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The increase in opioid deaths in black communities can be linked to health disparities.
The opioid epidemic caused half a million deaths between 1999 and 2019. But far from abating, the COVID-19 pandemic has caused a dramatic increase, with more people dying from opioids each year past than in any previous year. However, the contours of the crisis have changed.
The opioid epidemic has traditionally been thought to primarily affect white Americans, and largely in rural areas. This was partly intentional, as drug companies targeted these areas to avoid the glare of law enforcement. Another reason white Americans were more likely to be addicted to opioids was because blacks were far less likely to receive opioids for pain control, even when medically indicated for emergent conditions. However, new data from the Centers for Disease Control and Prevention (CDC) shows that the reason the opioid epidemic is growing at a breakneck pace is because of its rapid infiltration into black communities.
New research shows more black Americans are dying from overdoses
A recently released CDC report offers a stark look at how the opioid epidemic is increasingly trapping black people in its wake. In 2020, opioid overdoses increased by 30% compared to 2019, resulting in 91,799 deaths. However, the increase was not noticed uniformly. The death rate among black Americans increased by 44%, the largest increase among all racial and ethnic groups, and double that for white Americans.
Black youth ages 15-24 saw an 86% increase in the opioid death rate. In fact, according to my analysis of the CDC WONDER database, in 2020 black Americans had a higher opioid death rate than white Americans for the first time in the entire two-decade history of the opioid crisis.
In 2020, for the first time during the entire opioid epidemic, the opioid overdose death rate was higher for black Americans than for white Americans, largely due to the increase in illicit fentanyl. |
Opioid deaths add to the systemic burdens of black communities
One of the black victims of opioid addiction was George Floyd. “Our story, it’s a classic story of how many people become addicted to opioids,” Courteney Ross, Floyd’s girlfriend, testified during the trial in Minneapolis. “We both struggled with chronic pain. Mine was in my neck and his was in my back.” In fact, opioids could have killed George Floyd before his murder in May 2020; he was hospitalized for an opioid overdose in March of that year.
At a time when black communities are suffering disproportionately from the COVID-19 pandemic and police brutality, they are also being doubly harmed by the ongoing opioid epidemic. Opioid epidemic is exacerbating existing inequalities in America: CDC study shows that areas with the highest degree of income inequality had double the opioid death rate among black Americans in compared to the areas with the lowest income inequality.
What is causing this increase in opioid deaths?
Why has opioid misuse increased among black Americans during the pandemic? A key culprit is the rise of fentanyl, an opioid that is far more lethal than others, which has invaded America through rampant exports from overseas. Research my team published in JAMA showed that the pandemic was associated with a drop in prescriptions for opioids, and subsequent work suggested that this occurred only for new users rather than opiates which had previously been prescribed.
This reduction was due to the closing of clinics and pharmacies, but stopping prescription opioids abruptly can be dangerous. A recent study showed that patients who are suddenly stopped from opioids are at increased risk of suicide, as it can lead them to turn to illicit opioids such as heroin and fentanyl.
Unequal access to addiction treatment adds to the problem
One of the main reasons for the growing racial divide on opioids is based on who actually has access to substance use treatment. While only 14% of those who died from opioids received substance abuse treatment overall, among black Americans the proportion was 8%, the lowest of any group. Treatment services for opioid use disorder were severely affected by the pandemic, leading to abrupt closures of services that served as lifelines for many users.
Policy changes and better access to pain treatments could turn the tide
Simply making substance use and mental health resources available is unlikely to move the needle on its own. Opioid death rates among black Americans were highest in areas with the greatest availability of mental health and addiction treatment centers. What is really needed is a broad public health and outreach campaign in Black communities that highlights the dangers of opioid misuse, provides community resources for harm reduction and addiction treatment, and reduces stigma associated with opioid misuse and seeking treatment.
One of its creators revealed that the war on drugs was racist in nature. The last thing we need is for us to re-criminalize the use and misuse of these drugs, which could put already vulnerable black communities disproportionately affected by opioids and overzealous law enforcement in double jeopardy . Getting fentanyl off the streets through stricter scrutiny is an important part of the national drug control strategy released earlier this year by the Biden administration, but care must also be taken to ensure that the black Americans who are in pain or have been prescribed a chronic illness. opioids, they don’t let themselves suffer.
Evidence-based interdisciplinary pain treatments can provide significant relief for people with chronic pain, and an important goal should be to ensure that all patients, especially those who already suffer disproportionately, receive access to these therapies. However, to ensure that black people are able to obtain adequate pain relief and are also not disproportionately affected by the opioid epidemic, we must ensure that barriers to treatment are removed once and for all.
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