Mortality Due to Opioid Overdose in the United States: Trends from a CDC WONDER Analysis (1999-2024)

The opioid epidemic in the United States has led to a sharp rise in overdose deaths over the past two decades. Although some progress was observed prior to the coronavirus disease 2019 pandemic, opioid-related mortality has increased again in recent years, underscoring the need to re-examine national trends. A retrospective analysis of opioid overdose mortality among US adults aged 25 years and older from 1999 to 2024 was performed using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiological Research (CDC WONDER) Multiple Cause-of-Death database. Opioid-related deaths were identified using the International Classification of Diseases, Tenth Revision, codes T40.0-T40.4 and T40.6. Mortality rates were calculated by year, sex, age, race/ethnicity, and US census region. Temporal trends were evaluated using Joinpoint regression to estimate annual percent changes. A total of 806,765 opioid overdose deaths occurred during the study period. The age-adjusted mortality rate (AAMR) increased from 4.41 to 22.84 per 100,000. Men consistently had higher AAMRs than women (men: 20.64; women: 9.52). Racial disparities were evident, with the highest rates observed among non-Hispanic American Indian/Alaska Native (21.79), non-Hispanic White (18.07), and non-Hispanic Black (15.97) populations. Adults aged 35-44 years had the highest crude mortality rates (20.52). Among US regions, the Northeast had the highest AAMR (18.09), followed by the Midwest (15.69), South (14.74), and West (13.09). These findings confirm that opioid overdose remains a major public health issue, with persistent demographic and regional disparities necessitating targeted strategies to reduce mortality.