Opioid overdose death rate increases 40% among Black individuals
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Opioid overdose death rates increased among non-Hispanic Black individuals between 2018 and 2019, despite having leveled off overall, according to study results published in the American Journal of Public Health.
“This study was conducted as part of the HEALing Communities Study (HCS), the largest addiction implementation study ever conducted,” Marc R. Larochelle, MD, MPH, a physician at Boston Medical Center, told Healio Psychiatry. “HCS has a goal of reducing opioid overdose deaths by 40% across 67 communities in four states. The study is testing a community engagement intervention where each community selects and implements from a menu of evidence-based practices proven to reduce opioid overdose.”
According to Larochelle, communities asked the researchers for timely, community-specific data on race and ethnicity for informing an “intentional focus on equity” while planning their selection of evidence-based practices. Larochelle and colleagues evaluated trends in opioid overdose deaths according to race/ethnicity between 2018 and 2019 across 67 HCS communities in Kentucky, New York, Massachusetts and Ohio, for which they determined opioid overdose death rates per 100,000 adult residents using state death certificate records. Further, they calculated the ratio of 2019 to 2018 rates using Poisson regression. They also compared changes by race/ethnicity by creating a ratio of rate ratios (RRR) for each racial/ethnic group compared with non-Hispanic white individuals.
Results showed opioid overdose death rates of 38.3 and 39.5 per 100,000 for 2018 and 2019, which did not represent a significant change (rate ratio = 1.03; 95% CI, 0.98-1.08). Larochelle and colleagues noted an approximate 40% increase in opioid overdose death rate among non-Hispanic Black individuals (RRR = 1.4; 95% CI, 1.22-1.62) compared with non-Hispanic white individuals; however, they observed no change among other races/ethnicities.
“These data have led the communities and research team to work together to better understand what is driving these trends and work to implement services that will reverse them,” Larochelle said. “In particular, we are trying to improve equity in access to highly effective medication for opioid use disorder, and we are seeking to reach non-Hispanic Black individuals with overdose education and naloxone distribution.”
In a related press release, Nora D. Volkow, MD, director of NIH’s National Institute on Drug Abuse, noted the importance of considering the role of structural racism in drug use.
“We must explicitly examine and address how structural racism affects health and leads to drug use and overdose deaths,” Volkow said. “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.”