The Factors Behind Overdose Deaths Among Black Men

Black History Month is certainly a time to celebrate Black history and achievement. It’s also an opportunity to acknowledge the health disparities and health inequity so many Black Americans continue to face.

Whether people are seeking primary care or mental health and substance use treatment and care, access remains a massive hurdle for Black Americans.

Treatment for substance use disorders provides a stark example. On Jan. 7, the Centers for Disease Control and Prevention released the latest data on overdose deaths — about 106,000 overdose deaths occurred during the 12-month period ending in August 2023.

Once considered an epidemic among rural white Americans, the overdose crisis is ravaging Black Americans. Although rates of illicit drug use in 2022 were comparable for Black and white Americans (26.7% vs. 25.8%), historically, Black Americans have accounted for a disproportionate share of overdose deaths. From 2015 to 2020, overdose deaths among Black men increased 245%.

Among Black men in their 30s and 40s, fatal overdoses will increase through 2025, according to one study. “Black men have been disproportionately harmed by this latest surge [in fatal overdoses] due in part to the separate but unequal public health response to the opioid crisis,” the study noted. “Black males alone now account for 13% of all overdose deaths in the U.S.”

So, how do we tackle this disparity? We can start by improving access to treatment.

National Council Substance Use Lead Phil Rutherford said many people in Black communities struggle to get the addiction-treatment medications they need. “Buprenorphine is the gold standard among opioid use disorder medications but is routinely less prescribed to Black patients. Methadone is laden with stigma both inside and outside Black communities.”

Politico reported that research shows Black patients are far less likely to get a buprenorphine prescription than white patients, and in 2020 Black Americans who died from a drug overdose were about half as likely to have had medication substance use treatment compared with whites that year.

“Access to buprenorphine remains unequal across communities,” according to a study by Pew. “Buprenorphine treatment among all Medicare beneficiaries varied across states. For example, in 33 states, Black beneficiaries with disabilities received buprenorphine at less than half the rate of white beneficiaries.”

Why does lack of access to buprenorphine matter? Buprenorphine can be prescribed by any doctor, nurse or physician assistant and does not require daily visits to a clinic to take the medication — all of which can make it easier for patients to get and stay on the medication.

Methadone remains tightly regulated, but federal restrictions for methadone will loosen April 2. “Amid complaints that methadone doses are too low to stave off withdrawal, clinic doctors will have flexibility to prescribe methadone in larger doses to new patients. Clinics will also have more freedom to prescribe patients ‘take-home’ medication, meaning they would be required to show up at the clinic less often,” according to STAT.

This is a big step in the right direction. Simply put, all patients should have equal access to effective treatment.

“Stigma and the absence of equitable access to treatment and care continue to hold communities back from providing people with the opioid use disorder medication they need to survive,” Rutherford said. “We have so much work to do to make substance use treatment equitable.”

While creating our recent Start With Hope/Comienza Con Esperanza campaign to raise awareness about the resources available to Black women, Black men and Hispanic/Latinx populations, we discovered how few substance use treatment programs there are for Black individuals. So, communities have opportunities to increase options for culturally informed care, boost health equity and eliminate barriers to access.

These resources may help:

• Tools for Overdose Prevention.
• Overdose Prevention Work and Resources.
• Capacity Building Resource Hub.
• The National Council’s Center of Excellence for Integrated Health Solutions will host a webinar on Feb. 15, Amplifying Black Voices: Overcoming Institutionalized Racial Discrimination in Integrated Care.
• In addition, the Great Lakes Addiction Technology Transfer Center will present a webinar on providing culturally responsive care to Black clients, Black History Month Panel Presentation: Featuring 2024 Hall of Fame Award Recipients, Museum of African American Addictions, Treatment and Recovery.