THURSDAY, Dec. 20, 2018 — As the epidemic of opioid addiction rips through the United States, one group is being hit especially hard: Native Americans.
During the years 2013-2015, the rate of fatal opioid overdoses was nearly three times higher among American Indian and Alaska Natives compared to whites, new research shows.
Rates for overdoses specifically linked to heroin were more than four times as high, the study found.
The research is based on statistics from Washington state, and differ from nationwide statistics, which show less of a disparity.
But the researchers said their numbers may be more accurate than national statistics, because they took care to correct for “misclassified” ethnicity data on death certificates.
That means that prior studies may have “underestimated drug overdose mortality rates among American Indians/Alaska Natives by approximately 40 percent,” said researchers led by Sujata Joshi of the Northwest Tribal Epidemiology Center in Portland, Ore.
The bottom line, they said, is that these ethnic populations “have experienced larger increases in drug overdose mortality than have other racial/ethnic groups in the United States.”
One doctor who’s seen the ravages of opioid addiction firsthand called the statistics alarming.
“The number of deadly opioid overdoses among American Indians and Alaska Natives has been steadily increasing over the past several years, with fentanyl-laced heroin linked to a larger portion of the deaths last year,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
“Underreporting of opioid overdoses among [these groups] underestimates the severity of this epidemic,” he said.
In the study, Joshi’s team pored over data from death certificates compiled by the Washington State Center for Health Statistics. Two staff members conducted detailed analyses to verify the ethnicity of each person who died of a drug overdose between 2013 and 2015.
The study found steep increases in opioid overdose death rates among Native Americans. Young males ages 25-54 were hit hardest. In fact, young Native American men had more than double the odds of dying of an opioid OD than their similarly aged white peers, the study showed.
Why the big disparity? Joshi and her colleagues believe societal issues may play a role.
American Indians and Alaska Natives “experience high rates of physical, emotional, and historical trauma and significant socioeconomic disparities, which might contribute to higher rates of drug use in these communities,” they wrote.
They added that Indian Health Services has also suffered from “longstanding underfunding,” so Native Americans continue to “face barriers to receiving quality medical and behavioral health care.”
Another physician working in the field called the Washington state findings “chilling.”
They “reveal an alarming trend with the American Indian/Alaska Native community,” said Dr. Harshal Kirane. He directs addiction services at Staten Island University Hospital in New York City.
Kirane called for urgent action to “mobilize adequate support for this community.”
Glatter said so-called “medication-assisted treatment” (MAT) programs, which help addicts reduce and then quit opioids, are key.
These interventions are an “evidence-based and validated approach to treating those affected, while also reducing the risk of relapse,” he explained. Also helpful: dispensing OD-antidote naloxone kits to help save lives.
Joshi’s group agreed, noting that the Indian Health Service is already forging partnerships with tribal governments and regional Indian health boards. Together, they are boosting access to “medication-assisted treatment and naloxone for first responders,” the researchers said.
The new findings were published in the Dec. 21 Morbidity and Mortality Weekly Report, a journal of the U.S. Centers for Disease Control and Prevention.
More information
The U.S. Centers for Disease Control and Prevention has more on overdose deaths.
Posted: December 2018
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