Trends in opioid death rates per 100 000 (95% CI) among US non-Hispanic American Indian/Alaska Native 12 and older by opioid-only (no other substances), opioid/polysubstance (opioids and at least one other substance) and all opioid-related cases (sum of opioid-only and opioid/polysubstance)
| 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | Trend p value* | |
| Overall | ||||||||||||||||||||||
| All opioid-related | 5.2 (4.2 to 6.3) | 5.0 (4.1 to 6.1) | 5.7 (4.6 to 6.8) | 6.8 (5.7 to 8.0) | 8.6 (7.3 to 10.0) | 10 (8.7 to 11.5) | 12.0 (10.5 to 13.5) | 11.5 (10.0 to 13.0) | 14.1 (12.5 to 15.8) | 16.0 (14.3 to 17.8) | 19.8 (17.9 to 21.7) | 17.3 (15.5 to 19.1) | 18.0 (16.2 to 19.9) | 20.0 (18.2 to 22.0) | 18.5 (16.8 to 20.4) | 21.5 (19.6 to 23.4) | 22.2 (20.3 to 24.2) | 25.6 (23.5 to 27.7) | 28.6 (26.4 to 30.9) | 25.8 (23.8 to 28.0) | 33.9 (31.5 to 36.3) | <0.001 |
| Opioid-only | 3.7 (2.8 to 4.6) | 3.3 (2.5 to 4.2) | 4.2 (3.3 to 5.2) | 5.1 (4.1 to 6.1) | 6.4 (5.3 to 7.5) | 7.5 (6.3 to 8.8) | 8.2 (7.0 to 9.5) | 8.4 (7.2 to 9.7) | 9.6 (8.3 to 11.0) | 11.3 (9.9 to 12.9) | 13.5 (12.0 to 15.2) | 11.4 (10.0 to 12.9) | 12.2 (10.8 to 13.8) | 13.2 (11.7 to 14.8) | 12.7 (11.2 to 14.2) | 14.2 (12.6 to 15.8) | 14.3 (12.7 to 15.9) | 16.6 (15.0 to 18.3) | 18.2 (16.5 to 20.0) | 16.5 (14.8 to 18.2) | 20.6 (18.7 to 22.5) | <0.001 |
| Opioid/polysubstance | 1.5 (1.0 to 2.1) | 1.7 (1.2 to 2.3) | 1.5 (1.0 to 2.1) | 1.7 (1.2 to 2.3) | 2.2 (1.6 to 3.0) | 2.5 (1.9 to 3.3) | 3.8 (2.9 to 4.7) | 3.1 (2.3 to 3.9) | 4.5 (3.6 to 5.5) | 4.7 (3.8 to 5.6) | 6.2 (5.2 to 7.4) | 5.9 (4.9 to 6.9) | 5.8 (4.8 to 6.8) | 6.8 (5.8 to 8.0) | 5.9 (4.9 to 6.9) | 7.3 (6.2 to 8.5) | 8.0 (6.8 to 9.2) | 9.0 (7.8 to 10.2) | 10.4 (9.1 to 11.8) | 9.4 (8.1 to 10.7) | 13.3 (11.8 to 14.8) | <0.001 |
| Population count | 1 764 431 | 1 830 341 | 1 857 916 | 1 888 990 | 1 917 057 | 1 946 151 | 1 972 126 | 1 996 129 | 2 016 480 | 2 036 583 | 2 054 468 | 2 067 226 | 2 099 967 | 2 126 296 | 2 151 271 | 2 176 524 | 2 199 588 | 2 222 736 | 2 243 570 | 2 265 155 | 2 285 417 | |
| Female | ||||||||||||||||||||||
| All opioid-related | 3.9 (2.7 to 5.3) | 3.6 (2.5 to 5.0) | 5.2 (3.8 to 6.7) | 4.9 (3.6 to 6.4) | 6.4 (4.9 to 8.1) | 6.8 (5.3 to 8.5) | 9.6 (7.8 to 11.6) | 7.6 (6.0 to 9.4) | 12.9 (10.8 to 15.2) | 11.3 (9.4 to 13.4) | 13.1 (11 to 15.4) | 15.0 (12.8 to 17.4) | 15.7 (13.4 to 18.1) | 16.8 (14.4 to 19.3) | 16.7 (14.4 to 19.2) | 15.3 (13.1 to 17.7) | 16.7 (14.4 to 19.1) | 21.0 (18.4 to 23.7) | 22.1 (19.4 to 24.9) | 18.5 (16.1 to 21.0) | 26.1 (23.2 to 29.1) | <0.001 |
| Opioid-only | 2.8 (1.8 to 4.0) | 2.2 (1.4 to 3.3) | 3.9 (2.7 to 5.2) | 3.8 (2.7 to 5.2) | 5.1 (3.8 to 6.6) | 5.2 (3.9 to 6.7) | 6.8 (5.3 to 8.5) | 5.9 (4.5 to 7.4) | 9.0 (7.3 to 10.9) | 8.6 (6.9 to 10.5) | 9.1 (7.4 to 11) | 10.6 (8.7 to 12.6) | 10.6 (8.7 to 12.6) | 11.7 (9.8 to 13.9) | 11.9 (9.9 to 14) | 10.5 (8.7 to 12.5) | 11.0 (9.1 to 13) | 13.8 (11.7 to 16) | 13.8 (11.8 to 16.0) | 12.0 (10.1 to 14) | 15.8 (13.6 to 18.1) | <0.001 |
| Opioid/polysubstance | 1.1 (0.5 to 1.9) | 1.4 (0.7 to 2.2) | 1.3 (0.7 to 2.1) | 1.0 (0.5 to 1.8) | 1.3 (0.7 to 2.1) | 1.6 (0.9 to 2.5) | 2.8 (1.8 to 3.9) | 1.8 (1.0 to 2.7) | 3.9 (2.8 to 5.2) | 2.7 (1.8 to 3.8) | 4.0 (2.9 to 5.3) | 4.4 (3.3 to 5.8) | 5.1 (3.8 to 6.5) | 5.0 (3.8 to 6.5) | 4.8 (3.6 to 6.2) | 4.8 (3.6 to 6.2) | 5.7 (4.4 to 7.1) | 7.2 (5.7 to 8.8) | 8.3 (6.7 to 10.0) | 6.5 (5.2 to 8.1) | 10.3 (8.6 to 12.2) | <0.001 |
| Population count | 902 815 | 935 494 | 949 825 | 965 851 | 980 999 | 995 787 | 1 009 648 | 1 022 161 | 1 033 040 | 1 043 730 | 1 053 484 | 1 060 368 | 1 076 977 | 1 090 386 | 1 102 971 | 1 115 777 | 1 127 409 | 1 139 704 | 1 150 832 | 1 162 585 | 1 173 309 | |
| Male | ||||||||||||||||||||||
| All opioid-related | 6.5 (4.9 to 8.3) | 6.5 (4.9 to 8.3) | 6.2 (4.7 to 7.9) | 8.8 (7.0 to 10.8) | 10.9 (8.9 to 13.1) | 13.4 (11.1 to 15.8) | 14.4 (12.1 to 16.9) | 15.5 (13.1 to 18.1) | 15.4 (13.0 to 17.9) | 20.9 (18.2 to 23.9) | 26.8 (23.7 to 30.1) | 19.7 (17.0 to 22.5) | 20.4 (17.8 to 23.3) | 23.5 (20.6 to 26.5) | 20.5 (17.9 to 23.3) | 27.9 (24.8 to 31.2) | 28.1 (25.0 to 31.3) | 30.4 (27.2 to 33.7) | 35.5 (32.1 to 39.1) | 33.6 (30.2 to 37.1) | 42.1 (38.4 to 46.0) | <0.001 |
| Opioid-only | 4.6 (3.3 to 6.2) | 4.5 (3.2 to 6.0) | 4.5 (3.2 to 6.0) | 6.4 (4.9 to 8.1) | 7.7 (6.0 to 9.6) | 9.9 (8.0 to 12) | 9.7 (7.8 to 11.7) | 11.1 (9.1 to 13.3) | 10.2 (8.3 to 12.3) | 14.2 (12.0 to 16.6) | 18.2 (15.6 to 20.9) | 12.3 (10.2 to 14.6) | 14.0 (11.8 to 16.4) | 14.8 (12.5 to 17.2) | 13.5 (11.4 to 15.9) | 18.0 (15.5 to 20.6) | 17.7 (15.3 to 20.3) | 19.6 (17.0 to 22.3) | 22.8 (20.0 to 25.7) | 21.2 (18.6 to 24.0) | 25.6 (22.7 to 28.7) | <0.001 |
| Opioid/polysubstance | 1.9 (1.1 to 2.9) | 2 (1.2 to 3.0) | 1.7 (0.9 to 2.6) | 2.4 (1.5 to 3.5) | 3.2 (2.2 to 4.4) | 3.5 (2.4 to 4.8) | 4.8 (3.5 to 6.3) | 4.4 (3.2 to 5.8) | 5.2 (3.9 to 6.7) | 6.7 (5.2 to 8.5) | 8.6 (6.9 to 10.5) | 7.3 (5.8 to 9.1) | 6.5 (5.0 to 8.1) | 8.7 (7.0 to 10.6) | 7.0 (5.5 to 8.6) | 9.9 (8.1 to 11.9) | 10.4 (8.5 to 12.4) | 10.8 (8.9 to 12.8) | 12.7 (10.7 to 14.9) | 12.3 (10.3 to 14.5) | 16.5 (14.2 to 18.9) | <0.001 |
| Population count | 861 616 | 894 847 | 908 091 | 923 139 | 936 058 | 950 364 | 962 478 | 973 968 | 983 440 | 992 853 | 1 000 984 | 1 006 858 | 1 022 990 | 1 035 910 | 1 048 300 | 1 060 747 | 1 072 179 | 1 083 032 | 1 092 738 | 1 102 570 | 1 112 108 |
Opioid/polysubstance (underlying: R78.0, X40-45, X60-65, X85, Y10-Y15; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 and T40.5, T42.4, T43.6, T51.0, T51.1, T51.9).
All-opioid related: sum of ‘opioid-only’ and ‘opioid/polysubstance’.
*Non-parametric Jonckheere-Terpstra test for trend.
†Opioid-only (underlying: X40-44, X60-64, X85, Y10-Y14; multiple: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6).