Overdose Death Rates increased significantly for Black, American Indian, and Alaska Native People in 2020

In 2020, overdose death rates (number of drug overdose deaths per 100,000 people) increased 44 percent for Black* people and 39 percent for American Indian and Alaska Native (AI/AN) people compared with 2019, according to a new Centers for Disease Control and Prevention (CDC) Vital Signs report with drug overdose data from 25 states and the District of Columbia. Overdose death rates in other groups, specifically White people, for whom the increase was 22 percent, are also at historic highs. Against the backdrop of the COVID-19 pandemic, disruption in access to prevention, treatment, harm reduction, and recovery support services has likely contributed to this growth in overdose deaths. Recent increases in deaths were largely driven by illicitly manufactured fentanyl and fentanyl analogs (IMFs).  In 2020, the overdose death rate among Black males 65 years and older was nearly seven times that of White males 65 years and older.  Black people 15–24 years old experienced the largest rate increase (86 percent) compared with changes seen in other age/race groups during 2019–2020.  Overdose death rates for AI/AN women 25–44 years of age were nearly two times that of White women 25–44 years of age.  Additionally, the report analyzed drug overdose death rates by treatment access and income inequality, which continue to show concerning trends and widening disparities between different population groups.  A history of substance use was common, but a history of receiving substance use treatment was not. Only about 1 in every 10 AI/AN and Hispanic people had reportedly received substance use treatment; evidence of treatment was even lower for Black people (1 in every 12).  Opioid overdose rates in 2020 were higher in areas with higher availability of opioid treatment programs compared with areas with lower treatment availability, particularly among Black (34 vs. 17) and AI/AN (33 vs. 16) people per 100,000. Higher availability of treatment services does not mean improved access to care. The known differences in access, barriers to care, and healthcare mistrust could play a role in exacerbating inequities even when treatment is available in the community.  In counties with more income inequality, there were greater disparities in overdose deaths, particularly among Black people, where the rate was more than two times as high in areas with more income inequality versus those with less income inequality.  In counties with the lowest income inequality, rates were highest among AI/AN people.