Fatal ODs Are Hitting Less-Educated Americans the Hardest

October 6, 2023
Cara Murez HealthDay Reporter

Americans who haven't been to college appear to be a risk group for drug overdose deaths.

Deaths due to overdose increased among less-educated Americans, with the rate nearly doubling in a three-year period for those without a high school diploma, according to a new study by the RAND Corporation, a nonprofit research organization.

While it's not new that less-educated Americans represent a higher proportion of drug-overdose deaths, the emergence of illicit fentanyl and the COVID-19 pandemic appear to have made matters worse.

For example, in 2021, people without a high school diploma and high school graduates with no college were nearly nine times more likely to die of a drug overdose than people who had a bachelor's degree, the study showed.

"The analysis shows that the opioid crisis increasingly has become a crisis involving Americans without any college education,"study author David Powell, a senior economist at RAND, said in a news release from the organization. "I found large and growing education disparities for all racial and ethnic groups -- disparities that have accelerated since the beginning of the COVID-19 pandemic."

The new study looked at the link between drug deaths and education over a longer stretch of time than other research, using a national cause-of-death database.

Powell correlated educational attainment with overdose deaths for more than 20 years, from 2000 through 2021.

During that time, he found more than 912,000 overdose deaths. More than 625,000 were among individuals who had never been to college and more than 286,000 were among people who had some college.

Overdose death rates increased for both groups over the study period, but grew faster among the no-college group.

For those with no college, the overdose death rate increased from 12 deaths per 100,000 in 2000 to 82 deaths per 100,000 in 2021. It grew from 4.6 deaths per 100,000 to 18.6 per 100,000 in that same timeframe among folks with some college.

From 2018 to 2021, overdose deaths among high school dropouts grew by 35 per 100,000 people, an 83% increase.

That compared to increases of 32 deaths per 100,000 for high school graduates, 10 per 100,000 for people with some college and 2 per 100,000 for those with bachelor's degrees.

The study also broke down data by race. Powell saw substantially higher overdose rates in American Indian and Alaskan Native populations.

Black individuals with a high school diploma had especially high overdose rates compared to white people.

For high school dropouts, white people had higher overdose death rates, though rates have grown faster among Black folks since 2018.

Powell pointed to the need to target resources to economically disadvantaged individuals and communities, such as expanding treatment access in lower-income communities and subsidizing naloxone for low-income individuals. Naloxone (Narcan) is a medication that is used to reverse an opioid overdose.

"Understanding who is most impacted by overdose deaths provides critical information about how resources, such as access to treatment and preventive medicine like naloxone, should be more effectively allocated,"Powell said.

The study findings were published Oct. 6 in JAMA Health Forum. The U.S. National Institute on Drug Abuse and the U.S. Centers for Disease Control and Prevention provided support for the study.

More information

The National Safety Council has more on drug overdoses.

SOURCE: RAND Corporation, news release, Oct. 6, 2023

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