Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska Native populations from 1999 to 2019: a retrospective longitudinal ecological study.

When looking deeper into individual opioid types ( figure 3 , table 4 ) there was a significant rise in natural and semi-synthetic (prescription) opioid death rates (rates per 100 000 overall: 1.4 to 5.1, p<0.001; rates per 100 000 women: 1.1 to 4.8, p<0.001; rates per 100 000 men: 1.6 to 5.4, p<0.001) and heroin (rates per 100 000 overall: 1.2 to 6.3, p<0.001; rates per 100 000 women: 1.1 to 4.9, p=0.056 (on the boundary of significance); rates per 100 000 men 1.3 to 7.7, p<0.001).

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1 9 17 Similarly, deaths resulting from opioid combinations with other drugs among AI/AN populations follow an increasing trend that is supported by prior research. 16 The combination of opioids with other substances can be a potent inducer of drug overdose.

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