1. Drug, Opioid-Involved, and Heroin-Involved Overdose Deaths Among American Indians and Alaska Natives - Washington, 1999-2015.
- Author
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Joshi S, Weiser T, and Warren-Mears V
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Washington epidemiology, Alaska Natives statistics & numerical data, Analgesics, Opioid poisoning, Drug Overdose ethnology, Drug Overdose mortality, Heroin poisoning, Indians, North American statistics & numerical data
- Abstract
The opioid epidemic has resulted in a threefold increase in drug overdose deaths in the United States during 1999-2015 (1). Whereas American Indians/Alaska Natives (AI/AN) have experienced larger increases in drug overdose mortality than have other racial/ethnic groups in the United States (2), little is known about the regional impact of opioids in tribal and urban AI/AN communities. To address this data gap, death records from the Washington State Center for Health Statistics, corrected for misclassification of AI/AN race, were examined to identify trends and disparities in drug, opioid-involved, and heroin-involved overdose mortality rates for AI/AN and non-Hispanic whites (whites) in Washington. Although AI/AN and whites had similar overdose mortality rates during 1999-2001, subsequent overdose rates among AI/AN increased at a faster rate than did those among whites. During 2013-2015, mortality rates among AI/AN were 2.7 and 4.1 times higher than rates among whites for total drug and opioid-involved overdoses and heroin-involved overdoses, respectively. Washington death certificates that were not corrected for misclassification of AI/AN race underestimated drug overdose mortality rates among AI/AN by approximately 40%. National statistics on the opioid epidemic, which report that overdose mortality rates are significantly higher among whites than among AI/AN, are not reflective of regional prevalences, disparities, and trends. Comprehensive efforts to address the opioid epidemic in AI/AN communities rely on strong partnerships between tribal governments and local, state, and federal entities. Additional measures are needed for community-based surveillance, treatment, and prevention to effectively respond to the epidemic across diverse tribal and urban AI/AN communities., Competing Interests: All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Sujata Joshi reports travel support from the Council of State and Territorial Epidemiologists during the conduct of the study. No other potential conflicts of interest were disclosed.
- Published
- 2018
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