BACKGROUND: Recent headlines have suggested that the current drug epidemic has garnered national attention because, unlike other drugs, opioids and heroin are killing white males at high rates. Curious about the changing landscape of the drug epidemic in our own state, we analyzed the demographic breakdown of drug overdose deaths in North Carolina (NC) from 2000-2015.
METHODS: Using Vital Records death certificate data, we examined unintentional deaths involving medication or drugs, heroin, methadone, other opioids, other synthetic narcotics, and cocaine from 2000-2015 in NC. Mortality rates were calculated by race/ethnicity, sex, and age for each drug type for the entire study period. Mortality rates were also calculated for five-year time periods by each drug type and race/ethnicity to identify any trends over time.
RESULTS: During the study period, American Indians had the highest death rates for medication/drug, other opioids, other synthetic narcotics, and cocaine; whites had the highest death rates in heroin and methadone and the second highest rates for medication/drug, other opioids, and other synthetic narcotics; and blacks had the second highest rates for cocaine. Death rates were highest among males and among ages 25-54 for all drug types. Trends over the five-year time periods showed that rates of unintentional medication/drug deaths and other opioid deaths have increased across all races. White and American Indians had the most dramatic increase in death rates while increases among blacks and Hispanics were smaller. Heroin deaths rates have increased the most among whites. Methadone death rates have decreased in recent years except among American Indians. Other synthetic narcotic deaths rates have increased for whites and blacks, and decreased for American Indians. Cocaine death rates have increased for whites, blacks, and American Indians, and is now highest among American Indians.
CONCLUSIONS: In NC, death rates were higher among whites than blacks in all drug categories except cocaine. However, our results showed that American Indians had rates as high or higher than white and black populations in almost every drug category. While the media may imply that the opioid and heroin epidemic are a white male problem, our data show that American Indians have the highest rates in our state. These results suggest a need for overdose prevention interventions tailored to the American Indian population in North Carolina.