Educational Articles

A Deadly Trio: How A PANDEMIC American Overdoses, In 2019, there were more than 7,300 deaths from opiod overdoses among African-Americans, according to a collection of data from the Kaiser Family Foundation. Community African and Disparities are affecting THE

Black patients with opioid use disorder were 35 times less likely than white people to be prescribed Suboxone

Research Center. However, experts and medical researchers within the minority population are still encouraging others not to discount the coronavirus vaccine and contribute to the already staggering number of Black people who have died from the virus. Receiving the vaccine gives a chance of lowering and stabilizing this rate. A study found that since the start of the pandemic, 179 per 100,000 Afri- can-Americans died from the virus. Inequalities in struc- tural systems such as open hours for COVID-19 testing sites, workers’ ability to take a sick day from work and exposure to high volumes of people in enclosed areas like public transportation systems have all contributed to this rate. Experts are recommending people take the vaccines to help close these gaps. While the struggles are many, grassroots organizations and small community treatment facilities are among the efforts making dedicated strides in addressing structural biases within the arena of providing addiction treatment for African-Americans. These voices are the advocates for the needs of these individuals, like wider access to medi- cations like Suboxone and affordable long-term care pro- grams. Distributing Narcan kits in vulnerable areas and educating these communities on the dangers of fentanyl are some of the current priorities. Further, creating specific policy and educational inter- ventions for providers is needed to promote the use of Suboxone in diverse populations. In February, President Biden added to his team aiming to tackle the opioid crisis. They discussed plans for immediate efforts that would help curb overdose deaths and focus on racial equity in drug policy and expanding access to medications like Sub- oxone. Thus, as researchers, addiction treatment facilities and providers look for ways to better serve their clients, they must look beyond the suburban gated communities and work to address the opioid crisis among the under- served population of African-Americans.

Journal of the American Medical Association showed Black patients with opioid use disorder were 35 times less likely than white people to be prescribed Suboxone, a medication that is highly effective in preventing relapses and fatal overdoses. These differences in prescriptions are apparent in the treatment facilities located in Black and lower-income communities as compared to those in suburban white areas. When injected, Suboxone produces opiate withdrawal, limiting its abuse potential. It is also less lethal in over- dose compared to methadone, which has higher rates of addiction and can produce severe withdrawal symp- toms. A national survey of Suboxone and methadone patients showed 92 percent of patients taking Suboxone were white, whereas this demographic only accounted for 53 percent of patients taking methadone. Treatment providers that can prescribe Suboxone are often listed online and require access to web-based resources. Clinics prescribing methadone, however, receive referrals from agencies with limited funding and that serve people with low incomes, social welfare offices and the criminal justice system. Additionally, the majority of clinics certified to pre- scribe Suboxone receive payment through a client’s private insurance. Few of these clinics accept Medicaid, which covers a large percentage of clients receiving meth- adone. In light of recent heightened awareness and concentrat- ed demands for equal healthcare and treatment services among minority populations, there has been an increased focus on distributing COVID-19 vaccines to those within the African-American community. Conversations have ris- en surrounding distrust in government and widespread administrations due to racist medical malpractice studies like the Tuskegee Syphilis Study. While about 60 percent of Americans reported they plan to receive a coronavi- rus vaccine, only about 42 percent of Black Americans said they plan to do so, according to a survey by the Pew

A CDC study from the same year reported a steady increase in the rates of opioid over- doses in the African - American community. Because the numbers of deaths from overdos- es continue to plague white, suburban communities at a higher volume, the narrative for discussing solutions surrounding the epidemic centers around providing aid to these majority communities. These solutions have often overlooked the needs and struggles of Black communities, especially those of low-income areas, that are suffering from steadily increasing rates. In the wake of the coro- navirus pandemic, disparities in treatment among this minority community have been greatly exposed, along with inequalities in treatment quality and options for ur- ban and low-income areas regarding addiction and mental health treatment. During the coronavirus pandemic, the CDC has record- ed a 20 percent surge in fatal drug overdoses across the nation. Researchers at the University of Pennsylvania analyzed Philadelphia’s drug overdose data and found a surge of more than 50 percent among the city’s Black pop- ulation, whereas the rate of deaths among white residents remained constant and even declined in some months. In the pre-pandemic times, researchers were finding over- dose rates among Black people rising faster than those among white people.

During the scope of the overall drug epidemic, another plague surrounding opioids has been rising within the African-African community. Fentanyl was first introduced in the 1960s as an anesthetic or pain medication. Its use scaled as other pain medications also emerged onto the market. During the 1990s, the increasing severity of the prescription drug crisis did not primarily affect African Americans. This was due partly to racism in the health- care system regarding doctors’ approach to treating pain among Black patients. Thus, it was clear African-Amer- icans did not have the same issue with the epidemic as white people in suburban areas. However, during that time and through the present day, crack cocaine has been the consistent drug of choice for users within the Black community. In 2015, the illicit drug market began using fentanyl and manufacturing it overseas. Dealers began wedding cocaine and fentanyl, and that marked the start of an explosion of overdose deaths among African Ameri- cans from these drugs. As inequalities in healthcare systems contributed to a drug crisis that varied from African-American users to white users during the 90s, these same disparities have accounted for a lack of preventative and responsive care and treatment among the minority community. They have continued through systemic biases that remain present in current systems. A 2019 study by the