To the Editor Zhu identified significant US racial and ethnic fentanyl and polysubstance overdose death disparities. They astutely identified that American Indian or Alaska Native and Black populations experience the highest overdose death rates. However, as Pacific Islander health care professionals and researchers, we share concern for the continual aggregation of the Native Hawaiian and Pacific Islander population with the Asian American population when data exist as it obscures well-appreciated patterns of Native Hawaiian and Pacific Islander overdose deaths.