Rising Opioid-related Overdose Mortality Rates in the American Indian and Alaska Native Communities, 1999–2021

Opioid-related overdose (OOD) mortality rates increased in the US from 1999 to 2021, following the four waves of the opioid crisis. American Indian (AI) and Alaskan Native (AN) populations were disparately affected. Researchers used observational, population-based data to quantify OOD mortality growth rates within the AI/AN population based on race, Hispanic ethnicity, age, and sex via segmented time series analysis.

• OOD mortality rates increased in the overall AI/AN population from 0.36 per 100,000 in 1999–2019 to 6.5 per 100,000 in 2019–2021.
• OOD mortality growth rates were highest among 24–44 year-olds in 2019–2021.
• OOD mortality growth rates were similar in females and males in 2019–2021.
• Compared with the overall AI/AN population, the non-Hispanic AI/AN subpopulation demonstrated a greater OOD mortality growth rate, which was generally consistent across age groups.

Comments: The AI/AN community experienced a steep acceleration in OOD mortality rates from 2019–2021. The data suggest that two subpopulations are particularly at risk: adults 24–44 years old, and those of non-Hispanic ethnicity. A greater understanding of this population’s vulnerabilities (stemming from structural racism, oppression, and health inequities) and strengths (including a holistic, community-based mindset) could inform culturally sensitive approaches to comprehensive treatment (i.e., medications for opioid use disorder and naloxone).

Emily Nields, DO

Reference: Bauer C, Hassan GH, Bayly R, et al. Trends in fatal opioid-related overdose in American Indian and Alaska Native communities, 1999–2021. Am J Prev Med. 2024;66(6):927–935.