedings of the National Academy of Sciences Nexus, found that by 2019, around 600,000 deaths could have been prevented if the US had similar mortality rates to its peer nations.

But in 2020 and 2021, this rose to 1.1million.  

Steffie Woolhandler, senior author and professor at the School of Urban Public Health at Hunter College, blamed America’s healthcare system, insurers, corporate greed and politicians for the avoidable deaths the country has seen.

‘We waste hundreds of billions each year on health insurers’ profits and paperwork, while tens of millions can’t afford medical care, healthy food, or a decent place to live,’ Woolhandler said.

‘Americans die younger than their counterparts elsewhere because when corporate profits conflict with health, our politicians side with the corporations,’ she added.

The United States was only one of a handful of countries on the list that does not provide universal healthcare coverage to its residents. 

Despite the number of excess deaths peaking in 2020 and 2021, the team from Boston University School of Public Health, University of Pennsylvania, Harvard Chan School of Public Health and Hunter College found America’s excess death rate had been worsening since the 1980s.

During World War II and thereafter, America had a lower mortality rate than peer countries. 

In the 1960s and 70s, the rate was similar to other wealthy countries. 

However, in the 1980s, the number of excess deaths began to rise, climbing to approximately 622,500 in 2019. 

Deaths then spiked in 2020 and 2021 during the pandemic. Those years saw approximately one million excess deaths.

In the years between 1980 and 2021, there were 13.1 million ‘missing Americans’. 

Study lead and corresponding author Jacob Bor, an associate professor of global health and epidemiology at Boston University, called the number of missing Americans ‘unprecedented in modern times.’

Nearly half of the missing Americans died prior to age 65 in 2020 and 2021, a level of excess deaths Bor said was particularly stark. 

‘Think of people you know who have passed away before reaching age 65. Statistically, half of them would still be alive if the US had the mortality rates of our peers. The US is experiencing a crisis of early death that is unique among wealthy nations,’ Bor said. 

The Centers for Disease Control and Prevention (CDC) reported life expectancy in 2020 was 77 years old, a decline of nearly two years from 2019. In 2021, life expectancy declined again to 76.4 years. 

In 2020, nine of the 10 leading causes of death were the same as in 2019, though five causes switched ranks. 

However, heart disease and cancer remained the top two, while Covid was newly added and took the third slot. 

Unintentional injuries moved to fourth place and stroke moved to fifth place.

In 2021, nine of the 10 leading causes of death remained unchanged from the year prior and heart disease, cancer and Covid were the top three again.

Unintentional injury and stroke remained the fourth and fifth top causes of death in 2021, respectively. 

During both 2020 and 2021, deaths among all ages increased year-over-year, except those among one- to four-year-olds, which declined slightly only in 2020. 

‘Living in the US is a risk factor for early death that is common across many US racial and ethnic groups,’ Bor said. 

‘Whereas most health disparities studies assess differences between US racial/ethnic groups, such an approach renders the poor health of Whites invisible and grossly underestimates the health shortfall of minoritized groups. 

‘By using an international benchmark, we show that Americans of all races and ethnicities are adversely affected by the US policy environment, which places a low priority on public health and social protections, particularly for low-income people.’ 

Accounting for the future years lost due to someone dying prematurely, researchers estimate that in 2021, excess deaths translated to 26.4 million years of life lost when compared to peer countries. 

Based on the study results and the trend of excess deaths in the US, Mr Bor is not optimistic mortality rates will rebound in the near future, even as Covid deaths fall to some of their lowest numbers. 

‘The US was already experiencing more than 600,000 missing Americans annually before the pandemic began, and that number was increasing each year. There have been no significant policy changes since then to change this trajectory.

‘While COVID-19 brought new attention to public health, the backlash unleashed during the pandemic has undermined trust in government and support for expansive policies to improve population health.

‘This could be the most harmful long-term impact of the pandemic, because expansion of public policy to support health is exactly how our peer countries have attained higher life expectancy and better health outcomes.’

Facebook has found itself in hot water after wading into the debate over whether off-shore wind farms are responsible for a surge in whale deaths across the east coast.

Environmentalist Michael Shellenberger has accused the internet giant of ‘censoring accurate information’ after it slapped a content warning on a post about the beaching of 300 whales since 2017.

Officials admit there has been an ‘unusual mortality event’ on the east coast in the last six years with strandings reported from New York to North Carolina, but have insisted the string of new wind farms are not responsible.

The controversy blew up days after Facebook CEO Mark Zuckerberg was threatened with contempt of Congress amid claims the social media firm removed posts at the direction of the Biden White House.

‘Facebook is censoring accurate information about the relationship between industrial wind energy development and the increase in whale deaths off the East Coast,’ Shellenberger said.

‘Why is Facebook censoring accurate information and spreading disinformation?’

Construction is underway on two new wind farms off Rhode Island and Massachusetts after the White House pledged to deploy 30 gigawatts of offshore wind by 2030, enough to power 10 million homes.

Two are already operating off Rhode Island and Virginia Beach despite fury from conservationists and commercial fishing operators, and the $10billion Virginia development is expected to feature more than 175 wind turbines by 2026.

In January, the Clean Ocean Action environmental group asked President Joe Biden to step in and halt the wind farm projects, saying there was evidence it was related to the whale deaths.

‘We’ve gone too far, too fast,’ Clean Ocean Action executive director Cindy Zipf said.

‘Over 2.2 million acres is being allocated to offshore wind and 10,000 miles of cables.

‘This alarming number of deaths is unprecedented in the last half century, the only unique factor from previous years, is the excessive scope, scale, and magnitude of offshore wind powerplant activity in the region.’

The latest dead whale washed ashore on Takanassee Beach in New Jersey on Saturday, and this year is on course to be the worst on record for fatal strandings on the east coast.

Shellenberger has called the issue the ‘biggest environmental scandal in the world’ and delivered a series of angry posts to his thousands of Facebook followers this week.

‘The government says it’s not because of the wind industry’s high decibel pile driving and boat traffic in previously pristine waters,’ he wrote.

‘They’re lying. And now we have the proof.’

That triggered Facebook watchdogs to slap a warning, claiming the post was ‘missing context and could mislead people’.

It also linked to an article by Facebook partner Factcheck.org insisting there is no reason to believe wind farms are to blame.

‘Several factors, experts and officials have said, could be increasing the risk of these hazards,’ the checkers wrote.

‘For one, climate change is warming oceans and changing the distribution of prey that marine species depend on.

‘As a result, whales are altering their migration routes and moving out of protected areas and closer to the shores, where they are more vulnerable to ship strikes and entanglement with fishing gear.’

It pointed to autopsies carried out by the official National Oceanic and Atmospheric Administration suggesting that 40 per cent of dead humpbacks were killed by hitting boats or getting tangled in ropes.

But they admit: ‘The causes for the other 60 per cent have been inconclusive, in part, officials say, because the carcasses decompose quickly, making it difficult to determine a cause of death.’

Facebook automatically moves reduces the visibility of posts flagged by its fact-checking partners, including AFP, reducing the visibility of false or misleading content.

But earlier this month its parent company Meta changed its settings allowing users to partially disable the fact-checking that they see.

‘We’re giving people on Facebook even more power to control the algorithm that ranks posts in their feed,’ a Meta spokesman told AFP.

We’re doing this in response to users telling us that they want a greater ability to decide what they see on our apps.’

‘For the last 20 years, Facebook CEO Mark Zuckerberg has said that his social media company is the “digital equivalent of a town square,” committed to factual accuracy, and protecting the natural environment,’ Shellenberger said.

‘Facebook knows its “fact checks” are just their “opinion”.

‘Thus, labeling FactCheck.org, which in this case is simply repeating US government misinformation, as a “fact-checker” is disinformation.’

E-cigarettes have been linked to five deaths in Britain, MailOnline can reveal today.

None of the fatalities, which have all occurred since 2010, are proven to have been caused directly by vaping. No ages were mentioned for any of the deaths.

But health chiefs tasked with policing the safety of e-cigs admit there is ‘a suspicion’ the gadgets may have been to blame.

Two were put down to heart disorders, including one cardiac arrest.

Respiratory complications were blamed for the other three deaths, with one caused by inhalation of fat — a known potential consequence of vaping.

Almost 1,000 serious adverse reactions to e-cigs have also been logged by Britain’s health watchdog including blood, nervous system and respiratory disorders, as well as cancer and injuries such as burns.

Leading experts today told MailOnline the figures we uncovered ’emphasise vaping is not safe’ and warned the data may only represent ‘the tip of the iceberg’.

But others insisted the gadgets are ‘substantially less harmful than smoking’.

It comes amid growing fears over Britain’s burgeoning child vaping crisis, with rates having doubled within years.’

Colourful displays of the gadgets, sold for as little as £5, litter high streets across the UK. 

Predatory manufacturers lure kids in with flavours such as bubblegum and cotton candy and some shops even sell the devices next to sweets.

Rishi Sunak has vowed to crackdown on the crisis. 

Other experts have also demanded a total ban on disposable vapes such as Elf bars, popular with teenagers. New Zealand has already announced such a move.

The five fatalities from vaping are logged through the Yellow Card system, set up in the 1960s in the wake of the thalidomide scandal.

Officials use the same database to track the safety of Covid vaccines.

It allows doctors, pharmacists and patients themselves to report adverse reactions believed to be caused by prescription and over-the-counter drugs, implants and alternative medicines.

This can lead to them being reviewed, having warnings added to the label or even being taken off the market.

Since 2016, the scheme, run by The Medicines and Healthcare products Regulatory Agency (MHRA), has also covered e-cigarettes and refill containers.

However, a yellow card report – named after the yellow forms initially used in the 1960s – does not prove the product in question was to blame.

Regarding e-cigs, the MHRA says: ‘It may be difficult to tell the difference between something that has occurred naturally and an adverse reaction.

‘Sometimes reactions can be part of an underlying condition rather than being caused by the e-cigarette.’

It adds: ‘Many factors have to be considered when assessing whether an e-cigarette has caused a reported adverse reaction.’ 

Experts however fear the true toll of vaping adverse reactions could be far higher if swathes of the population are unaware of the yellow card scheme.  

Authorities track the database closely to spot any ‘potential patterns of concern’.

Similar issues surrounding blood clots caused by AstraZeneca’s Covid vaccine were found months into the historic immunisation drive.

According to the drug watchdog’s 25-page document of adverse reactions for e-cigs, some 942 reports of reactions have been logged since January 1, 2010. 

Almost half (405) of all reports logged cited respiratory disorders, including 47 with oropharyngeal pain and 57 with shortness of breath. 

Some 120 were for gastrointestinal disorders, while 114 general disorders, including chest pain, fatigue and malaise, were also noted. 

One report of laryngeal cancer, three of atrial fibrillation – a condition that causes an irregular heart rate – and one anaphylactic shock, were also logged by the MHRA. 

An MHRA spokesman told MailOnline: ‘We keep the safety of e-cigarettes under close review and convene working groups when required to review data and evidence surrounding suspected adverse reactions associated with e-cigarette usage.’

They added: ‘If you have purchased a product that is not published on our website, you should return it to the retailer or your local trading standards service.

‘If you experience an adverse effect from use of a nicotine-containing e-cigarette product, please report it to us via our yellow card scheme. 

‘It is important to note that a report of an adverse reaction does not necessarily mean that the e-cigarette has caused the reaction, only that the submitter suspects it may have. 

‘Many factors have to be considered when assessing whether an e-cigarette has caused a reported adverse reaction.’

In 2019, a 57-year-old British factory worker was named as the first e-cig user in the world feared to have developed a fatal disease directly linked to his vaping habit.

Terry Miller, 57, from Gateshead, Tyne and Wear, died in 2010 after developing lipoid pneumonia, with medics confirming oil from vaping fluid was found in his lungs.

After smoking around 20 cigarettes a day for 41 years, he decided to give up and bought an e-cigarette from his local pharmacy, believing it was an healthier option. 

He began vaping every day and would often buy nicotine liquid refills and new e-cigarettes on the internet from a company based in the South of England. 

But around eight months after he switched to vaping in 2010, Terry’s lungs began to fail and he was diagnosed with fibrosis. 

E-cigs allow people to inhale nicotine in a vapour — which is produced by heating a liquid, which typically contains propylene glycol, glycerine, flavourings, and other chemicals.

Unlike traditional cigarettes, they do not contain tobacco, nor do they produce tar or carbon — two of the most dangerous elements.

Vaping has risen rapidly over the past decade to reach record levels in the UK, with an estimated 4.3million people who are regular vapers, according to a report last year. 

The data suggested that 8.3 per cent of adults in England, Wales and Scotland vape, up from 1.7 per cent a decade ago, which equated to about 800,000 people. 

Health chiefs say e-cigarettes carry a fraction of the risk of smoking and believe they can play a key role in weaning the remaining five million smokers in Britain off tobacco and putting an end to the killer habit.

Although widely viewed as safer than smoking, the long-term effects of vaping still remain a mystery.

Doctors fear there could be a wave of lung disease, dental issues and even cancer in the coming decades in people who took up the habit at a young age.

Dr Salim Khan, head of department for public health at Birmingham City University, told MailOnline: ‘The MHRA analysis is welcomed as it provides additional evidence of the potential harm that e-cigarettes and vaping can cause.

‘In addition to more than half of the reports relating to respiratory disorders, there are several non-respiratory health events listed which is consistent with published research findings.

He added: ‘Whilst e-cigarettes and vaping are assumed to be the causal factor, it is important to recognise that there may be other contributing factors which could have resulted in the health events listed.

‘It is also important to note that the volume and pattern of adverse respiratory and other health events associated with e-cigarette use or vaping in the UK may not be fully represented by the data.

‘The data may only represent the tip of the iceberg.

‘To establish the potential impact that e-cigarettes and vaping are having on people’s health, we require continued data collection and reporting. We need rigorous evidence that clearly demonstrates the detrimental impact of e-cigarettes and vaping on health.’

Professor Jamie Brown, director of University College London’s Tobacco and Alcohol Research Group, meanwhile told MailOnline: ‘These new data emphasise that vaping is not safe and never smokers should not vape. 

‘However, to put these numbers in context, cigarette smoking causes about 76,000 deaths a year in the UK.

‘So, in the same period, cigarette smoking caused approximately 1million deaths in the UK.’

Equally, Professor John Britton, who sits on the Royal College of Physicians Tobacco Group, said the figures show reactions ‘are very rare’.

He told MailOnline: ‘These reports demonstrate adverse events from vaping, and in particular serious adverse events, are very rare. 

‘In contrast, since 2010 tobacco smoking has killed around one million people. 

‘We can thus be confident that vaping is substantially less harmful than smoking.’ 

Under its position statement, the Royal College of Physicians Tobacco Group acknowledges that while e-cigarettes ‘are probably more hazardous than nicotine replacement therapy, the harm is unlikely to exceed 5 per cent of that from smoking tobacco’. 

Mark Oates, founder of consumer advocacy group We Vape, also told MailOnline it is ‘important to keep the MHRA findings in perspective’ but acknowledged the research into the health impact of the devices.

He said: ‘We welcome detailed and continuous research into the health effects of vaping so the safest possible devices are available to smokers trying to quit.

‘Some 4.3million people now vape in the UK and there have been no confirmed deaths as a result. 

‘In contrast, since 2010, more than a million people have been killed by smoking. It’s therefore important to keep the MHRA findings in perspective.

‘Following the Covid vaccine rollout and booster scheme, for example, there were more than 11,500 reports of side effects from the jab using the Government’s yellow card system, yet we didn’t halt a programme that has invariably saved countless lives.’

He added: ‘Vaping is helping millions of people avoid a preventable and often agonising death, around the world, every year from smoking. 

‘This excellent news should not be overlooked when studying self-reported side effects in a significant minority of vapers.’

Earlier this month however, leading paediatricians also warned children were being hospitalised with vaping-induced breathing difficulties amid a ‘disturbing’ youth vaping epidemic.

The Royal College of Paediatrics and Child Health (RCPCH) warned that e-cigarettes ‘are not a risk-free product and can be just as addictive, if not more so than traditional cigarettes’.

It called for urgent action to protect youngsters, saying experts agree that longer-term data is needed on the effects of vaping, particularly in regard to cardiovascular disease.

Under an anti-smoking push, last month health minister Neil O’Brien revealed a £3million taskforce would be established to enforce the current rules of selling of vapes.

But one million cigarette addicts will also get e-cigarette ‘starter kits’ as part of a ‘swap to stop’ scheme.

The free kits are set to be offered to almost one in five of all smokers in England at an estimated cost of £45million over two years. 

Health chiefs hope the world-first policy will make England smoke-free.

But Mr O’Brien also acknowledged No10’s ambition to crackdown on the sale of e-cigarettes to under-18s as well as the colourful packaging and candy flavours they use to lure kids in.

It is illegal to sell vapes to under-18s but social media carries posts from teenagers showing vapes and discussing flavours such as pink lemonade, strawberry, banana and mango. 

A damning MailOnline expose in April laid bare the true scale of the problem and the marketing tactics of vape retailers trying to target children. 

Tom Padley, now 19, from Putney, London, told MailOnline at the time that he had been using vapes since the age of just 13.

Tom, who picked up the habit in boarding school, said ‘it’s not like cigarettes, where you would have to find a place to go outside and do it — you can just do it non-stop indoors’. 

But six years into vaping, he has begun to suffer health issues.

‘I get ill a lot more. I get ulcers occasionally in my mouth. I have a lot of coughs. I guarantee it’s massively increased due to vaping,’ he told MailOnline.

Last month, the BBC also discovered ‘highlighter vapes’, confiscated from youngsters at a college in Kidderminster, contained dangerous levels of lead, nickel and chromium.

The gadgets, which can cost as little as £5, were over 9.6 times the safe level of nickel and 6.6 times the safe level of chromium.

Exposure to lead can impair brain development, while the other two metals can trigger blood clotting. 

The bodies of the five Titanic sub crew may never be recovered from the ‘unforgiving’ ocean where they perished, the US Coast Guard announced grimly today after confirming that shattered pieces of the vessel have been found 500meters from the bow of the famous ship the men died trying to see. 

The nail-biting search for the Titan, a 21ft submersible operated by OceanGate Expeditions, drew to a devastating close today when a remote operated submarine from a Canadian ship found broken pieces of it on the ocean floor. 

Search and rescue efforts say they likely died on Sunday – before military planes using sonar buoys detected what they thought could have been SOS ‘banging’ sounds in the water. 

‘The implosion would have generated a significant, broadband sound that the sonar buoys would have picked up,’ explained Rear Admiral John Mauger of the US Coast Guard at a press conference today. 

It would have been an instant death for the men, some of whom had paid $250,000 each to see the famous shipwreck. 

In a gut-wrenching blow for the victims’ families, experts say there is little prospect of recovering any of their remains.  

‘This is an incredibly unforgiving environment down there. The debris is consistent of a catastrophic implosion of the vessel.. we’ll continue to work and search the area down there – but I don’t have an answer for prospects at this time,’ Paul Hankin, a deep sea expert involved in the search, said. 

In addition to the landing frame and rear cover that were the first pieces of debris detected, the ROV submarine also found fragments of the pressure hull – the main body of the submersible. 

‘The debris is consistent with the catastrophic loss of the pressure chamber. Upon this determination we immediately notified the families. On behalf of the Coast Guard and the entire unified command, I offer my deepest condolences to the families,’ Rear Admiral Mauger said.

In its own statement, OceanGate said this afternoon: ‘We now believe that our CEO Stockton Rush, Shahzada Dawood and his son Suleman Dawood, Hamish Harding, and Paul-Henri Nargeolet, have sadly been lost.

‘These men were true explorers who shared a distinct spirit of adventure, and a deep passion for exploring and protecting the world’s oceans. 

‘Our hearts are with these five souls and every member of their families during this tragic time. We grieve the loss of life and joy they brought to everyone they knew.’

The company added: ‘This is an extremely sad time for our dedicated employees who are exhausted and grieving deeply over this loss. 

‘The entire OceanGate family is deeply grateful for the countless men and women from multiple organizations of the international community who expedited wide-ranging resources and have worked so very hard on this mission. 

‘We appreciate their commitment to finding these five explorers, and their days and nights of tireless work in support of our crew and their families.

‘This is a very sad time for the entire explorer community, and for each of the family members of those lost at sea. 

‘We respectfully ask that the privacy of these families be respected during this most painful time.’ 

Earlier, David Mearns, who was friends with two of the men on board, said the ‘only saving grace’ for the men was how quickly their deaths would have occurred. 

‘The hull hasn’t yet been found but two very important parts of the whole system have been discovered and that would not be found unless its fragmented. That really indicates what is the worst case scenario which is a catastrophic failure, an implosion. 

‘The only saving grace is that it would have been immediate, literally in milliseconds and the men would have no idea what was happening… my worst fears have now been realized,’ he said. 

The world has been praying for a ‘miracle’ after rescuers estimated the vital oxygen supply would end at 7.08am EST (12.08pm UK time, 9.09pm Sydney) on Thursday.

Officials said the field had been found by Odysseus 6k, a remote operated vehicle (ROV) deployed by the Canadian vessel, the Horizon Arctic, that can dive 20,000ft underwater. 

A glimmer of hope came yesterday when the Coast Guard confirmed consistent ‘banging’ noises had been detected by P-3 aircraft, but the search teams were unable to find the source of the sound, or confirm that they were the SOS signals the world had hoped for. 

The families of the five men on board the sub are yet to publicly react to news of the debris discovery.

Experts have for days warned of the possibility that the Titan had sprung a leak and imploded under the pressure, which is 400 times that experienced at sea level. 

‘They would be dead before they knew anything had even happened,’ L. David Marquet, a retired Navy nuclear submarine commander, said earlier this week. 

If the debris does not belong to the Titan, the Coast Guard has vowed to continue its search. 

Earlier this morning, Rear Admiral John Mauger, who is coordinating the effort from Boston, said during an appearance on NBC’s Today show: ‘People’s will to live has to be accounted for.’ 

The submersible’s oxygen theoretically should have run out at 8am EST (1pm BST) Thursday, according to the 96 hours limit listed on OceanGate’s specs of the ship. 

The family of British billionaire, Hamish Harding, have spoken of their fury that it took OceanGate’s mothership, the Polar Prince, eight hours to report the sub missing on Sunday. 

The Titan submerged at 8am (1pm BST) and lost communications at 9.45am (2.45pm) but was not reported as missing to the US Coast Guard until 5.40pm (10.40pm). 

The sub was due to return to the Polar Prince ay 3pm EST (8pm BST) Sunday. 

Since Sunday night, there has been a frantic, international effort to find it and save the men on board.  

Those stuck onboard the sub included British billionaire Hamish Harding, OceanGate CEO Stockton Rush, French navy veteran PH Nargeolet and Pakistani businessman Shahzada Dawood and his son Suleman, who was just 19 and a student at Strathclyde University in Scotland. 

 The Titan craft, run by OceanGate Explorations, submerged on Sunday at 1pm UK time (8am EST and 10pm in Sydney) around 400 miles southeast of St John’s, Newfoundland.

At 2.45pm it lost contact with its mothership, the Polar Prince. But it wasn’t reported missing to the US Coast Guard until 10.40pm.

Kathleen Cosnett, a cousin of UK businessman Hamish Harding, 58, who was on the sub, said the eight-hour delay before contacting the authorities was ‘far too long’.

She told the Telegraph: ‘It’s very frightening. It took so long for them to get going to rescue them, it’s far too long. I would have thought three hours would be the bare minimum.’  

Titan lost communication on Sunday while about 435 miles south of St John’s, Newfoundland, during a voyage to the Titanic off the coast of Canada. The last ‘ping’ of its homing device was heard on Sunday afternoon – directly above the world’s most famous wreck.

A Canadian Navy ship carrying medics specializing in treating health issues relating to deep-sea diving arrived on the scene this morning on the HMCS Glace Bay, according to officials. 

They also brought a  hyperbaric chamber – which can be used for decompressing divers after they return to the surface. 

Above the wreck is a flotilla of at least ten ships, two robot subs and several aircraft scanning the Atlantic for any sign of Titan as sonar continues to hear a banging noise from the depths.  

Speaking today to Sky News, Rear Admiral John Mauger confirmed the initial reports suggesting the noise heard by sonar buoys was ‘background ocean noise’.

‘We’ve taken that information and shared it with top leading experts from the US Navy and the Canadian Navy, and they’re working on the analysis of that information, they’re continuing to work on the analysis of that information,’ he said. 

‘The initial reports is that there’s a lot of the sounds that were generated were from background ocean noise, but they continue to … look for all available information there.

‘What’s important to me, and what’s important as the unified command, is that we’ve continued search in the areas where noise was detected with the ROVs that we have from the time of that detection, so we’re not waiting for this analysis to take action.

‘The analysis is really helpful to our overall search-and-rescue efforts, but we’re not waiting on it, we’ve moved the remote operated vehicles that we’ve had on site to those areas where noise was detected.’

Shipping experts Marine Traffic have shared an animation of the ships rushing to the search zone. Titan’s mothership Polar Prince has been searching the area since Sunday and is zig-zagging the site in the hope that it will appear on the surface or get back in contact after communications cut out more than 72 hours ago. 

A Royal Navy submariner, as well as equipment from a British company, has been sent to assist in the search for Titan. Number 10 said Lieutenant Commander Richard Kantharia had been ’embedded… to assist the search and rescue effort’.

Rob Larter, a marine expert at the British Antarctic Survey, told a press conference on Thursday that he thought the Victor 6000 was the ‘main hope’ for an underwater rescue.

Alistair Greig, a professor of marine engineering at University College London, said the robot’s two manipulator arms could potentially allow it to untangle the Titan, or attach a device that could float it to the surface.

The Victor 6000 also has strong lights, allowing it to see through some of the murk at such depths.

But the experts warned that the rescuers would need to know fairly precisely where to look for Titan, which currently does not seem to be the case.

Finding the submersible ‘could potentially take weeks of intense survey,’ Larter warned.

And even if search teams do find the submersible, a rescue operation could take up precious time.

In a normal situation, it would take two hours for a ROV like the Victor 6000 to get down to the necessary depth – and another two hours to float back up, Greig said.

The missing submersible is also reportedly bolted from the outside, which could take up more time, he added.

Larter said it was a ‘desperate situation’.

‘It’s kind of unimaginable if people are alive, trapped in a submersible with oxygen supplies running down.

‘An objective assessment of where things are at the moment: it doesn’t look good,’ Larter said, adding that it was important to stay optimistic.

The Coastguard has admitted it does not know if it is the five men hammering on the side of their sub or simply the sound of the sea including perhaps debris falling from the Titanic itself at 12,500ft below the surface. 

But even if it is discovered it will take many hours to save Titan – meaning that the oxygen could run out before they get to the surface. Rescue efforts to find them have continued overnight – and are becoming ever more desperate.

Oceanographer and water search expert Dr David Gallo said today: ‘It’s going to be almost impossible. We need a miracle — but miracles do happen’. 

But former Royal Navy Officer, Chris Parry, said as Midday approached: ‘I’m afraid time’s up – I don’t think there’s any prospect of getting those people out alive now’.

It is a bleak picture for those trapped inside the stranded vessel, but officials have continued to insist that the hunt is ‘100 per cent’ still a search and rescue mission. 

Rescuers searching for the missing Titanic explorers had been racing against the clock as they struggled to find the source of underwater ‘banging noises’ detected earlier this week. 

Canadian aircraft picked up the sounds by sonar – some of which were said to be heard at regular 30-minute intervals – as recently as yesterday afternoon, close to where the Titan submersible disappeared.

But the Coast Guard admitted last night that extensive searches around the area 435 miles off Newfoundland had so far ‘yielded negative results’.

Rescuers were insistent that they would continue to look for the men even after the 96 hour oxygen window expired. 

Response co-ordinator Captain Jamie Frederick for First Coast Guard District said: ‘This is a search and rescue mission, 100 per cent.’

Locals are still reeling from the deaths of two children at a packed Bournemouth beach last week. 

Sunnah Khan, 12, and Joe Abbess 17, drowned on May 31 after reportedly being swept from a sandbank, while eight other beachgoers got into difficulty in the water.

Although Dorset Police are yet to work out exactly what happened, a father of one of the survivors said his daughter was one beachgoer carried by a ‘riptide’ near the pier.

While this is unconfirmed, Dorset Police said an investigation is ‘looking at all circumstances’ including weather, wind conditions and the state of the water.

Here, MailOnline looks at the science behind the phenomenon – and the best way to act if you ever get caught in one. 

WHAT IS A RIPTIDE?

Rip tides, more accurately known as rip currents and also known as simply ‘rips’, are fast-moving channels of water that move away from the shore and towards the open sea. 

They can reach speeds of up to five miles per hour – faster than an Olympic swimmer – making them a leading surf hazard for all beachgoers. 

The National Weather Service explains: ‘Rip currents form when waves break near the shoreline, piling up water between the breaking waves and the beach. 

‘One of the ways this water returns to sea is to form a rip current, a narrow stream of water moving swiftly away from shore, often perpendicular to the shoreline.’ 

Although a father of one of the survivors said his daughter was carried by a ‘riptide’, the more accurate term for these sorts of currents at beaches are simply ‘rip currents’. 

Gerd Masselink, a professor in coastal geomorphology at the University of Plymouth, told MailOnline: ‘Rip currents are often referred to as rip tides – this is an incorrect term and we have been campaigning for decades to get rid of the term, to no avail.’

Professor Masselink is part of a research project looking specifically at rip currents at Bournemouth – which are common there – and their link with coastal structures. 

‘They especially occur when the wind is blowing along the beach and waves strike the coast at an angle,’ he told MailOnline. 

‘This generates shore parallel currents that get deflected seaward when they encounter shore perpendicular coastal structure, such as groynes and piers, resulting in seaward flowing to currents.’ 

Chris Brewster, retired lifeguard chief for the San Diego Lifeguard Service, agreed that the term riptide is a ‘misnomer’ because ‘rip currents are not caused by tides’. 

‘That was an old belief that has been disproven,’ he told MailOnline. 

‘Typically wherever there is a jetty, pier or other structure, and waves, rip currents will form nearby.’

WHAT DO RIP CURRENTS LOOK LIKE? 

Rip currents can be seen from afar, so if you’re at a beach it’s worth having a look at the surf zone before you enter.

They look much like a road or river running straight out to sea, like a strip of blue amongst the crashing white of the waves. 

There’s a noticeable break in the pattern of the waves where a rip current is, although this is best viewed from a high vantage point – which is why lifeguards sit on high ‘tower-like’ chairs. 

ARE RIP CURRENTS CAUSED BY BOATS?

Dorset Police released a statement the day after the incident saying that a man ‘on the water at the time’ had been arrested on suspicion of manslaughter, although he’s since been released under investigation. 

His release comes as officers seized a cruise boat called The Dorset Belle placing it under the guard of Poole Harbour, five miles away from Bournemouth Pier from which it usually sails. 

It’s unconfirmed whether a rip current did occur last Wednesday or how it was related to the pleasure boat that was detained by police, the Dorset Belle. 

‘Insiders’ have suggested the ‘sudden riptide’ was said to have contributed to their deaths and could have been created by the boat. 

A source told The Sun: ‘They were on a sandbar to the east of the pier when the Dorset Belle moored alongside the pier. 

‘It created a riptide which deluged everyone on the sandbar and effectively forced them further out to sea.’

However, boats don’t cause rip tides or rip currents according to Professor Masselink; rather they are formed by the natural interaction of the water. 

WHY ARE RIP CURRENTS DANGEROUS? 

Rip currents can sweep even the strongest swimmer out to sea and result in fatalities, as those caught up in them try to resist. 

When in a rip current, panicked swimmers often try to counter it by swimming back to shore – putting themselves at risk of drowning because of fatigue. 

‘The danger arises when a misinformed swimmer uses an inadequate strategy to escape the rip, such as fighting the current directly,’ said Dr Sergio Maldonado, an expert in environmental fluid mechanics at the University of Southampton. 

‘This can lead to fatigue, panic, and in some cases drowning.

‘Swimming directly against the rip can require several times more power from the swimmer than other strategies advised by lifeguards.’ 

A rip current is typically the strongest about a foot off of the bottom of the water, according to the American Boating Association. 

As a result, this can cause someone’s feet to be knocked out from under them, making it feel like something under the water is pulling from below. 

HOW TO SURVIVE A RIP CURRENT 

The best way to escape a rip current is swimming parallel to the shore, rather than towards it, and above all, keep calm. 

Swimming back towards the shore just means you are swimming into the rip, which will tire you out and could lead to drowning. 

Alternatively, floating with the current may return you to a sandbank – a deposit of sand forming a shallow area in the sea.

National Oceanic and Atmospheric Administration gives the following advice if ever caught in a rip current: ‘Don’t fight it. Swim parallel to the shore and swim back to land at an angle.’ 

The best way to avoid rips altogether is to choose a lifeguarded beach and always swim between the red and yellow flags, which have been marked based on where is safer to swim in the current conditions. 

Virginia officials have launched a war on fentanyl, vowing to greatly reduce the number of deaths from fentanyl in his state.

Gov Glenn Youngkin, a Republican who entered office in 2022, called fentanyl a ‘weapon of terrorism’. 

Fentanyl was responsible for killing at least 70,600 Americans in 2022 and caused more than 1,950 deaths in Virginia alone. 

The synthetic opioid enters the US through the southern border and contaminates the illicit drug supply, ravaging local communities and major cities alike. 

The Republican governor issued a laundry list of initiatives to fulfill his goal of reducing opioid overdoses in Virginia by 20 percent during his term in office.

Gov Youngkin signed the executive order on Tuesday directing the Department of Health to develop a plan for wastewater surveillance ‘to detect the frequency, potency, and occurrences of fentanyl use in specific locations’.

The order also granted individual counties within the state more leeway to secure kits of the overdose reversal ‘miracle’ drug naloxone and directs law enforcement to step up efforts to interdict drug shipments into the state.

It also directed relevant state departments including those for health, social security, and corrections, to improve fatal overdose surveillance, drug interdiction, and public awareness.  

Opioids, particularly the ultra-potent synthetic fentanyl, have taken a significant toll on Virginians, who have seen the number of fatal fentanyl overdoses increase 20-fold since 2013, Gov Youngkin said. 

He added: ‘We cannot stand by as Virginians lose their lives when there are steps we can take to combat this deadly fentanyl poisoning crisis. We must act.’

Richmond, Virginia’s capital, is among the hottest spots for fatal overdoses due to opioids, with 272 deaths in 2022 and 262 of those due to fentanyl.

Fatal overdoses due to all opioids in Virginia in 2022 reached 2,104, slightly down from the 2021 tally of 2,229 but well above the 2019 total, 1,298.

The vast majority of those deaths were caused by fentanyl. 

The drug was introduced in the 1960s as a pain reliever and an IV anesthetic. By the 1990s, drug companies developed fentanyl patches that deposited the medicine into the body through the skin to treat severe pain in cancer patients. 

But it has increasingly been found in the illicit drug supply often as a pollutant in other drugs including cocaine, methamphetamine, and benzodiazepines, meaning many people ingest it unknowingly. 

Just two milligrams of fentanyl, equal to around 10 to 15 grains of table salt, can be lethal.

Preliminary figures from the state show that the synthetic drug 50 times stronger than heroin killed more than 1,950 people last year and more than 2,000 the year before.

John Littel, Virginia’s health secretary said: ‘Today, five Virginians will die from fentanyl. 

‘Tomorrow and every day this year, an average of five Virginians will die from this deadly drug. 

Within the next four months, the state health department will need to devise a cost-effective way to monitor the sewer system for concentrations of opioids including fentanyl and heroin. 

The objective is to use the surveillance data to inform resource allotment, meaning the communities with the highest presence of opiates will get greater access to naloxone and drug treatment options. 

The order also directs the Secretary of Public Safety and Homeland Security to scale up the state’s law enforcement system’s ability to interdict illicit drug shipments into and throughout the state.

Youngkin further ordered a cadre of state agencies such as the Department of Social Services, and the Department of Criminal Justice Services to come up with a more effective, thorough way to record and report fatal and nonfatal opioid overdoses ‘to allow for immediate interdiction, education, and abatement efforts’ in the neighborhoods experiencing the biggest spikes in overdoses. 

Fentanyl has blighted American cities and towns of all sizes. A recent government report shows that fatal overdoses involving synthetic opioid more than tripled from 2016-2021, rising from 5.7 per 100,000 in 2016 to 21.6 in 2021.

In Virginia specifically, that rate is around 22 per 100,000 persons, according to preliminary 2022 numbers. In 2021, it was nearly 24 per 100,000, up from about 19 in 2020.

The fentanyl overdose rate spiked in the first year of the Covid pandemic, having hit 11.3 per capita in 2019, the highest on record pre-Covid.

The rise of fentanyl has especially affected teens in recent years. Analysis of official overdose data show there were just nine fatalities from fentanyl among those aged 20 years and under in 1999. But by 2021, this had jumped to 1,550. 

Virginia is just one of 50 states and DC contending with the scourge of deadly fentanyl on their streets. 

Neighboring West Virginia has the highest death rate of all, coming in at about 91 per 100,000 total population, according to 2021 figures from the Centers for Disease Control and Prevention. 

Northwestern Virginia has consistently shown the highest rates of overdoses caused by opioids excluding heroin. But Southwestern Virginia has seen the highest rates of heroin overdoses. 

Spots two and three went to Tennessee and Louisiana with 56.6 deaths per 100,000 and 55.9 deaths per 100,000, respectively.

To address the ongoing crisis, rooted in a long history of poor regulation and malfeasance by the pharmaceutical industry, federal regulators have taken steps to make the nasal spray version of naloxone more accessible to the people who need it, as well as to good samaritans who have it on them in the event that someone nearby begins to overdose.

The appeal of the nasal spray, marketed as Narcan, is a combination of its efficacy and the ease of use. 

The plunger that sends 4mg of misted naloxone hydrochloride up the nose resembles an over-the-counter allergy medicine and it begins to work immediately.

A recent study by Brigham and Women’s hospital in Massachusetts found that over 93 percent of people given naloxone survived their overdose. 

Still, they require additional medical assistance immediately after because the effects do not last long.

When inhaled, the medicine is absorbed through mucous membranes in the nose, rapidly entering the bloodstream and traveling to the brain.

Once there, the medicine competes with opioids attaching themselves to receptors in the brain.

It attaches to the brain’s receptors, replacing the opioid. This blunts the effects of opiates on the brain, stopping an overdose from progressing.

Fentanyl is an incredibly insidious substance, often added as an adulterant to drugs like cocaine, ecstasy, and meth because it is both cheap and powerful and keeps users coming back for more.

But often, users of heroin and non-opiate drugs do not know they are taking fentanyl and may not have naloxone on hand. 

For this reason, the federal government aims to make the antidote ubiquitous without the necessity of talking to a pharmacist everywhere from big box retailers to vending machines.