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AHRQ: Agency for Healthcare Research and Quality

Disparities in Overdose Deaths Involving Stimulant and Opioid Co-Use

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While overdose deaths from the co-use of opioids and methamphetamine or other stimulants (MOS) have increased across all racial/ethnic groups nationwide, researchers have found large disparities when analyzing these deaths by racial/ethnic group and by State. This study is thought to be the first to estimate race/ethnicity-specific trends in combined stimulant/opioid overdose mortality by geography.

A new study in the American Journal of Epidemiology shows that between 2007 and 2019:

  • Black Americans died from cocaine and opioid co-use at more than three times the rate of non-Hispanic Whites, especially in eastern states.
  • Black Americans died from opioid and MOS co-use at more than five times the rate of non-Hispanic Whites, especially in eastern states.
  • Asian Americans and Pacific Islanders died from opioid and MOS co-use at a faster rate than White people in the West and Northeast.
  • Hispanic people died from opioid and MOS co-use at a faster rate than White people in the West, Northeast, and upper Midwest.

One conclusion of the authors is that “combined stimulant/opioid use and overdose represent a growing problem, likely due to both increased fentanyl contamination of nonopioid drugs and intentional co-use.” Authors also note

  • “A better understanding of the causes of rising stimulant/opioid overdose mortality, and its particular prominence among Black and Hispanic Americans, is needed.”
  • “Changing use or use disorder patterns may partly explain the racially disparate trends.”
  • “Expanded policies and programs to reduce harms related to combined stimulant/opioid use are urgently needed, including access to evidence-based treatment for substance use disorder, widespread provision of harm reduction services, including to people who do not intentionally use opioids, and policies to address upstream social determinants of stimulant and opioid use.”

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