AIn 2020, the U.S. was ravaged by COVID-19. Another health emergency was also in full swing: the drug overdose epidemic. The number of drug-related deaths in the United States rose by 30% to nearly 92,000, which is a 30 percent increase over 2019.
While overdose deaths rose across the population, the increase in deaths was far steeper among Black, American Indian, and Alaska Native people, according to data published July 19 in the U.S. Centers for Disease Control and Prevention (CDC)’s Weekly Report on Morbidity and Mortality Overdose deaths rose 44% among Black people from 2019 to 2020, and 39% among American Indian and Alaska Native persons, according to the CDC’s analysis of data from 25 states and the District of Columbia. These numbers rose 22% in white Americans.
Although drug-related deaths have been varied in terms of race and ethnicity for decades, new data suggests that these rifts are growing and that people of color are more affected. When opioids were first introduced, people of color had a higher risk of overdose than people who were Black. However, overdose deaths in Black communities have increased significantly over the past decade. According to an analysis released in March by the Insight, Black Americans are more likely than white Americans to die from overdoses every year since 2012. The rates of deaths due to overdose among Black Americans outpaced those among white Americans in 2020. JAMA Psychiatry. The rate of overdose deaths among Alaska Natives and American Indians was higher than that of white Americans in 2019, despite them having similar overdose rates as white Americans.
Recent research points out that there were many causes behind the disparity. This included inequal access and effectiveness of treatment options for substance-use disorders like buprenorphine. It also includes income inequality effects like unreliable transport, poor housing, lower insurance coverage and unstable housing. Black and Alaska Native Americans who were killed in an accident or illness had a lower chance of receiving substance treatment than those of us whites.
Jerreed Jerreed, an assistant professor at Colorado School of Public Health and member of the Metlakatla Indian Community, said that many American Indian or Alaska Native communities lack the resources necessary to treat substance abuse disorder. “You’re driving an hour, two hours plus, to get resources,” says Ivanich. “And if you don’t have a job, if you don’t have childcare, if you don’t have support networks at home, getting to those programs and resources becomes really difficult.”
Researchers note that the increasing number of deaths from overdoses among Black Americans and Alaska Natives has been due to fentanyl (a powerful opioid) that is often used in combination with stimulants such as cocaine or methamphetamine. There have been more overdoses involving both opioids as well as stimulants like cocaine and methamphetamine. In CDC research Alcohol and Drug Dependence In 2021, it was found that stimulants and opioids were most prevalent among American Indians and Alaska Natives. However, deaths from cocaine and opioids have been more common in Blacks.
“It is critical for prevention efforts to address fentanyl and polysubstance use, and work to reduce historical health inequities,” said Dr. Debra E. Houry, acting principal deputy director of the CDC, in a July 20 press briefing.
Both the disruption of the drug market as well as the deaths from drug-related overdoses caused by the pandemic increased drug overdose deaths. The pandemic made it more difficult for drugs to be moved, so traffickers may have increased the volume of their transports of fentanyl (which is lighter) during this period. The pandemic also worsened people’s mental health and isolated them, which may have pushed people who use drugs to take them alone—which experts warn makes it harder for people to receive help from others, in the form of the overdose reversal drug naloxone or by calling an ambulance.
Although research continues to indicate that those of color are at greatest risk of overdose death, it is still common for white Americans to be the focus of media coverage. According Dr. Ayana, Jordan, who is an assistant professor of psychology at New York University Grossman School of Medicine and researches the treatment of marginalized populations for substance-use disorder. “When I give talks all over the nation, people are still surprised to know that Black people are outpacing the rate of white people in terms of opioid-involved overdose deaths.” And as white people have become less affected than Black Americans, attention has waned, she says.
“Ten years ago, you could not turn on the TV and not hear about the opioid crisis, and how it was affecting white people, especially in middle America. You could not escape it,” says Jordan. “With that same intensity, we need to say that drug overdoses are being fueled in Black and Indigenous communities at rates we’ve never seen before.”
The lack of public attention could have serious consequences for the health of the community. Since neither Black people nor stimulant users have traditionally been the face of the overdose crisis, many people of color don’t know that they should be taking extra precautions, such as testing their drugs with fentanyl test strips. Black people also aren’t screened for opioid-use disorder often enough, she says. “A lot of people don’t even realize that fentanyl is indeed an opioid,” says Jordan. “I’ve talked to so many people who were like, ‘Oh, Dr. Jordan, I had no idea I was part of this opioid crisis.’”
There’s also an urgent need to develop medication-assisted treatment for addiction to stimulants like cocaine, Jordan says. She says it is crucial to raise awareness among clinicians and scientists about the vulnerability of Black and Indigenous individuals to overdoses in order to save lives.
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