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Opioid overdose deaths have historically been low in the Black community, but they’re now on the rise. Maskot/Getty Images
  • Overdose deaths from opioids have increased in the Black community, while remaining relatively stable among other groups.
  • Experts say one reason is that the opioid crisis is shifting from rural areas to more urban regions.
  • They add that fentanyl being added to certain recreational drugs (like cocaine) is another factor.

The rate of opioid overdose deaths among Black Americans rose 40 percent in 2019 compared to white Americans, according to a new study from the American Journal of Public Health.

Opioid overdose death rates have remained level among other ethnicities, marking this trend a concerning outlier — and a possible new front in the opioid epidemic.

Black Americans have historically had lower overall opioid overdose deaths and slower rates of increase in those deaths compared to whites, but that trend has reversed in recent years, suggests a 2020 study in the journal Addiction.

“This is an epidemic that started in rural areas of the country, which are predominantly Caucasian,” said Dr. Steve Powell, MPA, chief medical officer of the opioid addiction treatment service PursueCare.

“I do believe that over time, this has been an epidemic that’s really moved from the rural environments into some of the more populated areas, including suburbs and big cities,” Powell said. “With that, you’re naturally going to see more and more of an increase in dependency and overdose issues.”

According to data from the Kaiser Family Foundation, 72 percent of opioid overdose deaths occurred among the white population in 2019, 15 percent among the Black population, and 11 percent among the Hispanic population.

One factor that may be driving an increase in these opioid overdoses is the introduction of the synthetic opioid fentanyl into recreational drugs such as cocaine.

A 2017 report from the Centers for Disease Control and Prevention (CDC) found that “illicitly manufactured fentanyl and fentanyl analogs have fueled recent increases in opioid-involved overdose deaths,” accounting for 60 percent of opioid overdose deaths, as well as disproportionate increases in these deaths among Black Americans.

In New York City, 1 in 12 bags of cocaine is likely cut with fentanyl, according to the New York Police Department, and fentanyl-spiked cocaine has been involved in several high profile celebrity overdoses, Yahoo News reports.

“One thing that’s driving the increase opioid epidemic is the fact that more and more first-time users are getting their drugs from family, friends, or from others in environments they don’t consider harmful like parties and other social gatherings opposed to having them prescribed,” Marian Hubbard Jefferson, D.Min, clinical lead therapist at Greenhouse Treatment Center in Grand Prairie, Texas, told Healthline.

“It can lower one’s defenses, increasing vulnerability to physical, mental, emotional harm and even death,” Jefferson said.

Based on the findings from their latest study, researchers are calling for an “antiracist public health approach” to solve the rise in opioid overdose deaths among the Black community.

But what might that look like?

“African Americans need culturally sensitive addiction treatment providers, true peer recovery specialists, and help with financial/housing barriers to treatment,” said Dr. Pamela Booth Littles, the medical director at treatment center CleanSlate in Norfolk, Virginia.

In addition, buprenorphine — a drug used to treat opioid addiction and withdrawal symptoms — is not readily available, promoted, or common within the Black community, Littles told Healthline.

Expanding access to such life-saving drugs could improve outcomes, she said.

More radical approaches, such as decriminalizing hard drugs, might be called for as well.

“Criminalization of small amounts of substance use unfairly targets marginalized populations, with the vast majority of individuals who are arrested for drug possession being People of Color,” said Dr. S. Monty Ghosh, an assistant professor of internal medicine, disaster medicine, and addiction medicine at the University of Alberta in Canada.

“It prevents them from accessing services such as housing and jobs in the future once they are released, further limiting their potential for growth,” Ghosh said. “Removing barriers such as criminalization for small drug possession can help decrease health disparities with this population.”