The Opioid Crisis Is Getting Worse, Particularly for Black Americans

Josh Katz and Abby Goodnough, New York Times, December 22, 2017

The epidemic of drug overdoses, often perceived as a largely white rural problem, made striking inroads among black Americans last year — particularly in urban counties where fentanyl has become widespread.

Although the steep rise in 2016 drug deaths has been noted previously, these are the first numbers from the Centers for Disease Control and Prevention to break down 2016 mortality along geographic and racial lines. They reveal that the drug death rate is rising most steeply among blacks, with those between the ages of 45 and 64 among the hardest hit.

Drug deaths among blacks in urban counties rose by 41 percent in 2016, far outpacing any other racial or ethnic group. In those same counties, the drug death rate among whites rose by 19 percent. The data, released on Thursday, suggests that the common perception of the epidemic as an almost entirely white problem rooted in overprescription of painkillers is no longer accurate, as fentanyl, often stealthily, invades broader swaths of the country and its population.

Driven by the continued surge in drug deaths, life expectancy in the United States dropped for the second year in a row last year. It’s the first consecutive decline in national life expectancy since 1963. Drug overdoses have now surpassed heart disease as the leading cause of death for Americans under the age of 55.

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Dr. Andrew Kolodny, the co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, said it appeared that many of the African-Americans who died were older men who had become addicted to heroin during a previous epidemic in the 1970s. “Despite beating the odds for the past 40 to 50 years,” he said, “they’re dying because the heroin supply has never been so dangerous — increasingly it’s got fentanyl in it or it’s just fentanyl sold as heroin.”

Fentanyl-laced cocaine, too, may be playing a role. A study published this month in the journal Annals of Internal Medicine found that cocaine-related overdose deaths were nearly as common among black men between 2012 and 2015 as deaths due to prescription opioids in white men over the same period. Cocaine-related deaths were slightly more common in black women during that period than deaths due to heroin among white women, according to the study. But it also found that the largest recent increases in overdose deaths among blacks were attributed to heroin. {snip}

The study, by researchers at the National Cancer Institute and the National Institute on Drug Abuse, also found that the recent rise in overdose death rates was sharpest among older blacks. The same held true last year in New York City.

“What’s really interesting is you’re not seeing younger blacks getting involved in heroin as much,” said Denise Paone, senior director of research and surveillance in the city’s Bureau of Alcohol and Drug Use Prevention.

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Dr. Kolodny pointed to the rising drug death rate among older black men, many of whom he said have probably used heroin on and off since the 1970s, as evidence that progress against the new epidemic could take decades.

“Forty, 50 years later we’re still paying a price,” he said. “What this means is for our current epidemic, we’re going to be paying a very heavy human and economic price for the rest of our lives.”

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