TY - JOUR T1 - Racial/ethnic differences in opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States, 1999-2017. AU - Lippold,Kumiko, AU - Ali,Bina, Y1 - 2020/05/13/ PY - 2020/01/21/received PY - 2020/05/04/revised PY - 2020/05/05/accepted PY - 2020/5/25/pubmed PY - 2021/3/3/medline PY - 2020/5/25/entrez KW - Drug poisoning KW - Opioid overdose KW - Racial disparities KW - Rural KW - Urban SP - 108059 EP - 108059 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 212 N2 - BACKGROUND: From 1999 to 2017, more than 400,000 Americans died from a drug overdose death involving an opioid. Early surveillance studies have observed large variations in opioid-involved overdose deaths among different geographic regions and racial/ethnic groups. The purpose of this study was to characterize trends in racial/ethnic opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States from 1999 to 2017. METHODS: The analysis used National Vital Statistics System data from 1999 to 2017 that were accessed through the CDC WONDER online database. Drug overdose deaths involving any opioid were identified using the International Classification of Diseases, Tenth Revision, codes and were represented as age-adjusted rates per 100,000 population. Joinpoint regression was used to examine trends in opioid-involved overdose deaths among racial/ethnic groups (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic other) by metropolitan and non-metropolitan status (large metropolitan areas, medium-small metropolitan areas, and non-metropolitan areas). RESULTS: The annual age-adjusted death rates for drug overdose deaths that involved any opioid significantly increased for all racial/ethnic groups in metropolitan and non-metropolitan areas from 1999 to 2017. The largest average annual increases in rates occurred among non-Hispanic whites in non-metropolitan areas (13.6% increase per year) and medium-small metropolitan areas (12.3% increase per year), followed by non-Hispanic blacks in medium-small metropolitan areas (11.3% increase per year). CONCLUSIONS: The variations in opioid-involved overdose deaths among different racial/ethnic groups across geographic regions support the existence of multiple sub-epidemics in the current opioid overdose crisis and provide directions for targeted intervention efforts. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/32447173/Racial/ethnic_differences_in_opioid_involved_overdose_deaths_across_metropolitan_and_non_metropolitan_areas_in_the_United_States_1999_2017_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(20)30224-6 DB - PRIME DP - Unbound Medicine ER -