Drug Overdose Deaths Rise, Disparities Widen — CDC Vital Signs

A CDC Vital Signs report updated July 19, 2022, with data for 2019–2020.

At a glance

• In counties with more income inequality, overdose death rates for Black people were more than twice those in counties with less inequality in 2020.
• Overdose death rates among older Black men were nearly seven times those of older White men.
• Rates for younger American Indian and Alaska Native (AI/AN) women were nearly twice those of younger White women.

Widening gaps

Overdose data show troubling trends and widening gaps between groups. In a single year, overdose death rates — deaths per 100,000 people — rose 44% for Black people and 39% for AI/AN people. This happened as a record 92,000 lives were lost to overdoses in 2020.

Most people who died had no evidence of substance use treatment beforehand, and a smaller share of people from racial and ethnic minority groups had received treatment than White people. Conditions where people live, work and play can widen the gaps — places with a larger income gap between rich and poor have higher overdose death rates.

Why the gaps

• Access. Racial and ethnic minority groups have less access to proven treatment for substance use disorders — and not simply because services are missing: communities with more capacity to provide care had the highest death rates, a pattern even stronger for Black and AI/AN people.
• Income inequality, which falls hardest on racial and ethnic minority groups, can mean no stable housing, reliable transport or health insurance, making treatment and support harder still to reach.
• Deadlier drugs. Overdoses are becoming more common and more deadly, with more polysubstance use — mixing or using more than one drug — and the spread of illicitly manufactured fentanyls in the drug supply.

Prevention has to tackle polysubstance use while also reducing historical inequities, promoting primary prevention, and expanding proven treatment, recovery support and harm reduction. Health departments can bring criminal justice, health care, social services, employers and government together on comprehensive efforts.

Advancing equity

Overdoses are preventable. Public health professionals, health care providers, policymakers and communities can:

• make treatment and recovery support easier to start and continue, for example through telehealth, and expand insurance coverage;
• offer structural support — help with housing, transport and childcare — so people can get to and stay in treatment;
• combine culturally appropriate traditional practices, spirituality and religion, where suitable, with proven treatment;
• run culturally tailored campaigns that raise awareness and reduce stigma;
• offer support groups and community connection to reduce stigma and mistrust;
• reduce criminalisation of substance use disorders;
• link people to treatment from many settings — primary care, syringe services programmes, health care during incarceration — and through trusted messengers;
• improve access to programmes that address past trauma and prevent future trauma and other risk factors.

Preventing overdose deaths

Prevent overdose

• Reduce adverse childhood experiences, which raise the risk of substance use, and the root causes of health disparities.
• Raise awareness of the dangers of illicit fentanyls and of using more than one drug.
• Reduce the stigma of seeking treatment, harm reduction and recovery support.

Treat substance use disorder

• Help people start and stay in treatment from many settings.
• Improve access to proven treatment, such as medication for opioid use disorder.
• Include culturally tailored traditional practices, spirituality and religion, where suitable.

Support harm reduction

• Expand community naloxone distribution and education, and pharmacy prescribing and dispensing.
• Expand harm reduction services: naloxone, fentanyl test strips, syringe services programmes with overdose prevention, and connections to same-day treatment. Syringe services programmes are a valuable way to reach people who inject drugs, teach overdose prevention and link them to treatment.
• Educate employers, Medicaid and other insurers, and policymakers about substance use and overdose risk.

Everyone can

• Talk to a doctor if you or someone close to you needs help with substance use.
• Learn about naloxone, which can reverse an opioid overdose if given in time. Ask a doctor or pharmacist for a prescription, or get it from a local organisation, if you or a loved one uses illicit drugs, has a substance use disorder, takes high-dose prescription opioids or has other risk factors.
• Share information on overdose prevention and on the communities hit hardest.
• Learn about reducing stigma, a major barrier to getting help.

Sources

• Centers for Disease Control and Prevention, Vital Signs, Drug Overdose Deaths Rise, Disparities Widen, and the MMWR report behind it. The page's stock photo collage is left out.