The Drug Overdose Epidemic in the U.S.-Mexico Border Region: Shifts, Progression, and Community Characteristics

Abstract

Objective

Previous studies show the reach of the current drug overdose epidemic into the U.S.-Mexico border region, albeit with a unique border-specific wave pattern compared to national waves and a delayed onset of fentanyl involvement (Wave I: 2002–2011, Wave II: 2012–2016, and Wave III: since 2017). The objective of this study is to examine the community predictors and the progression of overdose deaths across the U.S-Mexico border-specific epidemic waves.

Method

Descriptive epidemiological profile of border communities across the unfolding of the opioid epidemic, integrated data from the CDC-WONDER multiple causes of death data set, the CDC SVI, Uniform Crime Report, and the Behavioral Risk Factor Surveillance System. Using spatially adjusted Bayes rates by border-specific epidemic waves, we provide a descriptive profile of the spatial unfolding of the drug overdose epidemic. Negative binomial regression models assessed community predictors of overdose deaths across waves.

Results

Spatial analysis identified moderate to steep increases in drug overdose deaths over the three waves along the border. The impact and unfolding of the epidemic in the U.S.-Mexico border region were not uniform and affecting communities with differing severity and timing. Our study also finds support for social vulnerability and community violence as predictors of overdose deaths over the current wave of the epidemic.

Conclusion

Findings suggest that more disadvantaged U.S.-Mexico border communities may encounter increasing rates of overdose death over the coming years. Interventions need to target not only the supply side but also the underlying social root causes for sustainable overdose prevention.

Keywords:

• Opioid epidemic
• border region
• drug abuse
• overdose deaths
• communities

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 All border counties are classified as high drug trafficking areas (National HIDTA Assistance Center (NHAC),), 2020).

2 The color-coding range in Figure 1 corresponds roughly to the national distribution. For example, from 2002-2011, the crude U.S. overdose death rate was at about ten to eleven overdose deaths per 100,000. Areas, shaded in red in Figure 1, therefore also showed overdose death rates above the average national level.

3 For example, in 2020 average overdose death rates in the U.S-Mexico Border Region were at the 2019 national level (CDC, 2021).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.