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The Potent Drug Mix Causing Unprecedented Rates of Black Americans to Overdose

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February 9, 2022
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Opioid overdoses have killed so many Individuals in recent times that specialists say the epidemic is in its fourth wave. However the present wave of the opioid epidemic presents a brand new and notably insidious menace: opioids, together with the extraordinarily potent artificial opioid fentanyl, are more and more being blended with different medication, whether or not the consumer is aware of it or not. As of 2019, greater than 75% of drug overdose deaths involving cocaine now embrace an opioid, for instance, in addition to half of all deaths from stimulants like methamphetamine.
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When mixed with different medication, opioids are proving notably lethal for Black Individuals, finds a brand new examine printed within the American Journal of Epidemiology. Overdose deaths that concerned a couple of substance elevated dramatically between 2007 and 2019, however rose much more shortly amongst Black Individuals than amongst whites. Amongst Black Individuals, the variety of deaths from opioids with cocaine throughout this time interval rose 575%—up from 0.6 to 4.05 deaths per 100,000 folks—whereas amongst white folks, the loss of life fee rose 184%, from 0.49 to 1.39 deaths per 100,000 folks.

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“Individuals are more and more dying of stimulants, cocaine, meth, and different stimulant medication largely, however not solely, pushed by fentanyl contamination of stimulants,” says Tarlise Townsend, the examine’s joint lead creator and a researcher within the division of inhabitants well being at New York College Faculty of Medication. “We’re now at this level the place many specialists advocate that individuals who use medication assume fentanyl is in something they’re utilizing.”

Even the researchers had been stunned by how dramatic the hole was, says Townsend. “What we discovered on this examine was actually, actually alarming,” she says. “Not solely are stimulant-opioid overdose deaths rising very quickly on this nation, however they’re disproportionately affecting folks from marginalized racial and ethnic teams, and notably Black Individuals.” The divide appears to be rising even wider. In the course of the ultimate 12 months of the examine—2018 to 2019—opioid and cocaine overdose deaths elevated 29% amongst Black folks whereas remaining regular within the white inhabitants.

Learn Extra: Older Individuals Are the Ignored Victims of the Opioid Epidemic

When opioids are mixed with meth and different stimulants apart from cocaine, white persons are nonetheless extra prone to die from an overdose than Black Individuals. Between 2007 and 2019, a majority of these deaths amongst white folks rose 3,200%, from .09 deaths to 2.97 deaths per 100,000 folks. Nevertheless, they accelerated even sooner within the Black group, rising from .01 to 1.63 per 100,000, a rise of 16,200%.

Increasing entry to drug therapy packages, particularly for communities of colour, is vital to serving to lower these deaths, Townsend says. Nevertheless, there isn’t a straightforward path to stopping overdose deaths. Not like with opioids, there are no FDA-approved drugs to deal with stimulant use dysfunction, and no evidence-based therapy designed particularly for folks with polysubstance use dysfunction but exists, says Townsend. “We completely have to scale up and develop extra therapy modalities,” she says. “We have to scale up funding for and do a greater job of focusing on opioid prevention or opioid overdose prevention instruments to individuals who primarily use stimulants.”

Black Individuals additionally face explicit obstacles that make it tough to get therapy, says Dennis Bailer, the overdose prevention program director at Challenge Weber/RENEW, a non-profit primarily based in Windfall Rhode Island centered on drug habit restoration. (Bailer was not concerned with the examine.) Restricted and low-quality insurance coverage choices, housing insecurity, and over-policing of Black communities all stand in the best way of therapy for many who want it, he says. Many Black Individuals additionally battle to belief establishments like well being care techniques, which they really feel have betrayed them, says Bailer. “As an individual of colour, I really feel like the reply for Black and Hispanic crack cocaine customers [has been] to lock them up,” he says. “That’s what we’ve seen prior to now, and that’s additionally why so many individuals are reluctant to interact. It’s all concerning the white opioid consumer. And plenty of instances, we really feel like we get the again seat.”

Making certain that everybody who makes use of stimulant medication has entry to instruments designed to assist to forestall opioid overdose deaths can assist, Bailer says. These embrace naloxone (also called Narcan), a drugs used to reverse opioid overdoses. Too usually, he says, individuals who use cocaine or meth don’t assume they want Narcan as a result of they don’t use intravenous medication—however they don’t understand they is likely to be in danger from stimulants laced with lethal opioids like fentanyl with out their data. That is particularly harmful, says Bailer, when the individual doesn’t have any tolerance to opioids. “Lots of our cocaine customers simply don’t get the message that they’re at as excessive danger of overdose [as opioid users],” he says. “Individuals are getting caught off guard.”

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google.com,pub-8241049497608997,RESELLER,f08c47fec0942fa0 yahoo.com,1832200,DIRECT,e1a5b5b6e3255540 smartadserver.com,4144,DIRECT smartadserver.com,4016,DIRECT smartadserver.com,4012,DIRECT smartadserver.com,4071,DIRECT smartadserver.com,4073,DIRECT smartadserver.com,4074,DIRECT google.com,pub-8933329999391104,RESELLER,f08c47fec0942fa0 google.com,pub-1325340429823502,RESELLER,f08c47fec0942fa0 google.com,pub-6110672335579159,RESELLER,f08c47fec0942fa0 adpushup.com,cfcb90bc3d34a71413ca5d041db539a8,DIRECT,b0b8ff8485794fdd pubmatic.com,160925,RESELLER,5d62403b186f2ace rubiconproject.com,15636,RESELLER,0bfd66d529a55807 otm-r.com,23,RESELLER taboola.com,1196805,DIRECT,c228e6794e811952 spotx.tv,71451,RESELLER spotxchange.com,71451,RESELLER advertising.com,8603,RESELLER pubmatic.com,156307,RESELLER,5d62403b186f2ace appnexus.com,3364,RESELLER Indexexchange.com,183756,RESELLER contextweb.com,560382,RESELLER openx.com,539154393,RESELLER tremorhub.com,z87wm,RESELLER,1a4e959a1b50034a rubiconproject.com,16698,RESELLER,0bfd66d529a55807 freewheel.tv,799841,RESELLER freewheel.tv,799921,RESELLER aol.com,53392,RESELLER rhythmone.com,1166984029,RESELLER,a670c89d4a324e47 richaudience.com,mA6M9Pbvib,DIRECT adform.com,1942,DIRECT adform.com,1941,DIRECT advertising.com,7574,DIRECT aerserv.com,2750,RESELLER,2ce496b9f80eb9fa appnexus.com,2928,DIRECT appnexus.com,8233,DIRECT contextweb.com,560520,RESELLER google.com,pub-9115524111147081,RESELLER,f08c47fec0942fa0 google.com,pub-4673227357197067,RESELLER,f08c47fec0942fa0 indexexchange.com,179394,RESELLER lijit.com,249425,RESELLER mobfox.com,74240,RESELLER mobfox.com,45499,RESELLER openx.com,539625136,RESELLER pubmatic.com,81564,DIRECT,5d62403b186f2ace pubmatic.com,156538,DIRECT,5d62403b186f2ace rubiconproject.com,13510,DIRECT smaato.com,1100037086,RESELLER smaato.com,1100000579,RESELLER smartadserver.com,2640,RESELLER smartadserver.com,2441,RESELLER sovrn.com,249425,RESELLER spotx.tv,173175,DIRECT spotx.tv,173177,DIRECT spotxchange.com,173177,DIRECT spotxchange.com,173175,DIRECT yahoo.com,57857,RESELLER,e1a5b5b6e3255540 smartadserver.com,2161,DIRECT pubmatic.com,156439,RESELLER,5d62403b186f2ace pubmatic.com,154037,RESELLER,5d62403b186f2ace rhythmone.com,2564526802,RESELLER,a670c89d4a324e47 adyoulike.com,b4bf4fdd9b0b915f746f6747ff432bde,RESELLER smartadserver.com,3668,DIRECT rubiconproject.com,18194,DIRECT,0bfd66d529a55807 spotx.tv,202009,DIRECT,7842df1d2fe2db34 spotxchange.com,202009,RESELLER,7842df1d2fe2db34 yieldlab.net,6378054,DIRECT freewheel.tv,1076049,DIRECT freewheel.tv,1076065,RESELLER appnexus.com,8833,DIRECT,f5ab79cb980f11d1 appnexus.com,8833,RESELLER,f5ab79cb980f11d1 freewheel.tv,228,RESELLER smartstream.tv,6459,RESELLER appnexus.com,3368,RESELLER yieldlab.net,2172218,RESELLER google.com,pub-9829476400767085,DIRECT,f08c47fec0942fa0 freewheel.tv,1131585,RESELLER piximedia.com,21168,DIRECT adtech.com,4803,RESELLER freewheel.tv,282482,RESELLER freewheel.tv,283026,RESELLER pubmatic.com,156492,RESELLER,5d62403b186f2ace smartadserver.com,3347,DIRECT pubmatic.com,156030,RESELLER,5d62403b186f2ace rubiconproject.com,13132,RESELLER,0bfd66d529a55807 groundtruth.com,107,RESELLER,81cbf0a75a5e0e9a appnexus.com,2579,DIRECT appnexus.com,884,DIRECT improvedigital.com,1220,DIRECT google.com,pub-1313834454494130,RESELLER,f08c47fec0942fa0 google.com,pub-8536066741654249,RESELLER,f08c47fec0942fa0 triplelift.com,4338,DIRECT,6c33edb13117fd86 appnexus.com,1314,RESELLER adform.com,2623,DIRECT,9f5210a2f0999e32 nobid.io,21968366300,DIRECT google.com,pub-1051504991213440,DIRECT,f08c47fec0942fa0 google.com,pub-1835489473992347,DIRECT,f08c47fec0942fa0 google.com,pub-1789253751882305,DIRECT,f08c47fec0942fa0 google.com,pub-1950215063958302,DIRECT,f08c47fec0942fa0 appnexus.com,11429,DIRECT gumgum.com,13926,DIRECT,ffdef49475d318a9 33across.com,0010b00002Mq2FYAAZ,DIRECT,bbea06d9c4d2853c sovrn.com,273657,DIRECT,fafdf38b16bf6b2b lijit.com,273657,DIRECT,fafdf38b16bf6b2b lijit.com,273657-eb,DIRECT,fafdf38b16bf6b2b revcontent.com,124709,DIRECT appnexus.com,7666,RESELLER,f5ab79cb980f11d1 rubiconproject.com,156042,RESELLER,0bfd66d529a55807 my6sense.com,9732,RESELLER criteo.com,7822,RESELLER pubmatic.com,156423,RESELLER,5d62403b186f2ace appnexus.com,1001,RESELLER,f5ab79cb980f11d1 appnexus.com,3135,RESELLER,f5ab79cb980f11d1 openx.com,537120563,RESELLER,6a698e2ec38604c6 openx.com,539392223,RESELLER,6a698e2ec38604c6 rhythmone.com,2439829435,RESELLER,a670c89d4a324e47 emxdgt.com,326,RESELLER,1e1d41537f7cad7f gumgum.com,13318,RESELLER,ffdef49475d318a9 google.com,pub-9557089510405422,RESELLER,f08c47fec0942fa0 adtech.com,9993,RESELLER adtech.com,12094,RESELLER advangelists.com,8d3bba7425e7c98c50f52ca1b52d3735,RESELLER,60d26397ec060f98 rubiconproject.com,13702,DIRECT pubmatic.com,157898,DIRECT,5d62403b186f2ace adtech.com,10109,DIRECT aolcloud.net,10109,DIRECT openx.com,540650310,DIRECT,6a698e2ec38604c6 sonobi.com,bc2afab5f7,DIRECT,d1a215d9eb5aee9e appnexus.com,9538,DIRECT triplelift.com,9789,DIRECT,6c33edb13117fd86 pubmatic.com,159302,DIRECT,5d62403b186f2ace decenterads.com,933,DIRECT onetag.com,694e68b73971b58,DIRECT sonobi.com,7ad1b9f952,RESELLER,d1a215d9eb5aee9e nativo.com,5677,DIRECT google.com,pub-1835489473992347,RESELLER,f08c47fec0942fa0 durationmedia.net,21968366300,DIRECT yahoo.com,57872,DIRECT smartadserver.com,3447,DIRECT xandr.com,11429,RESELLER,f5ab79cb980f11d1 xandr.com,12701,RESELLER,f5ab79cb980f11d1 rubiconproject.com,13702,DIRECT,0bfd66d529a55807 video.unrulymedia.com,3736557092,RESELLER rhythmone.com,3736557092,RESELLER,a670c89d4a324e47 admanmedia.com,812,DIRECT rhythmone.com,1059622079,RESELLER,a670c89d4a324e47 contextweb.com,560606,RESELLER,89ff185a4c4e857c amxrtb.com,105199579,DIRECT appnexus.com,12290,RESELLER,f5ab79cb980f11d1 indexexchange.com,191503,RESELLER,50b1c356f2c5c8fc pubmatic.com,158355,RESELLER,5d62403b186f2ace indexexchange.com,195491,RESELLER,50b1c356f2c5c8fc opera.com,pub5688296365760,DIRECT,55a0c5fd61378de3 indexexchange.com,192806,RESELLER,50b1c356f2c5c8fc Pubmatic.com,158565,RESELLER,5d62403b186f2ace smaato.com,1100042823,DIRECT,07bcf65f187117b4 rubiconproject.com,17608,RESELLER,0bfd66d529a55807 triplelift.com,10522,RESELLER,6c33edb13117fd86 smartadserver.com,4140,RESELLER appnexus.com,2081,RESELLER,f5ab79cb980f11d1 admixer.net,5e14a984-b5c9-4ffb-87e9-d8edba8492d3,DIRECT sovrn.com,268876,RESELLER,fafdf38b16bf6b2b lijit.com,268876,RESELLER,fafdf38b16bf6b2b openx.com,541031350,RESELLER,6a698e2ec38604c6 improvedigital.com,1556,RESELLER axonix.com,56222,RESELLER Contextweb.com,562309,RESELLER,89ff185a4c4e857c conversantmedia.com,100066,RESELLER,03113cd04947736d rubiconproject.com,12186,RESELLER,0bfd66d529a55807 onetag.com,72686cdf31f128b,RESELLER lemmatechnologies.com,552,RESELLER,7829010c5bebd1fb lemmatechnologies.com,144,RESELLER,7829010c5bebd1fb altitude-arena.com,FIRD0F0P6T2MLDMG7GCJFTBAI8,RESELLER leanback.digital,ESS-D666,RESELLER,b1d30350acaf0176 pubmatic.com,156494,RESELLER,5d62403b186f2ace smartadserver.com,3564,RESELLER admatic.com.tr,adm-pub-185375301865,RESELLER improvedigital.com,912,RESELLER pubmatic.com,159078,RESELLER,5d62403b186f2ace adform.com,2600,RESELLER stroeer.com,17938,RESELLER sovrn.com,380632,RESELLER,fafdf38b16bf6b2b lijit.com,380632,RESELLER,fafdf38b16bf6b2b lijit.com,380632-eb,DIRECT,fafdf38b16bf6b2b uis.mobfox.com,1424,RESELLER,5529a3d1f59865be openx.com,539249210,RESELLER,6a698e2ec38604c6 impactify.io,1146,DIRECT improvedigital.com,1058,RESELLER google.com,pub-1343218370015870,RESELLER,f08c47fec0942fa0 google.com,pub-4301669675472368,RESELLER,f08c47fec0942fa0 spotxchange.com,176703,RESELLER,7842df1d2fe2db34 spotx.tv,176703,RESELLER,7842df1d2fe2db34 appnexus.com,11197,RESELLER,f5ab79cb980f11d1 freewheel.tv,282594,RESELLER freewheel.tv,282786,RESELLER freewheel.tv,282802,RESELLER freewheel.tv,282818,RESELLER freewheel.tv,282850,RESELLER yahoo.com,1761548,RESELLER rubiconproject.com,19688,RESELLER,0bfd66d529a55807 advertising.com,9516,RESELLER smartadserver.com,2974,RESELLER google.com,pub-7019376976432612,RESELLER google.com,pub-5373693997956134,RESELLER,f08c47fec0942fa0 google.com,pub-4177862836555934,RESELLER,f08c47fec0942fa0 google.com,pub-1071602463683652,RESELLER,f08c47fec0942fa0 connectad.io,147,DIRECT pubmatic.com,55990,RESELLER,5d62403b186f2ace indexexchange.com,190906,DIRECT,50b1c356f2c5c8fc appnexus.com,8738,RESELLER,f5ab79cb980f11d1 EMXDGT.com,1138,DIRECT,1e1d41537f7cad7f sovrn.com,244287,DIRECT,fafdf38b16bf6b2b lijit.com,244287,DIRECT,fafdf38b16bf6b2b lijit.com,244287-eb,DIRECT,fafdf38b16bf6b2b yahoo.com,55248,DIRECT rubiconproject.com,17250,RESELLER,0bfd66d529a55807 xad.com,240,RESELLER,81cbf0a75a5e0e9a onetag.com,5d4e109247a89f6,DIRECT RTBHOUSE.COM,ofNe4Md3yOLt0qckkfER,DIRECT adpone.com,59e252f6de67f6c8d1f8,DIRECT connectad.io,50,DIRECT,85ac85a30c93b3e5 indexexchange.com,196713,DIRECT criteo.com,B-060278,DIRECT,9fac4a4a87c2a44f richaudience.com,06ehcbcfzk,DIRECT betweendigital.com,42666,DIRECT adform.com,2474,DIRECT,9f5210a2f0999e32 lijit.com,257429,RESELLER,fafdf38b16bf6b2b sovrn.com,257429,RESELLER,fafdf38b16bf6b2b openx.com,540603695,RESELLER,6a698e2ec38604c6 openx.com,539966405,DIRECT,6a698e2ec38604c6 pubmatic.com,157841,RESELLER,5d62403b186f2ace pubmatic.com,156383,RESELLER,5d62403b186f2ace smartadserver.com,1743,RESELLER,060d053dcf45cbf3 indexexchange.com,192450,DIRECT,50b1c356f2c5c8fc appnexus.com,10264,RESELLER,f5ab79cb980f11d1 appnexus.com,10264,DIRECT,f5ab79cb980f11d1 rubiconproject.com,20266,RESELLER,0bfd66d529a55807 rubiconproject.com,17210,RESELLER,0bfd66d529a55807 google.com,pub-2128757167812663,RESELLER,f08c47fec0942fa0 adtelligent.com,315476,DIRECT 33across.com,0010b00002T3JniAAF,RESELLER,bbea06d9c4d2853c bidtellect.com,1407,RESELLER,1c34aa2d85d45e93 contextweb.com,558355,RESELLER EMXDGT.com,1284,RESELLER,1e1d41537f7cad7f gumgum.com,13579,RESELLER,ffdef49475d318a9 improvedigital.com,1628,RESELLER lijit.com,310770,RESELLER,fafdf38b16bf6b2b onetag.com,59a18369e249bfb,RESELLER openx.com,541177116,RESELLER,6a698e2ec38604c6 pubmatic.com,157897,RESELLER,5d62403b186f2ace rhythmone.com,78519861,RESELLER,a670c89d4a324e47 sovrn.com,310770,RESELLER,fafdf38b16bf6b2b synacor.com,82151,RESELLER,e108f11b2cdf7d5b adform.com,2600,DIRECT admatic.com.tr,adm-pub-185375301865,DIRECT adyoulike.com,438e40b69c9e19f81b51401dce6e8be4,DIRECT,4ad745ead2958bf7 appnexus.com,11924,RESELLER,f5ab79cb980f11d1 appnexus.com,9733,RESELLER,f5ab79cb980f11d1 contextweb.com,558355,RESELLER,89ff185a4c4e857c e-planning.net,835fbafe26d231b1,DIRECT,c1ba615865ed87b2 gumgum.com,13579,DIRECT,ffdef49475d318a9 indexexchange.com,189529,DIRECT,50b1c356f2c5c8fc indexexchange.com,191973,RESELLER,50b1c356f2c5c8fc lijit.com,310770,DIRECT,fafdf38b16bf6b2b loopme.com,11378,RESELLER,6c8d5f95897a5a3b onetag.com,59a18369e249bfb,DIRECT pubmatic.com,156631,RESELLER,5d62403b186f2ace pubmatic.com,156813,DIRECT,5d62403b186f2ace pubmatic.com,159078,DIRECT,5d62403b186f2ace rhythmone.com,1767353092,RESELLER,a670c89d4a324e47 rubiconproject.com,12398,RESELLER,0bfd66d529a55807 rubiconproject.com,17184,DIRECT,0bfd66d529a55807 rubiconproject.com,21642,RESELLER,0bfd66d529a55807 sovrn.com,310770,DIRECT,fafdf38b16bf6b2b spotim.market,4446666,DIRECT,077e5f709d15bdbb stroeer.com,17938,DIRECT 152media.info,152M10,RESELLER rhythmone.com,3139274702404301777,DIRECT,a670c89d4a324e47 video.unrulymedia.com,3139274702404301777,DIRECT indexexchange.com,182257,RESELLER,50b1c356f2c5c8fc appnexus.com,6849,RESELLER,f5ab79cb980f11d1 rubiconproject.com,15268,RESELLER,0bfd66d529a55807 pubmatic.com,159277,RESELLER,5d62403b186f2ace advertising.com,28605,RESELLER openx.com,543878511,RESELLER,6a698e2ec38604c6 improvedigital.com,1699,RESELLER pubmatic.com,161562,RESELLER,5d62403b186f2ace vidoomy.com,2252369,DIRECT Qwarry.com,12,DIRECT,bf16059e4b3fb977 themediagrid.com,IH9PA4,DIRECT,35d5010d7789b49d criteo.com,B-059164,DIRECT,9fac4a4a87c2a44f themediagrid.com,7WYFHG,DIRECT,35d5010d7789b49d amxrtb.com,105199542,DIRECT appnexus.com,11786,RESELLER,f5ab79cb980f11d1 lijit.com,260380,RESELLER,fafdf38b16bf6b2b sovrn.com,260380,RESELLER,fafdf38b16bf6b2b appnexus.com,9393,RESELLER,f5ab79cb980f11d1 advertising.com,28305,RESELLER adform.com,2865,RESELLER smartadserver.com,3056,DIRECT viralize.com,4720,DIRECT adform.com,2688,RESELLER,9f5210a2f0999e32 adform.com,2437,RESELLER,9f5210a2f0999e32 freewheel.tv,1003361,DIRECT freewheel.tv,1003377,RESELLER freewheel.tv,939745,DIRECT freewheel.tv,941377,RESELLER pubmatic.com,156695,DIRECT,5d62403b186f2ace pubmatic.com,160405,RESELLER,5d62403b186f2ace improvedigital.com,1227,RESELLER spotxchange.com,241914,RESELLER,7842df1d2fe2db34 spotx.tv,241914,RESELLER,7842df1d2fe2db34 conversantmedia.com,100098,RESELLER,03113cd04947736d appnexus.com,4052,RESELLER contextweb.com,561998,RESELLER,89ff185a4c4e857c openx.com,540031703,RESELLER,6a698e2ec38604c6 pubmatic.com,158100,RESELLER,5d62403b186f2ace yahoo.com,55771,RESELLER,e1a5b5b6e3255540 loopme.com,11230,RESELLER,6c8d5f95897a5a3b freewheel.tv,1137761,RESELLER freewheel.tv,1138529,RESELLER freewheel.tv,962145,RESELLER freewheel.tv,962209,RESELLER improvedigital.com,1175,RESELLER freewheel.tv,1174465,RESELLER freewheel.tv,1174481,RESELLER undertone.com,3393,RESELLER appnexus.com,2234,RESELLER openx.com,537153564,RESELLER,6a698e2ec38604c6 ogury.com,f00b15ea-6210-4e34-bb76-384d7003d8e8,DIRECT appnexus.com,11470,RESELLER avantisvideo.com,8798,DIRECT Advertising.com,23598,DIRECT advertising.com,28918,DIRECT Appnexus.com,10062,DIRECT,f5ab79cb980f11d1 EMXDGT.com,1745,DIRECT,1e1d41537f7cad7f google.com,pub-2024690810381654,RESELLER,f08c47fec0942fa0 indexexchange.com,192106,DIRECT indexexchange.com,193375,RESELLER Pubmatic.com,159970,RESELLER,5d62403b186f2ace Pubmatic.com,160454,RESELLER,5d62403b186f2ace Pubmatic.com,160265,RESELLER,5d62403b186f2ace Contextweb.com,562357,DIRECT,89ff185a4c4e857c spotxchange.com,165877,RESELLER,7842df1d2fe2db34 spotx.tv,165877,RESELLER,7842df1d2fe2db34 rhythmone.com,871930104,DIRECT,a670c89d4a324e47 video.unrulymedia.com,871930104,DIRECT google.com,pub-5717092533913515,RESELLER,f08c47fec0942fa0 indexexchange.com,185192,DIRECT rhythmone.com,1149317856,DIRECT,a670c89d4a324e47 rubiconproject.com,17346,DIRECT,0bfd66d529a55807 pubmatic.com,157904,DIRECT,5d62403b186f2ace sharethrough.com,8a03a67b,DIRECT,d53b998a7bd4ecd2 indexexchange.com,186046,RESELLER,50b1c356f2c5c8fc spotxchange.com,212457,RESELLER spotx.tv,212457,RESELLER,7842df1d2fe2db34 pubmatic.com,156557,RESELLER pubmatic.com,158723,RESELLER,5d62403b186f2ace rubiconproject.com,18694,RESELLER,0bfd66d529a55807 openx.com,540274407,RESELLER,6a698e2ec38604c6 33across.com,0013300001kQj2HAAS,RESELLER,bbea06d9c4d2853c smaato.com,1100047713,RESELLER,07bcf65f187117b4 appnexus.com,9027,DIRECT aax.media,AAX23QE99,DIRECT Media.net,8CUOMF1PP,DIRECT pubmatic.com,158984,RESELLER,5d62403b186f2ace openx.com,543731411,RESELLER,6a698e2ec38604c6 indexexchange.com,192393,RESELLER districtm.io,100600,RESELLER sonobi.com,83729e979b,RESELLER onetag.com,66d66dec41ef0cc,RESELLER appnexus.com,10273,RESELLER,f5ab79cb980f11d1 indexexchange.com,192922,RESELLER,50b1c356f2c5c8fc onetag.com,5adb88524e24e50,RESELLER engagebdr.com,10427,RESELLER google.com,pub-9945624415527048,DIRECT,f08c47fec0942fa0 Media.net,8PR6YK195,DIRECT EMXDGT.com,1759,RESELLER,1e1d41537f7cad7f google.com,pub-7310785613215102,DIRECT,f08c47fec0942fa0 google.com,pub-8600492219386651,DIRECT,f08c47fec0942fa0 e-planning.net,d6e04fe7533a7d3b,DIRECT,c1ba615865ed87b2 indexexchange.com,190243,DIRECT richaudience.com,25BiP9IMgN,DIRECT aol.com,57992,RESELLER,e1a5b5b6e3255540 Yahoo.com,57992,RESELLER,e1a5b5b6e3255540 sonobi.com,8efb591506,DIRECT,d1a215d9eb5aee9e sonobi.com,4d443a3ea2,RESELLER,d1a215d9eb5aee9e adriver.ru,187150,DIRECT smartadserver.com,2491,RESELLER advertising.com,21483,DIRECT,e1a5b5b6e3255540 improvedigital.com,1010,RESELLER indexexchange.com,193216,RESELLER admanmedia.com,722,DIRECT video.unrulymedia.com,3948367200,RESELLER rhythmone.com,3948367200,RESELLER,a670c89d4a324e47 appnexus.com,8804,RESELLER,f5ab79cb980f11d1 smartadserver.com,3713,RESELLER improvedigital.com,1668,RESELLER indexexchange.com,191497,RESELLER openx.com,540866936,RESELLER,6a698e2ec38604c6 appnexus.com,10040,RESELLER rubiconproject.com,19814,RESELLER,0bfd66d529a55807 spotxchange.com,178357,RESELLER,7842df1d2fe2db34 spotx.tv,178357,RESELLER,7842df1d2fe2db34 pubmatic.com,158810,RESELLER,5d62403b186f2ace pubmatic.com,158481,DIRECT,5d62403b186f2ace spotx.tv,238936,RESELLER,7842df1d2fe2db34 rubiconproject.com,19668,RESELLER,0bfd66d529a55807 indexexchange.com,190856,RESELLER,50b1c356f2c5c8fc pubmatic.com,158615,RESELLER,5d62403b186f2ace indexexchange.com,183965,RESELLER,50b1c356f2c5c8fc pubmatic.com,156458,RESELLER,5d62403b186f2ace pubmatic.com,156325,RESELLER,5d62403b186f2ace pubmatic.com,156674,RESELLER,5d62403b186f2ace rubiconproject.com,18222,RESELLER,0bfd66d529a55807 rubiconproject.com,16114,DIRECT azeriondigital.com,43710415,DIRECT appnexus.com,12223,RESELLER,f5ab79cb980f11d1 improvedigital.com,1210,RESELLER improvedigital.com,1221,RESELLER pubmatic.com,150561,RESELLER,5d62403b186f2ace EMXDGT.com,1836,DIRECT,1e1d41537f7cad7f EMXDGT.com,1289,DIRECT,1e1d41537f7cad7f advertising.com,28335,DIRECT,e1a5b5b6e3255540 smilewanted.com,1362,DIRECT adyoulike.com,b3e21aeb2e950aa59e5e8cc1b6dd6f8e,DIRECT,4ad745ead2958bf7 loopme.com,11013,DIRECT,6c8d5f95897a5a3b connectad.io,204,DIRECT,85ac85a30c93b3e5 EMXDGT.com,1701,DIRECT,1e1d41537f7cad7f quantum-advertising.com,6222,RESELLER themediagrid.com,BG415O,DIRECT,35d5010d7789b49d smartadserver.com,3392,DIRECT appnexus.com,10212,RESELLER improvedigital.com,1633,RESELLER yahoo.com,58977,RESELLER,e1a5b5b6e3255540 onetag.com,75779831fd8c740,DIRECT adyoulike.com,22e5955a10a7f98b037f13dd297cdd74,DIRECT,4ad745ead2958bf7 freewheel.tv,1089937,DIRECT freewheel.tv,1099761,RESELLER bliink.io,cfe6f06e-2ff0-11eb-8d68-7aaa96b266b5,DIRECT gothamads.com,1750,DIRECT,d9c86e5dec870222 connectad.io,190,DIRECT,85ac85a30c93b3e5 improvedigital.com,1937,RESELLER e-planning.net,54275499d4eb431b,DIRECT,c1ba615865ed87b2 trmqb.com,4512,DIRECT ssp.logan.ai,LG9,RESELLER opera.com,pub6060502141568,DIRECT,55a0c5fd61378de3 openx.com,544015448,RESELLER,6a698e2ec38604c6 synacor.com,82460,DIRECT,e108f11b2cdf7d5b video.unrulymedia.com,123476257,RESELLER bizzclick.com,30,RESELLER,7e936b1feafdaa61 betweendigital.com,43818,RESELLER smaato.com,1100042823,RESELLER,07bcf65f187117b4 mobilefuse.com,3719,RESELLER,71e88b065d69c021 conversantmedia.com,100269,RESELLER,03113cd04947736d outbrain.com,002d7f7ba0bd74452f2b155d0dfb5cd6c8,RESELLER yahoo.com,58935,RESELLER,e1a5b5b6e3255540 inmobi.com,f58140d7af1a4fcb83deb5b1c76f0c04,RESELLER,83e75a7ae333ca9d tpmn.io,472,RESELLER seedtag.com,619f620afe426c0700a5c30d,DIRECT seedtag.com,61a78375e0fb8f0800ec50fb,DIRECT seedtag.com,61a783c8517244070096f118,DIRECT seedtag.com,61a783f0e0fb8f0800ec50fc,DIRECT seedtag.com,61a7804cfe829e0700f0db81,DIRECT seedtag.com,61a7849ac342880700fc6da2,DIRECT seedtag.com,61a784f8fe829e0700f0dbba,DIRECT seedtag.com,61a78466517244070096f119,DIRECT seedtag.com,61a78446c342880700fc6da1,DIRECT pubmatic.com,157743,DIRECT,5d62403b186f2ace spotxchange.com,249286,DIRECT,7842df1d2fe2db34 spotx.tv,249286,DIRECT,7842df1d2fe2db34 rubiconproject.com,17280,DIRECT,0bfd66d529a55807 33across.com,0010b00002MptHCAAZ,DIRECT,bbea06d9c4d2853c indexexchange.com,191730,RESELLER improvedigital.com,1680,RESELLER smartadserver.com,3050,DIRECT contextweb.com,560288,DIRECT,89ff185a4c4e857c openx.com,537149888,DIRECT,6a698e2ec38604c6 districtm.io,101760,DIRECT,3fd707be9c4527c3 xandr.com,4009,DIRECT richaudience.com,ns9qrKJLKD,DIRECT aerserv.com,2750,DIRECT,2ce496b9f80eb9fa aolcloud.net,4687,DIRECT mobfox.com,74240,DIRECT openx.com,539625136,DIRECT smaato.com,1100037086,DIRECT adyoulike.com,83d15ef72d387a1e60e5a1399a2b0c03,DIRECT yahoo.com,58578,DIRECT,e1a5b5b6e3255540 aol.com,58578,DIRECT,e1a5b5b6e3255540 advertising.com,29034,DIRECT adform.com,1889,RESELLER,9f5210a2f0999e32 condigolabs.com,c6blkn6kv5dumh3tsfj0,RESELLER 33across.com,0015a00002vNEdMAAW,DIRECT,bbea06d9c4d2853c conversantmedia.com,100141,DIRECT gumgum.com,15500,RESELLER,ffdef49475d318a9 justpremium.com,2976,RESELLER appnexus.com,2758,RESELLER,f5ab79cb980f11d1 rubiconproject.com,23434,RESELLER,0bfd66d529a55807 openx.com,537149485,RESELLER,6a698e2ec38604c6 admanmedia.com,799,RESELLER smartadserver.com,4005,RESELLER 33across.com,0013300001r0t9mAAA,RESELLER,bbea06d9c4d2853c vidoomy.com,62496,DIRECT google.com,pub-2831120411392012,RESELLER,f08c47fec0942fa0 tremorhub.com,4cywq-a04wk,RESELLER,1a4e959a1b50034a yieldmo.com,2731991718797714293,DIRECT adform.com,2742,RESELLER advertising.com,22762,RESELLER aol.com,22762,RESELLER adtech.com,11303,RESELLER advertising.com,26631,RESELLER appnexus.com,12475,RESELLER,f5ab79cb980f11d1 pubmatic.com,156498,RESELLER,5d62403b186f2ace freewheel.tv,872257,RESELLER freewheel.tv,894193,RESELLER openx.com,540804929,RESELLER,6a698e2ec38604c6 lkqd.net,430,RESELLER,59c49fa9598a0117 lkqd.com,430,RESELLER,59c49fa9598a0117 districtm.io,101540,RESELLER,3fd707be9c4527c3 spotxchange.com,218443,RESELLER,7842df1d2fe2db34 spotx.tv,218443,RESELLER,7842df1d2fe2db34 emxdgt.com,1495,RESELLER,1e1d41537f7cad7f beachfront.com,6547,RESELLER smartadserver.com,3136,RESELLER smartadserver.com,1963,RESELLER smartadserver.com,3276,RESELLER improvedigital.com,1738,RESELLER conversantmedia.com,100112,DIRECT,03113cd04947736d appnexus.com,4052,RESELLER,f5ab79cb980f11d1 aol.com,55011,RESELLER,e1a5b5b6e3255540 indexexchange.com,192311,RESELLER indexexchange.com,193069,RESELLER loopme.com,11058,RESELLER,6c8d5f95897a5a3b google.com,pub-7995104076770938,DIRECT,f08c47fec0942fa0 appnexus.com,8790,RESELLER,f5ab79cb980f11d1 indexexchange.com,187924,DIRECT indexexchange.com,189458,DIRECT openx.com,540322758,RESELLER,6a698e2ec38604c6 pubmatic.com,157102,RESELLER,5d62403b186f2ace pubmatic.com,157163,RESELLER,5d62403b186f2ace pubmatic.com,157752,RESELLER,5d62403b186f2ace rubiconproject.com,13894,RESELLER,0bfd66d529a55807 rubiconproject.com,18008,RESELLER,0bfd66d529a55807 yahoo.com,56860,RESELLER,e1a5b5b6e3255540 aol.com,56860,RESELLER,e1a5b5b6e3255540 rhythmone.com,274200170,RESELLER,a670c89d4a324e47 video.unrulymedia.com,274200170,RESELLER,a670c89d4a324e47 yahoo.com,59652,RESELLER,e1a5b5b6e3255540 appnexus.com,1868,RESELLER appnexus.com,11664,RESELLER EMXDGT.com,273,RESELLER,1e1d41537f7cad7f indexexchange.com,184110,RESELLER,50b1c356f2c5c8fc indexexchange.com,184349,RESELLER,50b1c356f2c5c8fc indexexchange.com,195924,DIRECT indexexchange.com,183875,RESELLER,50b1c356f2c5c8fc indexexchange.com,184626,RESELLER,50b1c356f2c5c8fc openx.com,544096208,RESELLER,6a698e2ec38604c6 pubmatic.com,156971,RESELLER,5d62403b186f2ace pubmatic.com,133799,RESELLER,5d62403b186f2ace pubmatic.com,156078,RESELLER,5d62403b186f2ace pubmatic.com,157840,RESELLER,5d62403b186f2ace pubmatic.com,155967,RESELLER,5d62403b186f2ace pubmatic.com,160048,RESELLER,5d62403b186f2ace pubmatic.com,156084,RESELLER,5d62403b186f2ace contextweb.com,562258,RESELLER,89ff185a4c4e857c telaria.com,4jdlm-4qsx6,RESELLER,1a4e959a1b50034a tremorhub.com,4jdlm-4qsx6,RESELLER,1a4e959a1b50034a triplelift.com,9979,RESELLER,6c33edb13117fd86 media.net,8CUIHQJ4B,RESELLER indexexchange.com,196845,RESELLER,50b1c356f2c5c8fc sovrn.com,378732,RESELLER,fafdf38b16bf6b2b lijit.com,378732,RESELLER,fafdf38b16bf6b2b 33across.com,0010b00002EdWnZAAV,RESELLER,bbea06d9c4d2853c pubmatic.com,161784,RESELLER,5d62403b186f2ace pubmatic.com,161593,RESELLER,5d62403b186f2ace improvedigital.com,1790,RESELLER smartadserver.com,3554,RESELLER 33across.com,0015a00002oUk4aAAC,RESELLER,bbea06d9c4d2853c richaudience.com,1BTOoaD22a,RESELLER pubmatic.com,81564,RESELLER,5d62403b186f2ace rubiconproject.com,13510,RESELLER yahoo.com,49648,RESELLER rubiconproject.com,24298,RESELLER,0bfd66d529a55807 inmobi.com,8f261ace12c3486ba2e0d2011cd97976,DIRECT,83e75a7ae333ca9d adform.com,2736,RESELLER,9f5210a2f0999e32 pubmatic.com,160987,RESELLER,5d62403b186f2ace pubmatic.com,160998,RESELLER,5d62403b186f2ace google.com,pub-7019376976432612,RESELLER,f08c47fec0942fa0 yahoo.com,59133,RESELLER,e1a5b5b6e3255540 yahoo.com,59356,RESELLER,e1a5b5b6e3255540 EMXDGT.com,1966,RESELLER,1e1d41537f7cad7f smartadserver.com,3056,RESELLER pubmatic.com,161527,RESELLER,5d62403b186f2ace rubiconproject.com,23844,DIRECT,0bfd66d529a55807 yahoo.com,59531,RESELLER,e1a5b5b6e3255540 smartadserver.com,4071,RESELLER 152media.info,152M1,RESELLER indexexchange.com,189372,RESELLER,50b1c356f2c5c8fc consumable.com,2001326,RESELLER,aefcd3d2f45b5070 Media.net,8PR6YK195,RESELLER rubiconproject.com,23280,RESELLER,0bfd66d529a55807 smartadserver.com,4102,RESELLER vidoomy.com,57205,RESELLER EMXDGT.com,2007,DIRECT,1e1d41537f7cad7f uis.mobfox.com,1263,RESELLER,5529a3d1f59865be loopme.com,11470,RESELLER,6c8d5f95897a5a3b onetag.com,5927d926323dc2c,DIRECT yandex.com,97790217,DIRECT openx.com,557083110,RESELLER,6a698e2ec38604c6 yahoo.com,59702,DIRECT,e1a5b5b6e3255540 loopme.com,11468,RESELLER,6c8d5f95897a5a3b contextweb.com,562499,RESELLER,89ff185a4c4e857c indexexchange.com,194730,RESELLER outbrain.com,00fe7cdd9f63b40ea93c0c4ae346bf4541,DIRECT vi.ai,987349031605160,DIRECT xandr.com,10736,RESELLER freewheel.tv,1220655,RESELLER indexexchange.com,193091,RESELLER,50b1c356f2c5c8fc improvedigital.com,1863,RESELLER loopme.com,11314,RESELLER,6c8d5f95897a5a3b triplelift.com,11656,RESELLER,6c33edb13117fd86 appnexus.com,13227,RESELLER yandex.com,95746987,RESELLER rubiconproject.com,24386,RESELLER,0bfd66d529a55807 ### THE MONEYTIZER END ### ### Sovrn ### sovrn.com, 306258, DIRECT, fafdf38b16bf6b2b lijit.com, 306258, DIRECT, fafdf38b16bf6b2b lijit.com, 306258-eb, DIRECT, fafdf38b16bf6b2b ### Sovrn END ### ### Revcontent ### revcontent.com, 92656, DIRECT engagebdr.com, 10304, RESELLER synacor.com, 82291, RESELLER, e108f11b2cdf7d5b indexexchange.com, 192143, RESELLER, 50b1c356f2c5c8fc ### Revcontent END ### ### 33Across ### 33across.com, 0010b00002cnuc6AAA, DIRECT, bbea06d9c4d2853c rubiconproject.com, 21642, RESELLER, 0bfd66d529a55807 rubiconproject.com, 21434, RESELLER, 0bfd66d529a55807 rubiconproject.com, 21720, RESELLER, 0bfd66d529a55807 pubmatic.com, 158569, RESELLER, 5d62403b186f2ace openx.com, 540995201, RESELLER, 6a698e2ec38604c6 aol.com, 47594, RESELLER, e1a5b5b6e3255540 yahoo.com, google.com, pub-8787923930478618, RESELLER, f08c47fec0942fa0 yahoo.com,
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