MONDAY, September 13, 2021 (HealthDay News) – The decades-long opioid epidemic in the United States could hit blacks harder than whites as the crisis enters a new phase.
Opioid overdose death rates among black Americans jumped nearly 40% from 2018 to 2019 in four epidemic-stricken states, researchers found.
Fatal ODs among all other races and ethnicities have remained roughly the same during this time.
This represents a significant change in the opioid crisis, which in the early 2000s largely affected whites in rural areas, said lead researcher Dr Marc Larochelle, assistant professor at the Boston University School of Medicine.
“Since 2010, we now recognize what people call the ‘triple wave’ of the opioid epidemic,” he said. “The first wave was for prescription opioid pain relievers, then from 2010 to 2013 the increases were largely due to heroin, and from 2013 onwards illicit fentanyl seeped into the supply. in drugs. “
Racial inequalities in health care and social services in the United States are a likely reason for the continued increase in OD deaths among black Americans, even as deaths among other ethnic groups have leveled off, have said Larochelle and Dr. Kenneth Stoller, director of the Johns Hopkins Broadway Center. for Addiction in Baltimore, which reviewed the results of the study.
The spread of the potent opioid fentanyl in the country’s illegal drug market has also likely played a role, both added.
“Cocaine and methamphetamine are increasingly contaminated with fentanyl,” Stoller said. “These other drugs cause overdoses in people who are not accustomed to using opioids, whose bodies cannot tolerate these opioid drugs.”
Larochelle’s team collected data for this study as part of the Long-Term Communities Study to Help End Addiction, a federally-funded effort to stem OD deaths in 67 communities. hard hit by the opioid crisis.
These communities are found in Kentucky, Massachusetts, New York and Ohio. The project has “a goal of reducing opioid overdose deaths by 40% in three years,” Larochelle said.
Overall, OD opioid-related death rates were stable in target communities between 2018 and 2019, the researchers reported on September 9 in the American Journal of Public Health.
But on closer inspection, researchers found a 38% increase in opioid overdose deaths among blacks.
Actions that have helped reduce the tide of OD deaths among other racial and ethnic groups do not appear to have the same impact on black Americans, Larochelle said.
He noted that laws have been passed to combat the illicit use of prescription opioid analgesics; communities were educated on ways to treat overdoses and armed with naloxone, an OD reversal drug, and the drugs were made more widely available to treat people addicted to opioids.
“Unfortunately, they were provided in a way that reflected structural inequalities across our health and public health systems,” with the benefits going primarily to white people, Larochelle said.
Other issues that hinder black Americans’ access to health care likely play a role here as well, Stoller added. These include a lack of access to healthcare and affordable health insurance, no childcare available, problems with transportation to and from treatment, as well as homelessness.
“These are just a few of a host of other obstacles that may limit the effectiveness of what we are trying to do to reduce the number of OD deaths among black Americans,” Stoller said.
“Substance use disorders are very complex, in terms of training and maintenance,” he added. “We need to address the sustaining factors that limit access to treatment and the effectiveness of treatment for blacks.”
Fentanyl could also contribute to AD deaths among black Americans, through contamination from other illicit recreational drugs, Larochelle and Stoller said.
“What we’re starting to see is the emergence of stimulants contaminated with fentanyl – for example, someone who intends to use cocaine and the cocaine is contaminated with fentanyl,” Larochelle said. “For a person who does not use opioids and is exposed to even small amounts of fentanyl, this can lead to an unexpected overdose.”
He added that these are not the people who have typically been targeted for opioid harm reduction efforts because they have no intention of using opioids.
The numbers for this study were collected before the COVID-19 pandemic, which caused drug and OD use rates to start rising again among all ethnic and ethnic groups, Larochelle noted.
This means that black Americans may be even more exposed to opioid OD today than they were before the pandemic.
“The trends in this article are actually pre-pandemic, but the pandemic has certainly exacerbated the overdose crisis,” Larochelle said. “Unfortunately, overall overdose levels in the population have picked up in the context of the pandemic.”
The US Department of Health and Human Services has more information on the opioid epidemic in the United States.
SOURCES: Marc Larochelle, MD, MPH, general practitioner in internal medicine, Boston Medical Center, and assistant professor, medicine, Boston University School of Medicine; Kenneth Stoller, MD, director, Johns Hopkins Broadway Center for Addiction, Baltimore; American Journal of Public Health, September 9, 2021