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Given unprecedented increases in drug-poisoning deaths, suicidality, and suicide deaths in recent years, an updated examination of the trends in suicide deaths involving opioids is warranted. In this descriptive epidemiologic analysis, we leverage final and provisional mortality data from the US Centers for Disease Control and Prevention\u2019s WONDER database to examine trends in suicide deaths involving opioid poisoning from 1999 to 2021 by biological sex. Results reveal complex changes over time: the number and age-adjusted rate of suicide deaths involving opioid poisoning among male and female residents tended to track together, and both increased through 2010, but then diverged, with the number and rate of suicide deaths involving opioid poisoning among female residents outpacing that of male residents. However, the number and rate of suicide deaths involving opioid poisoning among male residents then began to stabilize, while that of female residents declined, closing the sex-based gap. Across all years of data, the proportion of suicide deaths that involved opioid poisoning was consistently higher among female decedents (5.8%-11.0%) compared with male decedents (1.4%-2.8%). Findings have implications for improved suicide prevention and harm reduction efforts.<\/jats:p>\n               <jats:p>This article is part of a Special Collection on Mental Health.<\/jats:p>","DOI":"10.1093\/aje\/kwae094","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T11:16:02Z","timestamp":1716981362000},"page":"1511-1518","source":"Crossref","is-referenced-by-count":3,"title":["Suicide deaths involving opioid poisoning in the United States, by sex, 1999-2021"],"prefix":"10.1093","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5992-9007","authenticated-orcid":false,"given":"Rachel A","family":"Hoopsick","sequence":"first","affiliation":[{"name":"University of Illinois at Urbana-Champaign Department of Kinesiology and Community Health, College of Applied Health Sciences, , Champaign, IL 61820,","place":["United 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