Background: The U.S. drug overdose epidemic is increasingly severe and steep increases have been seen among women.
Objective: To explore trends in drug overdose deaths among women in the United States by race, ethnicity, and age group.
Design: This study is a retrospective observational study of drug overdose deaths among U.S. women from 1999 to 2021.
Methods: We use CDC WONDER Multiple Causes of Death files data using International Classification of Diseases, 10th Revision (ICD-10) codes X40-X44, X60-X64, X85, and Y10-Y14 to identify overall drug overdose deaths, T40.5 for cocaine-related deaths, T40.0-T40.4, T40.6 for opioid-related deaths, T42.4 for benzodiazepines, and T43.6 to identify psychostimulants. Race and ethnicity were defined as non-Hispanic Black, White, American Indian/Alaska Native (AI/AN), Asian, and Hispanic. We calculated overdose death rates per 100,000 women for all overdose deaths and for specific drugs by year, stratified by race and ethnicity.
Results: From 1999 to 2021, overdose deaths among all women in the United States increased by 480%. Overdose deaths rose 750% for non-Hispanic AI/AN women, 490% for non-Hispanic Black women, 450% for non-Hispanic White women, 325% for Hispanic women, and 150% for non-Hispanic Asian or Pacific Islander women. Women ages 35-44 and 45-54 saw the largest increases in overall overdose deaths. Cocaine-related deaths were more prevalent among non-Hispanic Black women, opioid and methamphetamine-related deaths were more prevalent among non-Hispanic AI/AN women, and benzodiazepine-related deaths were more prevalent among non-Hispanic White women.
Conclusion: Increases in overdose deaths were noted in all races, ethnicities, and age groups, with deaths continuing to accelerate in 2021. Our study highlights a need for interventions expanding access to medications for opioid use disorder, naloxone, fentanyl test strips, and contingency management while accounting for gendered roles and vulnerabilities.
Keywords: age; drug overdose deaths; race and ethnicity; substance use; women.
Drug overdose deaths among women 1999–2021 in the United States: Differences by race/ethnicity and ageBackground:The U.S. drug overdose epidemic is increasingly severe and steep increases have been seen among women. The study aimed to explore trends in drug overdose deaths among women in the U.S. by race, ethnicity, and age group. From examining these differences, the researchers sought to offer insights to inform overdose prevention strategies for women who use drugs and face different treatment needs.
Methods: We used CDC WONDER Multiple Causes of Death files data to identify drug overdose deaths overall and by type (cocaine-related, opioid-related, benzodiazepine-related, and psychostimulant-related) among U.S. women from 1999–2021. Race and ethnicity were defined as Non-Hispanic Black, White, American Indian/Alaska Native (AI/AN), Asian, and Hispanic. We calculated overdose death rates per 100,000 women for all overdose deaths and for specific drugs by year, grouped by race and ethnicity.
Results: Increases in overdose deaths were noted in all races, ethnicities, and age groups, with deaths continuing to accelerate in 2021. Our findings were: Overdose deaths among all women in the United States increased by 480%. Specifically, overdose deaths rose by: 750% for Non-Hispanic AI/AN women 490% for Non-Hispanic Black women 450% for Non-Hispanic White women 325% for Hispanic women 150% for Non-Hispanic Asian or Pacific Islander women. Women ages 35–44 and 45–54 saw the largest increases in overall overdose deaths. Cocaine-related deaths were more prevalent among Non-Hispanic Black women. Opioid and methamphetamine-related deaths were more prevalent among Non-Hispanic AI/AN women. Benzodiazepine-related deaths were more prevalent among Non-Hispanic White women.
Conclusions: Our study highlighted a need for interventions expanding access to medications for opioid use disorder (MOUD), naloxone, fentanyl test strips, and contingency management while taking roles and vulnerabilities specific to women into account.