Table 3

Trends in opioid combination* death rates per 100 000 (95% CI) among US non-Hispanic American Indian/Alaska Native 12 and older by substance combination type

199920002001200220032004200520062007200820092010201120122013201420152016201720182019Trend p value†
Overall                       
Opioids and alcohol1.1 (0.7 to 1.7)1.1 (0.7 to 1.6)1.1 (0.7 to 1.6)1.2 (0.7 to 1.7)1.4 (0.9 to 2.0)1.4 (0.9 to 2.0)1.4 (0.9 to 1.9)1.1 (0.7 to 1.6)1.9 (1.4 to 2.6)2.2 (1.6 to 2.9)3.0 (2.3 to 3.8)2.7 (2.0 to 3.4)2.4 (1.8 to 3.1)2.5 (1.9 to 3.2)2.8 (2.1 to 3.5)3.1 (2.4 to 3.9)3.0 (2.3 to 3.8)2.9 (2.3 to 3.7)3.5 (2.8 to 4.3)3.2 (2.5 to 4.0)4.2 (3.4 to 5.1)<0.001
Opioids and benzodiazepines1.1 (0.7 to 1.7)1.1 (0.7 to 1.6)1.1 (0.7 to 1.6)1.1 (0.6 to 1.6)1.0 (0.6 to 1.5)1.1 (0.7 to 1.6)1.3 (0.8 to 1.8)1.6 (1.1 to 2.1)2.0 (1.5 to 2.7)2.0 (1.4 to 2.7)2.5 (1.9 to 3.3)2.5 (1.9 to 3.2)2.2 (1.6 to 2.9)2.9 (2.2 to 3.7)1.8 (1.3 to 2.4)2.8 (2.1 to 3.5)2.9 (2.2 to 3.6)3.6 (2.8 to 4.4)2.9 (2.2 to 3.6)1.3 (0.9 to 1.8)2.6 (2.0 to 3.3)<0.001
Opioids and cocaine1.1 (0.7 to 1.7)1.1 (0.7 to 1.6)1.1 (0.7 to 1.6)1.1 (0.6 to 1.6)1.0 (0.6 to 1.5)1.1 (0.7 to 1.6)1.5 (1.0 to 2.1)1.1 (0.7 to 1.5)1.0 (0.6 to 1.5)1.1 (0.7 to 1.6)1.3 (0.9 to 1.9)1.4 (0.9 to 1.9)1.0 (0.6 to 1.5)1.0 (0.6 to 1.5)1.1 (0.7 to 1.5)1.0 (0.6 to 1.4)1.2 (0.8 to 1.7)1.5 (1.1 to 2.1)1.9 (1.3 to 2.5)2.7 (2.1 to 3.4)2.9 (2.3 to 3.7)0.14
Opioids and methamphetamine0.6 (0.3 to 1.0)–1.1 (0.7 to 1.6)0.5 (0.3 to 0.9)1.0 (0.6 to 1.5)1.0 (0.6 to 1.5)1.0 (0.6 to 1.5)1.0 (0.6 to 1.5)0.5 (0.2 to 0.8)1.0 (0.6 to 1.5)1.1 (0.7 to 1.6)1.0 (0.6 to 1.4)1.0 (0.6 to 1.4)1.5 (1.0 to 2.1)1.5 (1.0 to 2)1.8 (1.3 to 2.4)2.3 (1.7 to 3.0)3.0 (2.3 to 3.7)4.6 (3.7 to 5.5)4.4 (3.6 to 5.3)6.7 (5.6 to 7.7)0.001
Population count1 764 4311 830 3411 857 9161 888 9901 917 0571 946 1511 972 1261 996 1292 016 4802 036 5832 054 4682 067 2262 099 9672 126 2962 151 2712 176 5242 199 5882 222 7362 243 5702 265 1552 285 417 
                       
Female                       
Opioids and alcohol1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.1 (0.5 to 1.8)1.0 (0.5 to 1.8)1.0 (0.5 to 1.7)1 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.4 (0.7 to 2.2)1.0 (0.5 to 1.6)1.8 (1.1 to 2.7)1.6 (0.9 to 2.5)1.8 (1.1 to 2.6)1.0 (0.5 to 1.7)1.7 (1.0 to 2.6)1.3 (0.8 to 2.1)1.5 (0.9 to 2.3)2.0 (1.3 to 2.9)1.7 (1.1 to 2.6)1.9 (1.2 to 2.8)2.1 (1.4 to 3.0)0.01
Opioids and benzodiazepines1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.1 (0.5 to 1.8)1.0 (0.5 to 1.8)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.8 (1.1 to 2.8)1.6 (0.9 to 2.5)1.9 (1.2 to 2.8)1.8 (1.1 to 2.7)2.2 (1.4 to 3.2)2.5 (1.6 to 3.5)2.1 (1.3 to 3.0)2 (1.2 to 2.9)2.7 (1.9 to 3.8)3.5 (2.5 to 4.7)2.3 (1.5 to 3.2)0.9 (0.4 to 1.5)2.0 (1.3 to 2.9)0.01
Opioids and cocaine1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.1 (0.5 to 1.8)1.0 (0.5 to 1.8)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.1 (0.5 to 1.8)1.0 (0.5 to 1.6)0.9 (0.5 to 1.6)0.9 (0.5 to 1.6)1.0 (0.5 to 1.7)0.9 (0.4 to 1.6)0.9 (0.4 to 1.5)1.0 (0.5 to 1.6)0.9 (0.4 to 1.5)1.1 (0.6 to 1.8)1.6 (0.9 to 2.4)1.7 (1.1 to 2.6)2.6 (1.8 to 3.7)0.49
Opioids and methamphetamine––1.1 (0.5 to 1.8)–1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)–1.0 (0.5 to 1.6)0.9 (0.5 to 1.6)0.9 (0.5 to 1.6)0.9 (0.4 to 1.6)1.4 (0.8 to 2.2)1.5 (0.9 to 2.4)1.3 (0.8 to 2.1)2.0 (1.3 to 3.0)2.1 (1.3 to 3.0)4.5 (3.4 to 5.8)3.4 (2.5 to 4.6)6.2 (4.9 to 7.7)0.02
Population count902 815935 494949 825965 851980 999995 7871 009 6481 022 1611 033 0401 043 7301 053 4841 060 3681 076 9771 090 3861 102 9711 115 7771 127 4091 139 7041 150 8321 162 5851 173 309 
Male                       
Opioids and alcohol1.2 (0.6 to 2.0)1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.3 (0.7 to 2.1)1.8 (1.1 to 2.8)1.8 (1.0 to 2.7)1.8 (1 to 2.7)1.2 (0.6 to 2.0)2.5 (1.6 to 3.6)3.5 (2.5 to 4.8)4.3 (3.1 to 5.7)3.8 (2.7 to 5.1)3.1 (2.1 to 4.3)4.1 (2.9 to 5.4)3.9 (2.8 to 5.2)5.0 (3.7 to 6.4)4.6 (3.4 to 5.9)3.9 (2.8 to 5.1)5.4 (4.1 to 6.9)4.5 (3.4 to 5.9)6.5 (5.1 to 8.1)<0.001
Opioids and benzodiazepines1.2 (0.6 to 2.0)1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.2 (0.6 to 1.9)1.6 (0.9 to 2.4)2.2 (1.3 to 3.2)2.2 (1.4 to 3.3)2.4 (1.5 to 3.5)3.2 (2.2 to 4.4)3.3 (2.3 to 4.5)2.2 (1.4 to 3.3)3.4 (2.4 to 4.6)1.4 (0.8 to 2.2)3.6 (2.5 to 4.8)3.0 (2.0 to 4.1)3.6 (2.6 to 4.8)3.5 (2.5 to 4.7)1.8 (1.1 to 2.7)3.1 (2.2 to 4.3)<0.001
Opioids and cocaine1.2 (0.6 to 2.0)1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.2 (0.6 to 1.9)2.0 (1.2 to 3.0)1.1 (0.6 to 1.9)1.0.0 (0.5 to 1.7)1.3 (0.7 to 2.1)1.7 (1.0 to 2.6)1.8 (1.1 to 2.7)1.0 (0.5 to 1.7)1.2 (0.6 to 1.9)1.2 (0.7 to 2.0)0.9 (0.5 to 1.6)1.6 (0.9 to 2.4)1.9 (1.2 to 2.9)2.2 (1.4 to 3.2)3.7 (2.7 to 4.9)3.2 (2.3 to 4.4)0.02
Opioids and methamphetamine1.2 (0.6 to 2.0)–1.1 (0.5 to 1.9)1.1 (0.5 to 1.9)1.1 (0.5 to 1.8)1.1 (0.5 to 1.8)1.0 (0.5 to 1.8)1.0 (0.5 to 1.8)1 (0.5 to 1.7)1.0 (0.5 to 1.7)1.2 (0.6 to 2.0)1.0 (0.5 to 1.7)1.0 (0.5 to 1.7)1.6 (1.0 to 2.5)1.4 (0.8 to 2.2)2.4 (1.5 to 3.4)2.6 (1.7 to 3.7)3.9 (2.8 to 5.1)4.7 (3.5 to 6.0)5.4 (4.2 to 6.9)7.1 (5.6 to 8.8)0.02
Population count861 616894 847908 091923 139936 058950 364962 478973 968983 440992 8531 000 9841 006 8581 022 9901 035 9101 048 3001 060 7471 072 1791 083 0321 092 7381 102 5701 112 108 

  • *Opioids and cocaine (underlying: X40-44, X60-64, X85, Y10-Y14; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 and T40.5).

  • Opioids and benzodiazepines (underlying: X40-44, X60-64, X85, Y10-Y14; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 and T42.4).

  • Opioids and alcohol (underlying: R78.0, X40-45, X60-65, X85, Y10-Y15; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 and T51.0, T51.1, T51.9).

  • *Opioids and methamphetamine (underlying: X40-44, X60-64, X85, Y10-Y14; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 and T43.6).

  • †Non-parametric Jonckheere-Terpstra test for trend.