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Abstract
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Reports have documented national and state-level increases in drug overdose-related emergency department visits, emergency medical services incidents, and deaths among racial and ethnic minority groups in the United States during 2020 amid the COVID-19 pandemic (1-3). In June 2021, the Nevada Department of Health and Human Services reported an increase in drug overdose deaths during 2020 among Hispanic or Latino (Hispanic) persons, who make up approximately one third of Nevada's population (4). To better understand this increase, investigators analyzed 2019-2020 State Unintentional Drug Overdose Reporting System (SUDORS) data.*
SUDORS is a CDC surveillance system containing detailed information on death scene investigations, toxicology, and other risk factors associated with fatal drug overdoses of unintentional or undetermined intent. Hispanic persons were identified through the SUDORS ethnicity variable, which considers persons with Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin as Hispanic, regardless of race. Chi-square pairwise comparisons with Bonferroni adjustment were used to assess differences between 2019 and 2020 in characteristics and circumstances for all overdose deaths and for those among Hispanic persons (5).
From 2019 to 2020, drug overdose deaths among all races and ethnicities in Nevada increased 54.5% (from 510 to 788), compared with 119.7% (from 66 to 145) among Hispanic persons (Table). By sex and age group, the highest percentage increases occurred among males (overall = 6.9%; Hispanic persons = 6.2%) and those aged <25 years (overall = 77.6%; Hispanic persons = 86.2%). During 2020, the proportions of Hispanic decedents who were male (77.2%) and those aged <25 years (28.3%) were higher than overall proportions (68.3% male; 13.5% aged <25 years). From 2019 to 2020, the proportion of deaths involving illicitly manufactured fentanyls†increased significantly overall (115.6%) and among Hispanic persons (134.5%). By route of drug administration, oral ingestion was highest for deaths in both 2019 (overall = 38.0%; Hispanic persons = 40.9%) and 2020 (overall = 40.7%; Hispanic persons = 31.0%), and the proportion of smoking among Hispanic persons increased 31.6%. During 2020, among those with opioids contributing to death (opioid-involved deaths), only 28.1% of all decedents and 35.7% of Hispanic decedents were known to have received naloxone (Table). Data in SUDORS are dependent on information documented at time of death, and some might be missing, which could underestimate some of the percentages reported. In addition, Hispanic deaths are included in the "all deaths" group.
To improve evidence-based drug overdose prevention and response efforts among persons who use opioids in Nevada, particularly among young male Hispanic persons who have experienced overdoses involving illicitly manufactured fentanyls, a better understanding of the underlying risks for the recent increase in overdose deaths is needed. Naloxone can reverse the effects of overdose from opioids, such as illicitly manufactured fentanyls. Although evidence of naloxone administration for opioid-involved deaths was higher among Hispanic persons in 2020, only approximately one in three of those Hispanic decedents had evidence§ of naloxone administration. ...
Language: en |