In the Journals

Cocaine major contributor to overdose deaths, particularly among blacks

The rate of cocaine-related overdose deaths in non-Hispanic black individuals was similar to the rate of heroin and prescription opioid-related deaths in non-Hispanic white individuals, according to findings published in Annals of Internal Medicine.

“Rates of drug overdose deaths increased by 5.5% per year between 1999 and 2015 in the United States,” Meredith S. Shiels, PhD, MHS, from the National Cancer Institute, and colleagues wrote. “These dramatic increases have largely been attributed to opioid-related deaths in non-Hispanic white (NHW) persons... Increases in rates of drug overdose deaths were also recently reported for non-Hispanic black (NHB) and Hispanic persons; however, these increases have received less attention and whether these deaths were due to opioids is unclear.”

Shiels and colleagues performed age- and sex-specific analyses using complete United States death certificate data between 2000 and 2015 from the CDC’s National Center for Health Statistics to compare the trends in rates and types of drug overdose deaths among NHBs, Hispanics and NHWs.

The researchers used the International Classification of Diseases, 10th Revision, codes X40 through X44, to classify unintentional drug overdose deaths. They also used multiple-cause-of-death codes to determine the most commonly involved drug categories, such as heroin, natural/semisynthetic opioids, methadone, cocaine, benzodiazepines and psychostimulants with abuse potential.

Data indicated that the age-standardized rate of total overdose deaths increased between 2000 and 2003 and 2012 and 2015 among NHB (from 6.1 to 9.0 per 100,000 person-years), Hispanic (from 4.2 to 6.0 per 100,000 person-years) and NHW (from 5.6 to 15.5 per 100,000 person-years) individuals. Researchers observed the most pronounced increases in men aged 50 years or older and women aged 45 years or older in the NHB population.

Opioids most commonly caused overdose deaths in NHW individuals whereas cocaine was the most common cause among NHB individuals.

“Our findings show that cocaine-related overdose deaths in NHB persons are on par with heroin- and prescription opioid–related deaths in NHW women and men and that cocaine is a consistent and important contributor to deaths in Hispanic and NHW persons,” Shiels and colleagues wrote. “These deaths are an important, long-term public health problem that is often overlooked.”

The researchers note that their findings may be underestimated because about 20% of death certificates attributing death to unintentional overdoses did not report a contributing drug.

“Strategies to combat the U.S. prescription opioid and heroin epidemics remain critical for all race and ethnic groups,” they concluded. “However, additional efforts focused on the prevention of cocaine-related deaths, which disproportionately affect older NHB persons, are needed.” – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.

The rate of cocaine-related overdose deaths in non-Hispanic black individuals was similar to the rate of heroin and prescription opioid-related deaths in non-Hispanic white individuals, according to findings published in Annals of Internal Medicine.

“Rates of drug overdose deaths increased by 5.5% per year between 1999 and 2015 in the United States,” Meredith S. Shiels, PhD, MHS, from the National Cancer Institute, and colleagues wrote. “These dramatic increases have largely been attributed to opioid-related deaths in non-Hispanic white (NHW) persons... Increases in rates of drug overdose deaths were also recently reported for non-Hispanic black (NHB) and Hispanic persons; however, these increases have received less attention and whether these deaths were due to opioids is unclear.”

Shiels and colleagues performed age- and sex-specific analyses using complete United States death certificate data between 2000 and 2015 from the CDC’s National Center for Health Statistics to compare the trends in rates and types of drug overdose deaths among NHBs, Hispanics and NHWs.

The researchers used the International Classification of Diseases, 10th Revision, codes X40 through X44, to classify unintentional drug overdose deaths. They also used multiple-cause-of-death codes to determine the most commonly involved drug categories, such as heroin, natural/semisynthetic opioids, methadone, cocaine, benzodiazepines and psychostimulants with abuse potential.

Data indicated that the age-standardized rate of total overdose deaths increased between 2000 and 2003 and 2012 and 2015 among NHB (from 6.1 to 9.0 per 100,000 person-years), Hispanic (from 4.2 to 6.0 per 100,000 person-years) and NHW (from 5.6 to 15.5 per 100,000 person-years) individuals. Researchers observed the most pronounced increases in men aged 50 years or older and women aged 45 years or older in the NHB population.

Opioids most commonly caused overdose deaths in NHW individuals whereas cocaine was the most common cause among NHB individuals.

“Our findings show that cocaine-related overdose deaths in NHB persons are on par with heroin- and prescription opioid–related deaths in NHW women and men and that cocaine is a consistent and important contributor to deaths in Hispanic and NHW persons,” Shiels and colleagues wrote. “These deaths are an important, long-term public health problem that is often overlooked.”

The researchers note that their findings may be underestimated because about 20% of death certificates attributing death to unintentional overdoses did not report a contributing drug.

“Strategies to combat the U.S. prescription opioid and heroin epidemics remain critical for all race and ethnic groups,” they concluded. “However, additional efforts focused on the prevention of cocaine-related deaths, which disproportionately affect older NHB persons, are needed.” – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.