Youth and Young Adult National Overdose Rates: A Descriptive, Ecological Cross-Sectional Time-Trend Analysis of Drug Overdose Mortality in 10-24-Year-Olds in the United States.
Level 4 - case-series / case-control
Ecological cross-sectional time-trend analysis using national vital statistics surveillance data
PubMed 42367572 · doi:10.7759/cureus.109677
What was done
Ecological cross-sectional time-trend analysis of unintentional drug overdose mortality among US youth and young adults aged 10 to 24 years from 2018 to 2023 using the CDC WONDER database. Crude mortality rates per 100,000 individuals with 95% confidence intervals were calculated and analyzed by US geographic divisions, regions, race, ethnicity, and sex using non-inferential descriptive statistics.
What was found
Overdose death rates rose from 6.4 (95% CI 6.2-6.6) per 100,000 in 2018 and 6.6 (95% CI 6.4-6.8) in 2019 to 10.3 (95% CI 10.1-10.6) in 2020, peaking at 10.5 (95% CI 10.3-10.8) in 2021. Rates declined to 8.3 (95% CI 8.1-8.5) in 2023 but remained above pre-pandemic levels. Males had higher overall rates, while females showed higher percent increases across most census divisions. American Indian and Alaska Native youth overdose death rates increased from 8.7 (95% CI 7.0-10.7) pre-pandemic to 14.5 (95% CI 12.8-16.1) peri/post-pandemic for males, and from 3.5 (95% CI 2.4-4.9) to 9.1 (95% CI 7.7-10.4) for females. Black or African American youth rates increased from 5.5 (95% CI 5.0-5.9) pre-pandemic to 13.2 (95% CI 12.6-13.7) peri/post-pandemic for males, and from 2.5 (95% CI 2.2-2.8) to 6.2 (95% CI 5.9-6.6) for females.
Why it matters
Unintentional overdose mortality among US youth remains substantially elevated compared to pre-pandemic baselines despite a post-2021 decline, with disproportionate increases concentrated among American Indian/Alaska Native and Black youth.
Limits
The abstract does not state the total number of deaths analyzed. The study relies on aggregate mortality data from CDC WONDER, which are subject to potential death certificate misclassification and regional differences in toxicology reporting. Because the design is descriptive and ecological, it cannot identify specific drug classes, individual-level risk factors, or causal mechanisms.