Published: 09/8/2026 | Author: Eric Owens

Opioid overdose deaths fell sharply in 2023 and 2024 especially those that involved fentanyl. A national study went a step further and showed that improvements didn’t reach everyone equally. In fact, disparities persisted along racial lines.

The Study’s Results

Researchers in The Golden State based at the University of California San Diego reviewed every recorded overdose death in the United States from 1999 through 2024 using the CDC’s WONDER database. The research team broke results down by substance involved and by race and ethnicity.

The national overdose death rate fell 24.4% to 23.7 deaths per 100,000 people in 2024. But 80,000 people still died.

One point stands out. The demographic figures below describe overdose deaths from all substances, not opioid deaths alone. The study reports rates by group but didn’t set out to examine why those rates differ.

Deaths Dropped

Black Americans recorded the largest drop of any group, with overdose death rates falling 29.3% in a single year. Even after a decline that steep, the rate remained more than 1.5x the national average.

American Indians and Alaska Natives had the highest rate in the study with 50.8 deaths per 100,000. This was more than twice the national average.

Those stats show that race plays a part. One group can post the fastest improvement in the country and still lose folks to drugs at a rate well above everyone else because the gap it started from was that large.

Study author Joseph Friedman agreed. He stated that “national trends can improve while vulnerable communities continue to suffer disproportionately.”

Beneath the Numbers

Rates like these describe circumstances, not people. Nothing in this study suggests that anyone’s race makes them more likely to experience addiction or to die of an overdose.

However, the study didn’t look at things like access to treatment or insurance coverage. These and other conditions impact who can get care and how fast.

Substances Involved Differed by Community

The study also found that different drugs left different scars for certain groups.

Cocaine deaths affected Black Americans more than other ethnicities. Cases involving methamphetamine especially hurt American Indian and Alaska Native communities. Deaths involving xylazine and other veterinary sedatives now common in the illicit drug trade also hit higher among Black Americans.

The numbers show that a prevention effort only built around opioids won’t reach someone whose drug of choice is stimulants. 

Opioids & Stimulants

Opioids slow breathing and breathing actually stops when an overdose hits.

Stimulants like methamphetamine and cocaine work in the opposite direction by speeding up the cardiovascular and nervous systems. A stimulant overdose can look like chest pain or seizure rather than slowed breathing.

Xylazine isn’t an opioid, so naloxone doesn’t reverse its sedation. Give naloxone anyway if you don’t know what was involved since fentanyl is frequently present alongside it. Then call 911 and stay with the victim.

Harm Reduction Options

For opioid use disorders, medication remains the standard. Buprenorphine and methadone reduce cravings. Naltrexone is one option once someon’s fully withdrawn from opioids.

Naloxone is available over the counter and free through many state programs. Tolerance drops quickly after any break in use, which people at risk of relapse should know about.

The authors called for continued investment in treatment, harm reduction and targeted public health work. They emphasized closing these disparities rather than just lowering the total.

NA Still a Top Option

Help doesn’t depend on which community you belong to. In fact, peer support programs build communities and fellowship that cut across race, class and other demographics.

Narcotics Anonymous meetings are free and run nationwide. They only require that participants want to stop using drugs. Formats include step meetings and online options. Browse our directory to locate meetings nationwide. It’s completely searchable by state, city and program type.

Feel free to also call 800-934-1582(Sponsored) for free and confidential guidance. It’s available 24 hours a day.