Table. National Trends in Age-Adjusted Drug Overdose Death Rates for Deaths Involving Any Drug, Synthetic Opioids Other Than Methadone (Fentanyl), and Psychostimulants Other Than Cocaine (Methamphetamine) With or Without Fentanyl, by Age, Sex, and Race/Ethnicity.
| Drug overdose deatha | Fentanylb | Methamphetamine with Fentanylb,c | Methamphetamine without Fentanylb,c | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age-adjusted death rates per 100 000 | Mar-Aug 2018 to Mar-Aug 2021 ASPC | P value for ASPC | Age-adjusted death rates per 100 000 | Mar-Aug 2018 to Mar-Aug 2021 ASPC | P value for ASPC | Age-adjusted death rates per 100 000 | Mar-Aug 2018 to Mar-Aug 2021 ASPC | P value for ASPC | Age-adjusted death rates per 100 000 | Mar-Aug 2018 to Mar-Aug 2021 ASPC | P value for ASPC | |||||||||
| Mar- Aug 2018 | Mar- Aug 2020 | Mar- Aug 2021 | Mar-Aug 2018d | Mar-Aug 2020 | Mar-Aug 2021 | Mar-Aug 2018d | Mar-Aug 2020d | Mar- Aug 2021d | Mar-Aug 2018d | Mar-Aug 2020d | Mar-Aug 2021d | |||||||||
| Age 15-34 y | ||||||||||||||||||||
| Men | 16.0 | 24.2 | 24.8 | 10.2 | .002 | 9.7 | 18.5 | 19.8 | 15.9 | <.001 | 1.1 | 3.7 | 5.2 | 32.8 | <.001 | 1.7 | 2.1 | 2.1 | 2.3 | .01 |
| Race and ethnicitye | ||||||||||||||||||||
| AIAN | 20.5 | 40.3 | 42.0 | 15.0 | .001 | 8.3 | 28.3 | 30.2 | 27.4 | <.001 | 9.2 | NAf | 5.6 | 7.0 | 6.0 | NAf | ||||
| Asian | 3.3 | 6.6 | 4.6 | 8.5 | .05 | 1.6 | 4.9 | 3.3 | 16.1 | .02 | NAf | NAf | ||||||||
| Black | 11.0 | 23.7 | 25.5 | 19.4 | .001 | 6.3 | 19.0 | 20.5 | 26.1 | .001 | 0.6 | 2.8 | 3.6 | 1.8 | <.001 | 1.1 | 1.3 | 1.9 | 5.6 | .07 |
| Hispanic | 8.8 | 18.8 | 20.1 | 16.8 | <.001 | 4.4 | 13.7 | 16.1 | 25.9 | <.001 | 0.4 | 2.3 | 3.7 | 47.6 | <.001 | 1.9 | 1.9 | 1.8 | 2.2 | .26 |
| White | 22.1 | 29.5 | 29.0 | 7.1 | .007 | 13.9 | 22.5 | 23.2 | 11.9 | .002 | 1.6 | 4.8 | 6.7 | 29.4 | <.001 | 2.1 | 2.5 | 2.4 | 1.7 | .07 |
| >1 race | 8.7 | 15.2 | 15.6 | 14.9 | .009 | 4.3 | 12.0 | 12.3 | 24.5 | .003 | 3.2 | 3.8 | NAf | 1.8 | NAf | |||||
| Women | 6.5 | 9.5 | 9.6 | 9.1 | .002 | 3.9 | 6.9 | 7.6 | 14.8 | <.001 | 0.6 | 1.6 | 2.1 | 26.7 | <.001 | 1.7 | 2.1 | 2.1 | −0.2 | .91 |
| Race and ethnicitye | ||||||||||||||||||||
| AIAN | 8.5 | 23.4 | 23.5 | 16.9 | <.001 | 14.6 | 18.9 | 32.2 | .02 | 8.0 | NAf | 5.6 | 7.0 | 6.0 | NAf | |||||
| Asian | 0.8 | 1.4 | 1.6 | 12.8 | .006 | 0.9 | 1.0 | NAf | NAf | NAf | ||||||||||
| Black | 3.9 | 9.7 | 11.2 | 21.1 | <.0001 | 2.5 | 7.2 | 9.1 | 26.9 | <.001 | 1.0 | 1.4 | NAf | 1.1 | 1.3 | 1.9 | NAf | |||
| Hispanic | 2.7 | 4.9 | 5.5 | 16.2 | .001 | 1.3 | 3.4 | 4.2 | 25.2 | <.001 | 0.7 | 1.1 | NAf | 1.9 | 1.9 | 1.8 | 2.1 | .59 | ||
| White | 9.4 | 12.1 | 11.8 | 6.1 | .005 | 5.7 | 8.9 | 9.3 | 11.2 | <.001 | 0.9 | 2.3 | 2.9 | 23.3 | <.001 | 2.1 | 2.5 | 2.4 | −2.0 | .004 |
| >1 race | 4.2 | 6.0 | 6.7 | 9.8 | .006 | 2.0 | 4.1 | 4.8 | 15.5 | <.001 | NAf | 1.8 | NAf | |||||||
| Age 35-64 y | ||||||||||||||||||||
| Men | 23.0 | 34.6 | 38.0 | 10.3 | <.001 | 11.5 | 22.3 | 25.9 | 16.8 | <.001 | 1.3 | 4.7 | 7.4 | 37.6 | <.001 | 3.9 | 5.5 | 6.0 | 7.6 | <.001 |
| Race and ethnicitye | ||||||||||||||||||||
| AIAN | 31.6 | 50.7 | 60.0 | 10.5 | .003 | 9.5 | 21.7 | 30.9 | 22.0 | .02 | 5.4 | 12.6 | NAf | 12.6 | 17.2 | 22.9 | 4.9 | .06 | ||
| Asian | 4.2 | 6.9 | 5.0 | 7.0 | .08 | 1.1 | 2.6 | 2.3 | 17.5 | .21 | 0.6 | NAf | 1.2 | 1.7 | 1.7 | 6.4 | .007 | |||
| Black | 30.6 | 52.8 | 61.2 | 13.8 | <.001 | 16.3 | 35.7 | 43.3 | 19.4 | <.001 | 0.6 | 3.6 | 5.9 | 46.7 | <.001 | 2.6 | 4.3 | 5.0 | 13.7 | <.001 |
| Hispanic | 14.0 | 22.1 | 26.2 | 12.1 | <.001 | 6.2 | 13.2 | 17.1 | 20.4 | <.001 | 0.4 | 2.0 | 4.3 | 54.0 | <.001 | 3.3 | 4.8 | 5.0 | 8.1 | <.001 |
| White | 26.6 | 38.5 | 40.7 | 9.1 | <.001 | 13.7 | 25.3 | 28.0 | 15.2 | <.001 | 1.8 | 6.2 | 9.5 | 34.9 | <.001 | 4.4 | 6.1 | 6.6 | 6.9 | <.001 |
| >1 race | 12.4 | 23.8 | 24.6 | 13.1 | .002 | 3.6 | 11.0 | 15.3 | 30.8 | <.001 | 4.0 | 6.4 | NAf | 5.9 | 10.5 | 6.9 | 5.5 | .01 | ||
| Women | 10.7 | 14.4 | 16.2 | 8.9 | <.001 | 4.3 | 8.1 | 10.1 | 17.8 | <.001 | 0.5 | 1.9 | 3.0 | 37.1 | <.001 | 1.5 | 2.1 | 2.3 | 7.9 | <.001 |
| Race and ethnicitye | ||||||||||||||||||||
| AIAN | 18.7 | 27.2 | 34.8 | 13.1 | .008 | 12.8 | 17.5 | 32.9 | .004 | 5.7 | 9.4 | NAf | 8.8 | 8.3 | 11.6 | 6.2 | .37 | |||
| Asian | 1.0 | 1.3 | 0.9 | 0.8 | .92 | 0.5 | 0.5 | NAf | NAf | NAf | ||||||||||
| Black | 10.9 | 17.4 | 21.1 | 13.3 | <.001 | 5.1 | 10.6 | 14.3 | 20.3 | <.001 | 0.9 | 1.4 | 34.4 | <.001 | 0.6 | 1.2 | 1.3 | 12.8 | <.001 | |
| Hispanic | 3.8 | 5.9 | 7.2 | 12.1 | <.001 | 1.2 | 3.1 | 4.2 | 25.0 | <.001 | 0.6 | 1.0 | NAf | 0.8 | 1.2 | 1.3 | 8.8 | <.001 | ||
| White | 13.8 | 17.8 | 19.7 | 8.0 | <.001 | 5.6 | 10.1 | 12.2 | 16.4 | <.001 | 0.8 | 2.7 | 4.3 | 36.1 | <.001 | 1.9 | 2.5 | 2.9 | 7.7 | <.001 |
| >1 race | 7.6 | 8.5 | 11.5 | 9.3 | .001 | 3.7 | 6.9 | 27.2 | <.001 | 3.2 | NAf | 2.9 | 3.3 | NAf | ||||||
Abbreviations: AIAN, American Indian or Alaska Native; ASPC, average semiannual percentage change; ICD-10, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision; NA, not available.
ICD-10 codes X40-44 (unintentional) and Y10-14 (undetermined intent).
ICD-10 code T40.4: synthetic opioids other than methadone, including fentanyl or analogs.
ICD-10 code T43.6: psychostimulants with abuse potential other than cocaine, largely methamphetamine.
Missing values represent suppressed estimates. To estimate age-adjusted death rates simultaneously by age, sex, and race and ethnicity, age 35 years was used as the threshold between the 2 age categories for sufficient overdose deaths in each examined subgroup.
Race and ethnicity data were obtained from the National Vital Statistics System files and included the following recoded categories: AIAN, Asian, Black or African American, Hispanic, Native Hawaiian or Other Pacific Islander, not Hispanic, White, more than 1 race, and not stated. Age-adjusted drug overdose death rates for Native Hawaiians or Other Pacific Islander individuals were not reported because most were suppressed, and rates for those with unknown ethnicity were not estimated due to the lack of precise denominators.
NA indicates insufficient valid data points for joinpoint analyses. Because of space limitations, only age-adjusted semiannual mortality rates for March to August 2018, March to August 2020 (beginning of the COVID-19 pandemic), and March to August 2021 are displayed. Trend analyses were based on all 7 of the semiannual periods between March to August 2018 and March to August 2021, and nondisplayed data are available on request.