The common narrative around the opioid epidemic and its related overdose deaths has usually centered on white Americans, especially those in rural areas. But this overlooks the surge of fatalities among Black Americans and other minority communities. In fact, for the first time, Black people who use drugs are dying of overdoses at a higher rate than their white counterparts, reports People magazine.
Several factors fuel this increase in overdoses, notably the growing appearance of deadly fentanyl in street drugs. Fentanyl is similar to heroin but much more potent and cheaper to make; in recent years, it has begun to replace heroin.
Another factor contributing to the overdose crisis, People points out, is systemic racism. This results in discriminatory crime laws and barriers to accessing health care and addiction treatment, not to mention a lack of health care workers and specialists who come from and understand the Black community.
“African-American [drug use] looks different, so a therapist has to understand this," Desilynn Smith, an African-American clinical director at Gateway to Change, a behavioral health substance abuse treatment center, told People. “And we all want to see someone like us when we are dealing with something like addiction in the beginning until we build trust up.”
Shame is another issue, said Smith, who lost a husband to a drug overdose. “Shame and addiction go hand in hand with us. It’s not okay to be not okay.”
Overdose deaths among non-Hispanic Black Americans more than tripled between 2010 and 2019, compared with an increase of 58% among whites, noted Joseph Friedman, MPH, of the University of California at Los Angeles, in a letter to the editor published in the February issue of the American Journal of Psychiatry. Friedman has coauthored several related studies that examine overdose deaths by race and ethnicity, and he’s cited in the People article.
What’s more, according to Friedman’s research, the racial and ethnic disparities in drug overdoses have worsened since the emergence of COVID-19. Writing in JAMA Psychiatry on March 2, Friedman and coauthor Helena Hansen, MD, PhD, concluded:
Overdose death rates per 100,000 among Black individuals increased from 24.7 in 2019 to 36.8 in 2020, which was 16.3% higher than that for White individuals (31.6) in 2020. Thus, the 2020 overdose mortality rate among Black individuals was higher than that among White individuals for the first time since 1999. This is a reversal of the overdose mortality gap among Black and White individuals noted in 2010, when the rate per 100,000 among White individuals (15.8) was double (100.1% higher) that seen among Black individuals (7.9). These shifts reflect that Black communities have experienced higher annual percentage increases in overdose deaths compared with their White counterparts each year since 2012. In 2020, Black individuals had the largest percentage increase in overdose mortality (48.8%) compared with White individuals (26.3%).
However, the authors noted, overdose deaths were the highest among American Indian or Alaska Native individuals, at a rate of 41.4 deaths per 100,000 people. Overdose rates among Latinos remains relatively low: at 17.3 per 100,000 in 2020.
But for all racial and ethnic groups, the researchers found that “the relative increases in drug overdose mortality rates observed in 2020 were higher than any prior increase between 1999 and 2019.”
In related news, see “Drug Overdose Deaths Surpass 100,000 in a Single Year” and “International Overdose Awareness Day 2021 [VIDEO].”