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. 2023 Apr:114:103977.
doi: 10.1016/j.drugpo.2023.103977. Epub 2023 Feb 28.

Age-specific disparities in fatal drug overdoses highest among older black adults and American Indian/Alaska native individuals of all ages in the United States, 2015-2020

Abenaa Jones  1 , Alexis Santos-Lozada  2 , Amaya Perez-Brumer  3 , Carl Latkin  4 , Steve Shoptaw  5 , Nabila El-Bassel  6
Affiliations

Age-specific disparities in fatal drug overdoses highest among older black adults and American Indian/Alaska native individuals of all ages in the United States, 2015-2020

Abenaa Jones et al. Int J Drug Policy. 2023 Apr.

Abstract

Introduction: Increasing disparities within and between racial/ethnic groups in overdose deaths underscore the need to identify drivers and patterns to optimize overdose prevention strategies. We assess age-specific mortality rates (ASMR) in drug overdose deaths by race/ethnicity in 2015-2019 and 2020.

Methods: Data were from the CDC Wonder, and included information for N = 411,451 deceased individuals in the United States (2015-2020) with a drug overdose-attributed cause of death (ICD-10 codes: X40-X44, X60-X64, X85, Y10-Y14). We compiled overdose death counts by age, race/ethnicity, and population estimates to derive ASMRs, mortality rate ratios (MRR), and cohort effects.

Results: The ASMRs for Non-Hispanic Black adults (2015-2019) followed a different pattern than other racial/ethnic groups-low ASMRs among young individuals and peaking between 55-64 years-a pattern exacerbated in 2020. Younger Non-Hispanic Black individuals had lower MRRs than young Non-Hispanic White individuals, yet, older Non-Hispanic Black adults had much higher MRRs than older Non-Hispanic White adults (45-54yrs:126%, 55-64yrs:197%; 65-74yrs:314%; 75-84:148%) in 2020. American Indian/Alaska Native adults had higher MRRs than Non-Hispanic White adults in death counts compiled from pre-pandemic years (2015-2019); however, MRRs increased in 2020 (15-24yrs:134%, 25-34yrs:132%, 35-44yrs:124%, 45-54yrs:134%, 55-64yrs:118%). Cohort analyses suggested a bimodal distribution of increasing fatal overdose rates among Non-Hispanic Black individuals aged 15-24 and 65-74.

Conclusions and relevance: Overdose fatalities unprecedently impact older Non-Hispanic Black adults and American Indian/Alaska Native populations of all ages, deviating from the pattern found for Non-Hispanic White individuals. Findings highlight the need for targeted naloxone and low-threshold buprenorphine programs to reduce racial disparities.

Keywords: Age; Cohort effects; Drug overdose deaths; Race/ethnicity.

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Conflict of interest statement

Declarations of Interest Abenaa Jones (None) Alexis Santos (None), Amaya Perez-Brumer (None), Carl Latkin (None), Steve Shoptaw (None), Nabila El-Bassel (None).

Figures

Figure 1.
Figure 1.
Drug Overdose deaths in the US, 2000–2020. Panel A shows the Drug Overdose Mortality Rates for the Non-Hispanic Black and Non-Hispanic White population from 2000 to 2015. Panel B compares the Drug Overdose Mortality Rates for the Non-Hispanic Black and Non-Hispanic White population in 2015 with those observed in 2020. Panel C shows the Mortality Rate Ratio by age-group for the Non-Hispanic Black and Non-Hispanic White population. An MRR over 100 indicates an increase in the rates in 2020, and vice versa. The distance between the MRR and the Equal Rates line indicates the magnitude of the increase or decrease. The farthest from the line of equality the higher the change in comparison to 2015.
See this image and copyright information in PMC

References

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