THE OPIOID CRISIS Impact on Native American Communities

What are Opioids?Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, etc.

Opioid misuse and addiction can lead to overdose and deaths.

Heroin and fentanyl overdoses are driving the recent and rapid increase in opioid-related deaths throughout the U.S., including Indian Country.

How to Protect Yourself, Your Family and Our Community:• TALK TO YOUR KIDS. Tell your children about how deadly opioid drugs can be. Children who

learn about the risks of drugs at home are less likely to use drugs than those who don't. Surveys show that two-thirds of teens who misuse prescription painkillers got them from friends, family members, and acquaintances.

• STORE SAFELY. Keep opioids and other prescription medicine in a secure place. Count and monitor the number of pills you have and lock them up. Ask your friends, family members, and babysitters to do the same.

• DISPOSE LEFTOVER PRESCRIPTION MEDICATION. If you have unused prescription opioids at the end of your treatment, find your community drug take-back program or your pharmacy mail-back program.

• TALK TO YOUR DOCTOR. Discuss alternatives to opioids for pain relief with your doctor. Your doctor may suggest other non-addictive medicines or certain complementary and alternative treatments—such as acupuncture—as a first step for treating chronic pain.

• DON’T TAKE OPIOIDS WITH ALCOHOL AND OTHER MEDICATIONS. Benzodiazepines (such as Xanax® and Valium®), muscle relaxants (such as Soma® or Flexeril®), hypnotics (such as Ambien® or Lunesta®), and/or other prescription opioids. These drugs and substances can enhance each other’s effects, leading to dangerous intoxication and possible overdose.

• ASK FOR HELP. If you or a family member may be misusing opioids or developing an addiction, don't hesitate to seek help from your IHS, tribal health clinic or behavioral health program. Treatment options include counseling and medication assisted therapy.

• KNOW WHAT TO DO IN AN OVERDOSE EMERGENCY. Ask your health provider about Naloxone, which can be used at home to prevent opioid overdose deaths. Always call 911 if you believe someone is experiencing an overdose.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 2000-2017 on CDC WONDER Online Database. ICD-10 Codes: X40, X41, X42, X43, X44, X60, X61, X62, X63, X64, X85, Y10, Y11, Y12, Y13, Y14. AND any of these items: T40.1, T40.2, T40.3, T40.4, T40.6

The opioid-related overdose mortality rate for Native Americans in 2017 was 16.2 deaths per 100,000, which exceeded the national mortality rate of 15.2 deaths per 100,000.

Opioid overdose deaths have been on the rise among Native Americans since 2000.

Source: New Mexico Youth Risk and Resiliency Survey 2017

CURRENT Drug Use (Past 30 Days) Native American High School Students New Mexico 2017

Marijuana

Rx Pain Killer

Synthetic Marijuana

Inhalants

Cocaine

Ecstasy

Methamphetamine

Heroin

(Rx Pain Killer) without a doctor's order in the past 30 days. Nearly, 2% reported current heroin use.

More than 1 in 7 Native American high school students in New Mexico (15.4%) used a prescription pain medication

37.2%

15.4%

7.1%

6.3%

4.6%

3.1%

2.4%

1.6%

ALBUQUERQUE AREA SOUTHWEST TRIBAL EPIDEMIOLOGY CENTERwww.aastec.net • 1-800-658-6717

OVERDOSE Deaths Involving Opioids Among Native Americans U.S. 2000-2017

18

16

14

12

10

8

6

4

2

02001 2002 2004 2006 2008 2010 2012 2014 2016 2017

3.6

5.6

7.18.2

11.710.8 10.9

12.7

16.2

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HeroinHeroin is an illegal drug derived from opium which people inject, sniff, snort, or smoke. Some street names for heroin include: smack, dope, China white, and tar.

FentanylFentanyl is a synthetic (man-made) opioid that is 50x more potent than heroin and 100x more potent than morphine. There are two types of fentanyl:

Pharmaceutical fentanyl, which is primarily prescribed to manage acute and chronic pain associated with advanced cancer.

Non-pharmaceutical fentanyl, which is illicitly manufactured, and is often mixed with heroin and/or cocaine—with or without the user’s knowledge—in order to increase the drug’s effect.

Some street names for fentanyl include: Apache, China Girl, Jackpot, Dance Fever, and TNT.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2016 on CDC WONDER Online Database

OPIOID Overdose Deaths among Native Americans by Sex & Age, U.S. 2015-2017

20

16

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100,000). Opioid overdose deaths are most common among Native Americans 35-44 years old compared to other age groups.

The opioid overdose death rate among Native American males significantly exceeds the rate among Native American females (10.8 per 100,000 vs. 7.6 per

Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2016 on CDC WONDER Online Database.*Data were suppressed in the 65-74 year age group due to small numbers.

The most common age groups when heroin overdose deaths occur are during ages 25-34 (7.0 per 100,000) and ages 35-44 (6.1 per 100,000).*

More than twice as many Native American men (4.3 per 100,000) die from a heroin overdose than Native American women (2.1 per 100,000).

Age 15-24

5.0

Age 25-34

15.9

Age 35-44

17.1

Age 45-64

16.3

Age 55-64

12.4

Age 65-74

3.8

Male

10.8

Female

7.6

HEROIN Overdose Deaths among Native Americans by Sex & Age, U.S. 2015-2017

12

8

4

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100

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Age 15-24

2.0

Age 25-34

7.0

Age 35-44

6.1

Age 45-64

4.6

Age 55-64

3.4

Male

4.3

Female

2.1

Nearly 1 in 4 Native American high school students have been offered, sold, or

given an illegal drug on school property (24.9%).

24.9%Source: New Mexico Youth Risk and Resiliency Survey 2017