Drug overdose mortality rates among non-Hispanic American Indian/Alaska Native individuals, 1999-2022

To examine epidemiological trends in drug overdose deaths for non-Hispanic American Indian/Alaska Native (AIAN) individuals compared to White individuals.

We obtained data from the CDC WONDER database to examine crude drug overdose death rates per 100,000 among AIAN and White individuals from 1999-2022. Rates were further stratified by manner of death, sex, age, urbanization, Census region, state, and specific drug types.

From 1999-2022, drug overdose death rates for AIAN individuals increased from 3.17 (95 % CI, 2.48-4.00) to 40.73 (95 % CI, 38.19-43.27), representing a 12-fold increase; in contrast, rates rose by five-fold for White individuals. In 2022, methamphetamine was the leading driver of overdose death rates for AIAN individuals, at 31.39 (95 % CI, 29.16-33.62) per 100,000, followed by fentanyl, at 22.35 (95 % CI, 20.46-24.23) per 100,000. Geographical variations were notable, with the highest rates for AIAN individuals in large central metropolitan regions (53.54 per 100,000) and the Midwest (50.31 per 100,000). Rates were higher for AIAN than White individuals in 20 of the 21 states (95.2 %) included in our analysis.

AIAN individuals are disproportionately impacted by the overdose crisis. Further efforts are needed to expand access to harm reduction-informed, culturally-competent health education, addiction treatment, and social services in the AIAN population.