Drug overdose deaths among women 1999-2021 in the United States: Differences by race, ethnicity, and age.

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 (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.