Study: Opioid Overdose Death Rate Climbed Nearly 40% among Black Americans

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Opioid overdose death rates increased among non-Hispanic Black persons between 2018 and 2019 while rates for other race and ethnicity groups leveled off, according to new research published in the American Journal of Public Health.

“These data add to the evidence of worsening disparities in opioid overdose deaths by race/ethnicity,” wrote authors led by Marc Larochelle, MD, MPH, internal medicine physician, Boston Medical Center.

The research was conducted as part of the ongoing HEALing Communities Study (HCS), the largest addiction implementation study to date that was launched by the National Institutes of Health (NIH) in partnership with the National Institute on Drug Abuse (NIDA).

"We must explicitly examine and address how structural racism affects health and leads to drug use and overdose deaths."

The objective of HCS is to reduce opioid overdose deaths through community engagement interventions such as overdose education, naloxone distribution, and enhanced delivery of medications for opioid use disorder.

"We must explicitly examine and address how structural racism affects health and leads to drug use and overdose deaths," said NIDA Director Nora D. Volkow, MD, who was not part of the current study, in an NIH press release. "Systemic racism fuels the opioid crisis, just as it contributes mightily to other areas of health disparities and inequity, especially for Black people. We must ensure that evidence-based interventions, tailored to communities, are able to cut through the economic and social factors that drive disparities in substance use and addiction, to reach all people in need of services."

For the current study, Dr Larochelle and colleagues analyzed data from 2018-2019 death certificates for individuals aged ≥18 years across 67 communities disproportionally affected by opioid overdose deaths in 4 states (New York, Kentucky, Massachusetts, and Ohio) enrolled in HCS.

Researchers calculated opioid overdose death rates and trends overall and then stratified them by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, other) and state. The total population across the 67 communities was approximately 8.3 million.

Across all 4 states, there was no significant change in opioid overdose deaths rates between 2018 and 2019 (rate ratio [RR]=1.03; 95% confidence interval [CI], 0.98-1.08).

Researchers observed a 38% overall increase in the opioid overdose death rate for non-Hispanic Black individuals from 2018 to 2019 (RR=1.38; 95% CI, 1.21-1.57) relative to non-Hispanic White individuals but no change overall among other racial and ethnic groups, according to the study.

Opioid overdose death rate increases among non-Hispanic Black individuals was observed in Kentucky (RR=1.46; 95% CI, 1.01-2.11) and Ohio (RR=1.45; 95% CI, 1.24-1.7), but no significant increase was observed in Massachusetts.

Researchers noted that while opioid overdose death rates were unchanged for non-Hispanic Black adults in New York (RR=1.03; 95% CI, 0.72-1.48), there was an 18% decline among non-Hispanic White adults (RR=0.82; 95% CI, 0.72-0.93).

“These data highlight the importance of timely, local data to inform an equitable approach for developing community-tailored strategies to reduce opioid overdose deaths,” concluded researchers. “An antiracist public health approach that explicitly examines the role of racism is urgently needed in research, public health, and policy approaches to address the crisis of opioid-related harms.”

Reference: Larochelle MR, Slavova S, Root ED, et al. Disparities in opioid overdose death trends by race/ethnicity, 2018–2019, from the HEALing Communities Study. AJPH. Published online ahead of print September 9, 2021.