Unintentional drug overdoses take a disproportionate toll across the US, study finds

A recent study from Columbia University’s Mailman School of Public Health reveals significant racial and sex disparities in drug overdose mortality rates. The research found that both Black men and Black women have been disproportionately impacted by overdose deaths, with their mortality rates rising sharply compared to their white counterparts.

This study expands scientific understanding of how race, sex, and regional factors intersect to affect overdose outcomes. The study’s findings are published in JAMA Network Open.

“Efforts to reduce drug-related mortality must address the specific needs of marginalized communities, especially Black men,” said Kechna Cadet, Ph.D., postdoctoral researcher in the Department of Epidemiology. “Addressing these disparities requires a comprehensive, multifaceted approach that targets social, economic, physical, and policy risk factors.”

The study examined trends in drug poisoning mortality between Black men, Black women, white men, and white women across all 50 states from 2010 to 2020. Data on unintentional drug poisoning deaths were sourced from the CDC’s Injury Statistics Query and Reporting System.

The analysis included 518,724 fatal drug poisoning cases, broken down as follows: 46,776 Black men, 20,087 Black women, 150,405 white women, and 301,456 white men. The study accounted for 11,820,781 years of potential life lost during the 10-year period.

For the entire time period, findings show Black men had the highest mean age-adjusted mortality rate at 23 deaths per 100,000, followed by white men at 22 per 100,000, with lower rates for white women (12 per 100,000) and Black women (nine per 100,000).

The study revealed that Black men mortality rates saw the most dramatic increases, particularly in Maryland (+485%) and the District of Columbia (+360%). In contrast, white women mortality rates declined in states like Alaska (-23%), Wyoming (-20%), and Oklahoma (-19%).

“Our goal was to identify the specific sociodemographic groups and regions that have faced the highest levels of inequality and are in urgent need of intervention,” said Dr. Cadet.

The study found that in 2016, Black men overdose mortality rates surpassed those of white men, with Black men rates nearly 60% higher by 2020. Similarly, Black women saw a steady increase in mortality rates, surpassing those of white women by 2019.

The opioid overdose epidemic, which has caused nearly one million deaths in the U.S. since its onset, remains a leading contributor to the country’s declining life expectancy.

In 2021 alone, roughly 107,000 lives were lost to overdoses involving fentanyl, heroin, and cocaine. Historically, the majority of opioid-related deaths have been among white individuals. However, overdose rates involving opioids and cocaine have plateaued among non-Hispanic white populations while rising among Black and Hispanic groups. In addition, men have experienced consistently higher overdose rates than women.

“Our analysis of intersectional race and sex disparities over the past decade offers crucial insights for directing much-needed resources such as harm-reduction services and tailored treatment programs to the populations most in need of urgent targeted interventions to decrease unintentional drug overdoses,” said Silvia Martins, MD, professor of Epidemiology at Columbia Mailman School, and senior author of the study.

Dr. Bianca Smith, a co-author of the study from Johns Hopkins Bloomberg School of Public Health, also contributed to the research.