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Abstract
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Recent reports highlighted racial and ethnic differences in US drug overdose deaths from 1999 to 2020.1,2 Overdose deaths increased 37.2% from February 2020 to August 2021 and were predominantly associated with synthetic opioids other than methadone (primarily fentanyl or analogs) and methamphetamine.3,4 Yet data are lacking regarding racial and ethnic disparities in overdose death rates within specific sex-age combinations before and during the COVID-19 pandemic (since March 2020).
Methods
This study used publicly available deidentified data and was deemed exempt from review by the National Institutes of Health Institutional Review Board. We followed the STROBE reporting guideline.
Semiannual drug overdose death data were obtained from the National Vital Statistics System Multiple Cause-of-Death final (March 2018-December 2020) and provisional files (January-August 2021). These deaths were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes X40-X44 (unintentional) and Y10-14 (undetermined intent). Deaths involving synthetic opioids other than methadone (largely fentanyl or analogs) were identified using code T40.4. Deaths involving psychostimulants with abuse potential other than cocaine (largely methamphetamine) were identified using code T43.6.
Age-adjusted, sex- and race and ethnicity-specific overdose death rates were computed for overall drug, fentanyl, and methamphetamine with or without fentanyl among individuals aged 15 to 34 years and 35 to 64 years from March 2018 to August 2021. Joinpoint Regression Program, version 4.8.01 tested for significant changes in nonlinear trends using bayesian information criterion. Two-sided P < .05 was considered significant.
Results
Among individuals in the US aged 15 to 34 years from March 2018 to August 2021, age-adjusted overdose death rates involving any drug, fentanyl, and methamphetamine with or without fentanyl increased overall (Figure; Table). During March to August 2021, non-Hispanic American Indian or Alaska Native (hereafter American Indian or Alaska Native) men had the highest rates per 100 000 overall involving any drug (42.0; 95% CI, 35.5-48.4 per 100 000), fentanyl (30.2; 95% CI, 24.7-35.7), and methamphetamine without fentanyl (6.0; 95% CI, 3.6-8.5). American Indian or Alaska Native men (9.2; 95% CI, 6.1-12.2) and women (8.0; 95% CI, 5.1-10.9) and non-Hispanic White (hereafter White) men (6.7; 95% CI, 6.4-7.0) had the highest rates involving methamphetamine with fentanyl.
Among individuals aged 35 to 64 years from March 2018 to August 2021 (Figure; Table), age-adjusted overdose death rates per 100 000 increased overall for deaths involving any drug, fentanyl, and methamphetamine with or without fentanyl among most subgroups. During March to August 2021, overall drug overdose rates were highest among non-Hispanic Black or African American (hereafter Black) men (61.2; 95% CI, 59.4-62.9) and American Indian or Alaska Native men (60.0; 95% CI, 52.8-67.2), and fentanyl-involved death rates were highest among Black men (43.3; 95% CI, 41.8-44.8). Rates involving methamphetamine with fentanyl were highest among American Indian or Alaska Native men (12.6; 95% CI, 9.2-16.0) and women (9.4; 95% CI, 6.5-12.3) and White men (9.5; 95% CI, 9.1-9.8). Rates involving methamphetamine without fentanyl were highest among American Indian or Alaska Native men (22.9; 95% CI, 18.4-27.4)...
Language: en |