Racial/ethnic differences in US drug overdose mortality, 2017-2018

Abstract

Background: The year 2018 marked the first year since 1999 in which the number of drug overdose deaths in the United States (US) declined compared to the previous year. However, it is unclear whether this decline was observed across all racial/ethnic groups.

Methods: Death certificate data from the National Center for Health Statistics were examined for drug overdoses among US residents with a race and ethnicity specified (69,764 in 2017 and 66,949 in 2018). Age-specific and age-adjusted drug overdose mortality rates for 2017 and 2018 were compared by race/ethnicity, overall, by sex, and for overdoses involving stimulants. Percentages of overdose deaths involving specific drug combinations were computed by race/ethnicity.

Results: From 2017 to 2018, the age-adjusted drug overdose mortality rate significantly decreased in Non-Hispanic (NH) Whites; among Hispanics, in contrast, a significant increase was observed. Significant increases in drug overdose mortality rates from 2017 to 2018 were observed for NH Black males, Hispanic males, and NH Blacks aged 65 and older, as well as for overdoses involving psychostimulants (in all racial/ethnic groups) and cocaine (in NH Blacks and Hispanics). In 2018, the proportion of drug overdose deaths involving opioids ranged from 43.2% among NH Asian/Pacific Islanders to 70.8% among NH Whites, and the level of opioid co-involvement in stimulant-involved overdose deaths also varied by race/ethnicity.

Conclusions: The continually-evolving US overdose crisis necessitates an evolving response, not only to address changes in the drug combinations most involved in overdose deaths, but also to strengthen interventions targeting racial/ethnic minority groups.

Keywords: Drug; Mortality; Overdose; Race/ethnicity.