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These increases may particularly affect non-Hispanic Black and Hispanic populations. We used death certificate data from the US National Center for Health Statistics (2007\u20132019) to compare state-level trends in overdose mortality due to opioids in combination with 1) cocaine and 2) methamphetamine and other stimulants (MOS) across racial\/ethnic groups (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian American\/Pacific Islander). To avoid unstable estimates from small samples, we employed principles of small area estimation and a Bayesian hierarchical model, enabling information-sharing across groups. Black Americans experienced severe and worsening mortality due to opioids in combination with both cocaine and MOS, particularly in eastern states. Cocaine\/opioid mortality increased 575% among Black people versus 184% in White people (Black, 0.60 to 4.05 per 100,000; White, 0.49 to 1.39 per 100,000). MOS\/opioid mortality rose 16,200% in Black people versus 3,200% in White people (Black, 0.01 to 1.63 per 100,000; White, 0.09 to 2.97 per 100,000). Cocaine\/opioid overdose mortality rose sharply among Hispanic and Asian Americans. State-group heterogeneity highlighted the importance of data disaggregation and methods to address small sample sizes. Research to understand the drivers of these trends and expanded efforts to address them are needed, particularly in minoritized groups.<\/jats:p>","DOI":"10.1093\/aje\/kwab290","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T20:11:28Z","timestamp":1640981488000},"page":"599-612","source":"Crossref","is-referenced-by-count":115,"title":["Racial\/Ethnic and Geographic Trends in Combined Stimulant\/Opioid Overdoses, 2007\u20132019"],"prefix":"10.1093","volume":"191","author":[{"given":"Tarlise","family":"Townsend","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kline","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadne","family":"Rivera-Aguirre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M","family":"Bunting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia M","family":"Mauro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon D L","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia S","family":"Martins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"2022050706174206700_ref1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.drugalcdep.2018.08.029","article-title":"Twin epidemics: the surging rise of methamphetamine use in chronic opioid users","volume":"193","author":"Ellis","year":"2018","journal-title":"Drug Alcohol Depend."},{"issue":"34","key":"2022050706174206700_ref2","doi-asserted-by":"crossref","first-page":"737","DOI":"10.15585\/mmwr.mm6834a2","article-title":"Changes in opioid-involved overdose deaths by opioid type and presence of benzodiazepines, cocaine, and methamphetamine\u201425 States, July\u2013December 2017 to January\u2013June 2018","volume":"68","author":"Gladden","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"17","key":"2022050706174206700_ref3","doi-asserted-by":"crossref","first-page":"388","DOI":"10.15585\/mmwr.mm6817a3","article-title":"Drug overdose deaths involving cocaine and psychostimulants with abuse potential\u2014United States, 2003\u20132017","volume":"68","author":"Kariisa","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022050706174206700_ref4","author":"National Center for Health Statistics","year":"2021"},{"key":"2022050706174206700_ref5","author":"National Center for Health Statistics","year":"2020"},{"issue":"5","key":"2022050706174206700_ref6","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/add.14878","article-title":"The rise in non-fatal and fatal overdoses involving stimulants with and without opioids in the United States","volume":"115","author":"Hoots","year":"2020","journal-title":"Addiction."},{"issue":"5","key":"2022050706174206700_ref7","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1177\/0162243920912812","article-title":"Race as a ghost variable in (White) opioid research","volume":"45","author":"Hansen","year":"2020","journal-title":"Sci Technol Hum Val."},{"issue":"13","key":"2022050706174206700_ref8","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1080\/10826084.2020.1793367","article-title":"Drug overdose deaths among US Hispanics: trends (2000\u20132017) and recent patterns","volume":"55","author":"Cano","year":"2020","journal-title":"Subst Use Misuse."},{"key":"2022050706174206700_ref9","doi-asserted-by":"crossref","DOI":"10.1016\/j.addbeh.2020.106625","article-title":"Racial\/ethnic differences in US drug overdose mortality, 2017\u20132018","volume":"112","author":"Cano","year":"2021","journal-title":"Addict Behav."},{"issue":"1","key":"2022050706174206700_ref10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12954-015-0088-4","article-title":"Why the FUSS (fentanyl urine screen study)? 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