The opioid overdose epidemic has been affecting our country for years. However, there is a growing racial disparity in the rates of opioid-related deaths. A new study from the National Institutes of Health reveals that the rate of opioid overdose deaths among Black people increased a notable 38 percent from 2018 to 2019. Rates among other ethnic groups did not waver. While this study was specific to four states only – Kentucky, New York, Massachusetts, and Ohio – it is telling of budding trends nationwide.
Historically, Black Americans have always had lower rates of overdose deaths than white Americans, and between 1999 and 2012, this rate stayed stable. However, by the year 2013, overdose deaths among white individuals started to level off, while those among Black people started to increase. “We’re seeing a shift in the demographics,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse.
The rate of opioid overdoses among white Americans was double that of Black Americans just years ago, in 2015. Now, the rates of opioid-related overdoses are close among the two demographics. In 2019, the last year for which comprehensive data is available, it’s estimated that opioid overdoses accounted for 19 deaths for every 100,000 white people – and 17.1 deaths for every 100,000 Black people. While this is stable for white Americans, the rate of opioid overdoses amongst Black Americans is more than double what it was in 2015. According to QUARTZ’s analysis of the new data, this means that nearly 5,000 more Black people died of an opioid overdose in 2019 than in 2015.
There is no underestimating the devastating effect that the opioid epidemic has had on all Americans. However, it’s important to acknowledge the drastic uptick in Black overdose deaths caused by opioid drugs, and to understand the factors contributing to this rising concern.
Why is Opioid Abuse and Overdoses Rising Among Black Americans?
To understand the shift in opioid overdose trends among racial groups, we must first understand how the opioid epidemic began. Back in the 1990s, prescription opioids, or painkillers, were being heavily prescribed to patients experiencing pain. This kicked off the opioid crisis in America, and affected predominately white communities at first.
Racial Disparities in Healthcare
According to Dr. Volkow, white people were much more likely to be prescribed opioids than Black people. Wrongfully, this was due to prejudicial ideas that Black patients’ have a higher pain threshold than white people, making doctors less inclined to prescribe medication.
“That, in part, reflects on stigmatization against Black people that even if they have pain, physicians are not going to be as receptive to prescribing them opioids,” says Volkow. This inaccess, in turn, led to lower addiction rates among Black people—and therefore less risk of overdose.
Discrimination in Treatment
For those Black individuals who did develop an opioid use disorder, however, there have also been clear racial disparities in receiving treatment. These may also be contributing to the rise in opioid overdoses among Black communities. As cited in an NPR article:
“If you are Black American and you have an opioid use disorder, you are much less likely to be prescribed medications for opioid use disorder,” Volkow says, noting that medications like buprenorphine have been known to be effective in protecting patients from overdosing. “That’s discrimination,” Volkow continues.
The study also cites that Black communities that there are disparities in access to the antidote drug, naloxone, and in training for how to use it effectively in the wake of an opioid overdose.
A Rise in Fentanyl Abuse
Of course, we cannot ignore the rising number of overdoses involving fentanyl, which is affecting all races and communities in the United States. This also has a clear impact in the rapid increase we’re seeing in overdose death rates among Black people, too. Fentanyl is a powerful synthetic opioid that is often laced into other substances like heroin, cocaine, methamphetamine, and pills sold on the streets.
Historically speaking, the main driver of opioid-related deaths in the U.S. was prescription opioids, due to the over-prescribing of physicians. This led people to become dependent on painkillers and, when those became inaccessible or expensive, turned many to heroin. Heroin then became the leading driver of opioid overdoses in America for some time before we saw a shift to fentanyl. Today, fentanyl is the leading cause of opioid overdoses in America. It is also the leading cause of opioid overdose deaths in Black communities. Fentanyl is 50 times more potent than heroin. People are taking it unknowingly, due to the laced drugs on the streets, and overdosing unintentionally.
Limited Data Available
Dr. Volkow states that one of the key issues in understanding the opioid epidemic is the lack of data we have available. While there is data around the number of overdose deaths due to opioids, the federal government and healthcare systems (such as hospitals and family doctors) do not have mechanisms in place to effectively track people affected by opioid addiction. Many doctors do not screen for opioid use disorders. Therefore, the opportunity to help people struggling, and to prevent opioid overdose, is not always granted. Many people struggling with addiction do not ask for help.
In urban and inner city communities that are largely affected by drug abuse, this lack of surveillance is enabling the opioid epidemic to ramp up to record numbers. This is combined with the fact that these communities have less access to care providers—due to the inequities that exist in our nation today as well as the stigma associated with asking for help. Whether these communities have been ignored due to racism or cultural incompetence, it is time for a change. More intensive intervention is needed.
According to Dr. Andrew Kolodny, the medical director for opioid policy research at Brandeis University, “Opiate addiction is a disease that’s preventable and treatable, and you need a public health response that would be similar to even a communicable disease outbreak like COVID.”
Opioid Overdoses Continued to Affect Black Americans Disproportionately in 2020
While the latest survey highlighted the rising number of opioid overdoses in 2019, it’s important to note that this trend has continued into more recent years. Experts predict that opioid overdoses (and drug abuse, in general) reached new highs in 2020, during the COVID-19 pandemic. With COVID-19 disproportionately affecting minority groups – combined with the societal stress caused by the deaths of George Floyd, Breonna Taylor, and many more – it’s clear to see why Black communities may have seen a sharp rise in substance abuse, too. Stress is a main cause of substance use.
While national data from institutions like the CDC and NIDA is not available for overdoses by race in 2020, researchers at the University of California, Los Angeles, identified some key insights. After analyzing emergency medical calls nationwide, they found an overall increase of 42% in overdose deaths in 2020. Notably, the largest increase was among Black people, with a spike of more than 50%.
What Can We Do?
This is a call for public health officials, treatment professionals, clinicians, and communities to step in and help those suffering from the opioid overdose epidemic. Prevention efforts, education efforts, and access to treatment and screenings must be implemented in communities that are most affected by drug abuse, addiction, and overdose. In order to slow the epidemic, we must reduce the use of opioids and drugs, in general, in the needing communities.
Additionally, we must reduce discrimination in our healthcare systems, providing individualized care to all people based on their conditions, symptoms, and individual needs.
And, if you are in a community or family where a loved one is struggling, there are steps you can take to getting him or her help. You can always reach out to a treatment professional for guidance and support. Turnbridge is just one call away at 877-581-1793. In your community, you can also work to reduce the stigma around drug abuse and addiction by normalizing these conversations and the ask for help. Often, people are embarrassed to seek help for their drug problem. However, it is this intervention, or even simple conversation, that can help to save their life and prevent an overdose.
If you are looking for addiction treatment for yourself or a loved one, do not hesitate to call Turnbridge for help.