Black Americans Are Now Outpacing White Americans in Opioid Deaths

Opioid overdose-related deaths among African-Americans are increasing compared to those of white Americans, according to a new study in the American Journal of Public Health.

Once considered a crisis affecting primarily white Americans, the opioid crisis now affects largely communities of color, the research suggests.

Using state death certificate data across the four states of Kentucky, Ohio, Massachusetts and New York, researchers found a 38 percent increase in opioid overdose-related deaths among African-Americans between 2018 and 2019, and no increase for other ethnic groups. The authors of the study stated “an antiracist public health approach is needed to address the crisis of opioid-related harms.”

Adam J. Milam, Ph.D., M.D., a cardiothoracic anesthesiology Fellow at Cleveland Clinic, and author of an additional study addressing racial disparities in opioid-related deaths from 1999 to 2018, attributes this rising disparity to structural racism and implicit bias from medical providers as a reason as well as the lack of medication-assisted treatment for African-Americans with substance abuse disorders.

Several studies show that African-Americans are less likely to receive medication-assisted treatment for opioid-related substance abuse disorder compared to white Americans.

“We know that Black Americans are under-treated as far as pain,” Dr. Milam says, referencing a 2020 study in the journal Substance Abuse. “When they were prescribed opioids, they were less likely to be prescribed naloxone,” Dr. Milam adds, which is an often life-saving drug to reverse the effects of an opiate overdose.

Dr. Milam’s research also found a major misclassification of Black opioid-related deaths from 1999 to 2013, resulting in a number of deaths not being attributed to specific opiates like fentanyl, prescription opioids, methadone, and others.

“In order to have effective intervention and prevention programs, you need to know where the deaths are coming from,” says Dr. Milam. “If we don’t know where the deaths are coming from, it’s hard to know how to prevent them.”

How can we prevent this disparity from going further?

Dr. Milam made the following recommendations: Methadone clinics and increased Suboxone (both opiate addiction treatment drugs) available in communities of color, improved treatment of pain and accessible mental health resources to help prevent substance abuse disorders before they start.

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