African American overdose deaths spiked in pandemic

The number of deaths from drug overdoses in the United States shot up in the first year of the pandemic, with African Americans accounting for a sharply rising share of the fatalities in 2020, government figures released on Tuesday show.

The rate of fatal drug overdoses overall rose 30 percent from 21.6 deaths per 100,000 people in 2019 to 28.3 deaths, the Centers for Disease Control and Prevention reported. Most of the deaths that year were due to fentanyl, a powerful synthetic opioid.

"These numbers are staggering," said Debra Houry, the CDC's acting principal deputy director and director of the agency's National Center for Injury Prevention and Control. "Drug overdoses were on the rise prior to 2020, but not at this rate," she said.

The rate of overdose deaths increased 44 percent for black people and 39 percent for Native Americans in 2020 compared with 2019, as the COVID-19 pandemic disrupted access to care and exacerbated racial inequality, the agency said.

Fatal drug overdoses increased among white people though at a slower rate, 22 percent. In 2019,25.2 overdose deaths per 100,000 people occurred among white Americans, compared with 30.7 per 100,000 in 2020.

The agency said 2020 was the most recent year for which it had complete data from 25 states analyzed in the study, as well as from Washington, DC.

While substance abuse was common among people who died, CDC researchers found that a history of substance-use treatment wasn't.

About 10 percent of Native Americans had reportedly received treatment and 1 in 12 black people also had. White people were nearly twice as likely to have received medical treatment as black people.

The findings show how the escalating overdose crisis is exacting a mounting toll on minority groups that are in some cases marginalized by the healthcare system, the CDC researchers said.

According to the agency, black people aged between 15 and 24 experienced the largest increase in overdose death rates from 2019 to 2020, at 86 percent. Native American women aged between 25 and 44 were nearly two times as likely to die of an overdose in 2020 than their white counterparts.

Among black men aged 65 and older, the rate of deadly overdoses was nearly seven times that of white men of the same age in 2020.

Sharp increase

The sharp increase in drug overdose deaths was apparent by 2021, when the CDC reported that the country had surpassed 100,000 such deaths for the first time ever in 12-month period.

Overdose rates were higher than average in areas with more opioid-treatment programs, a finding that the study's authors said demonstrated other barriers to access for some people.

Overdose rates were also higher in regions with higher income inequality, according to the report.

"Just because there is availability of services doesn't mean that services are actually accessible," said Mbabazi Kariisa, a health scientist in the CDC's overdose-prevention division. "Factors like stigmatization as well as mistrust in the general healthcare system may prevent people from accessing the treatment services."

Drug deaths among black people in 2020 passed the rate in the white population for the first time since 1999, researchers at the University of California, Los Angeles, have shown. The gap in overdose rates between the black and white populations was narrowing before the pandemic.

Health providers are more likely to direct black patients to methadone, which is delivered by highly regulated opioid-treatment programs that often require daily visits to obtain the medication, researchers have found.

Expanding access to mobile services for opioid treatment would help improve access, said Houry.

"We believe that now is the time to provide the communities with the additional resources they need," she said.