Opioid overdose and cardiovascular disease-related mortality: a retrospective analysis using real-world data from the USA, 1999–2023

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of mortality in the U.S., a burden amplified by the ongoing opioid epidemic. This study characterized long-term trends and disparities in mortality involving both opioid overdose and CVD from 1999 to 2023. Methods: We conducted a retrospective analysis using death certificate data from the CDC WONDER multiple cause-of-death files. Data for adults aged 15 and older were analyzed using ICD-10 codes for CVD (I00-I99) and opioid overdose (T40.0, T40.1, T40.2, T40.3, T40.4). Age-adjusted mortality rates (AAMRs) per 100,000 population and crude mortality rates (CMRs) were calculated. Joinpoint regression determined the average annual percent change (AAPC). Results: < 0.001). Men had consistently higher mortality than women (overall AAMRs: 2.51 vs. 0.99). Non-Hispanic (NH) Black individuals showed the steepest escalation in AAMR (from 0.33 in 1999 to 6.48 in 2023; AAPC: 12.45%). The West exhibited the highest overall AAMR (2.11). Non-metropolitan areas consistently showed higher AAMRs than metropolitan areas (overall AAMR: 1.56 vs. 1.47). Middle-aged adults aged 45-64 years had the highest overall CMR (2.94). Conclusion: Opioid overdose and CVD-related mortality surged, disproportionately impacting men, NH Black individuals, Western regions, and non-metropolitan areas.