Background: Although provisional overdose data from the CDC shows that overall overdose deaths in the US may be plateauing, these numbers hide divergent trends in overdose death rates by specific demographic groups. This study focuses on the state of Ohio, where White overdose death rates have recently declined, while Black overdose death rates are rising quickly, surpassing White overdose death rates.
Objectives: We investigate the relationship between the changing composition of illicit drugs in Ohio and the changing demographics of overdose deaths. Specifically, we seek to understand whether increasing combinations of fentanyl with stimulants (e.g., cocaine) can partially explain recent disparate trends in drug overdose deaths among Whites and Blacks.
Methods: Content of the illicit drug supply, measured using crime lab data, 2009-2022, from Ohio’s Bureau of Criminal Investigation, and the Ohio Department of Health’s mortality data to estimate the county-month relationship between overdose death rates by race and the presence of fentanyl, other illicit drugs, as well as fentanyl-cocaine and other combinations.
Results: The presence of fentanyl as well as fentanyl-cocaine combinations predict increases in White and Black overdose deaths. However, fentanyl-cocaine mixtures are related to relatively higher Black overdose death rates.
Implications: Fentanyl-cocaine mixes have increased substantially in Ohio. This change in the illicit drug risk environment appears more strongly associated with Black overdose deaths. It may be partially responsible for driving increasing Black overdose deaths at a time that fatal overdoses have fallen among Whites.