Indigenous Americans see five-fold increase in fatal opioid overdoses over two decades, study says

Story at a glance

  • A new study published this week in the journal BMJ Open found opioid overdose deaths among American Indian and Alaska Native communities increased five-fold from 1999 to 2019.


  • The study’s authors looked at overdose deaths attributed to opioids alone, opioids in combination with other drugs and alcohol and deaths linked to specific types of opioids among American Indians and Alaska Natives ages 12 and older.


  • The research comes as nearly 107,000 Americans died from drug overdoses over the 12-month period ending in November 2021, a record high driven primarily by the pervasive and powerful synthetic opioid fentanyl


Fatal overdoses among Indigenous Americans are spiking as the U.S. remains mired in a worsening opioid crisis.

A new study published this week in the journal BMJ Open found opioid overdose deaths among American Indian and Alaska Native communities increased five-fold from 1999 to 2019, while the number of drug overdoses overall in the U.S. has quadrupled since 1999.

Researchers from the Parkinson School of Health Sciences and Public Health at Loyola University Chicago and colleagues analyzed death records data from the Centers for Disease Control and Prevention (CDC) over the past two decades.

The study’s authors looked at overdose deaths attributed to opioids alone, opioids in combination with other drugs and alcohol, and deaths linked to specific types of opioids among American Indians and Alaska Natives ages 12 and older.


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The analysis found mortality rates involving only opioids increased from 2.8 to 15.8 per 100,000 American Indian and Alaskan Native women, and from 4.6 to 25.6 per 100,000 among Indigenous American men over the past 20 years.

Researchers also found significant increases in mortality rates due to opioids in combination with alcohol, benzodiazepines, cocaine and methamphetamine.

The data showed deaths in which opioids were involved increased from 5.2 to 33.9 per 100,000 Indigenous Americans in total.

“These findings highlight existing inequities in drug related deaths and may point to broader systemic factors that disproportionately affect members of [American Indian and Alaska Native] communities,” researchers said in a statement.

“While the type of opioid driving these trends has changed over the years, many underlying social factors that drive these patterns have not,” researchers said.

The study found that death rates due to synthetic opioids like fentanyl have rapidly increased in recent years, increasing from 1.5 per 100,000 in total in 2013 to 12.5 per 100,000 in 2019. Among Indigenous American men, death rates attributed to synthetic opioids soared from 1.5 per 100,00 to 16.5.

The research comes as nearly 107,000 Americans died from drug overdoses over the 12-month period ending in November 2021, a record high driven primarily by the pervasive and powerful synthetic opioid — which is 50 times stronger than heroin and 100 times stronger than morphine.


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