The pandemic’s devastating impact on drug overdose deaths in the United States is hitting people of color the hardest, with rates among young black people rising the steepest, according to a federal report released Tuesday that analyzed overdose data by race, age and income.
Overall, overdose deaths jumped 30 percent from 2019 to 2020, the Centers for Disease Control and Prevention report said. Deaths among black people rose 44 percent, about twice the increase in deaths among white people (22 percent) or Hispanics (21 percent). American Indian and Alaska Native deaths increased by 39 percent.
Measured as a share of the population, in 2020 deaths among blacks were higher than in any other racial or ethnic group—39 per 100,000, compared with 31 for whites, 36 for American Indians and Native Americans. Alaska and 21 for the Spanish.
“The disproportionate increase in overdose deaths among Black, American Indian, and Alaska Native populations may be due in part to health care inequities, such as unequal access to substance use treatment and treatment bias,” said Dr. Debra Khoury, Acting principal deputy director of the CDC
Racial breakdowns are based on data from Washington, D.C., and 25 states that completed analyses. The study included data from some states where overdose deaths increased, such as Georgia, Kentucky and Maine, but not from others with high rates, such as Florida, New York and Michigan. The CDC researchers said, however, that the trends they saw in this data reflected statistical racial breakdowns across the country.
Nationally, overdose deaths have continued to rise since 2020, although the rate has slowed somewhat.
The effect across races becomes even more striking when age is taken into account. In 2020, the overdose death rate for men 65 and older was nearly seven times greater for black men than for white men. For blacks ages 15 to 24, overdose deaths rose 86 percent from 2019 to 2020.
The study’s authors say the deaths were largely caused by illegally manufactured fentanyl, with some caused by the combination of other drugs with the opioids, such as methamphetamine and cocaine.
The pandemic has exacerbated the spiral, the authors said. With young and old isolated from social services, peers, families and treatment centers, not to mention a drop in income for many, drugs have become a distraction and a comfort.
The results clearly showed the racial divide in access to substance abuse treatment. Although the data showed that treatment was rare among all who died, the proportion of people who received substance abuse treatment was lowest among blacks (8.3 percent), or about half that of white people who sought treatment and later died.
Income inequality also widens this gap, the report said.
Perhaps surprisingly, the report said overdose deaths were generally higher in counties with more treatment services and mental health care providers. Again, the impact varies by race. Among American Indians and Alaska Natives and blacks, for example, the 2020 rate in counties with at least one opiate treatment program was more than twice that of counties with no such services.
Among counties with relatively more treatment options than others, overdose deaths from 2019 to 2020 increased by 49 percent among black people compared to 19 percent among white people.
“Just because there is availability of services does not mean that those services are actually accessible,” said Mbabazi Kariisa, the report’s lead author and a health scientist in the CDC’s Division of Overdose Prevention. She noted that limited transportation and insurance options can be problematic. In addition, she said, fear of stigmatization and a pervasive distrust of the health care system can also be important factors.
The report also notes that in counties that are geographically large, a treatment center may be located in a densely populated center, which would make access difficult for those in remote areas. But it’s difficult to determine a causal relationship between clinic availability and mortality: A county with high rates of drug abuse and overdose deaths may simply be more likely to have a clinic.
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