While lawmakers and other officials strive to keep up with rapidly evolving drug-use trends, racial discrimination still plays a major role in drug policy making.
That’s one of the conclusions of a newly released study of comparing data on drug overdose deaths among African-Americans, Hispanics and non-Hispanic white persons.
Overlooked in the extensive media coverage of opioid addiction and overdoses among whites has been a significant increase in cocaine-related overdoses among blacks, the National Cancer Institute (NCI) reported last month in the Annals of Internal Medicine.
Using complete U.S. death certificate data from the Centers for Disease Control and Prevention’s National Center for Health Statistics, Meredith S. Shiels, Ph.D., and colleagues compared data from 2000–2003 with data from 2012–2015.
They found that total overdose death rates increased among blacks (6.1 to 9.0 per 100,000 person years), Hispanics (4.2 to 6.0) and whites (5.6 to 15.5). When analyzed based on age and race, increases were greatest among older blacks (men over 50 and women over 45).
The most common contributor to overdose deaths in whites was opioids, but for blacks, cocaine was the largest contributor to overdose, the researchers found. Between 2012 and 2015, cocaine-related overdose deaths were almost as common in black men as deaths due to opioids in white men (7.6 vs. 7.9). Cocaine-related deaths declined between 2008 and 2011, and then increased between 2012 and 2015.
The largest recent increases in drug overdose deaths for blacks and Hispanics were due to heroin, although there were also increases due to other opioids, benzodiazepines and psychostimulants.
The researchers noted that “important public health measures have been initiated, particular in heavily affected areas” in response to opioid deaths among whites. But overdose deaths among blacks and Hispanics “are an important, long-term public health problem that is often overlooked.” Their results are probably underestimates, they said, because about 20 percent of deaths classified as unintentional overdoses fail to report one or more contributing drugs.
Researchers urged additional research to understand the increasing rates of overdose among older black men and women, and more focus on preventing cocaine-related deaths, which disproportionately affect older blacks.
Along with racial discrimination, the article “Trends in U.S. Drug Overdose Deaths in Non-Hispanic Black, Hispanic, and Non-Hispanic White Persons, 2000–2015,” reveals another major problem with modern drug policy, said H. Westley Clark, M.D., J.D., Dean’s Executive Professor at Santa Clara University: focusing exclusively on deaths due to opioid overdoses.
“A single drug focus belies the nature of drug problems,” Clark told Alcoholism and Drug Abuse Weekly.
While the The 21st Century Cures Act passed by Congress in 2016 allocated $1 billion to address the opioid epidemic, “alcohol, cocaine and methamphetamine have been forgotten,” he said. “People dying because of alcohol, cocaine, methamphetamine or any other psychoactive substance are no less important than people dying from opioids.”
The report also supports a complaint long made by African Americans, said Clark. “When African Americans die of drug overdoses, it gets ignored. When whites die of drug overdoses, the whole world listens, from politicians, Big Pharma, researchers and the FDA to the media. When African Americans die, it isn’t news,” he said.
Clark noted that blacks in the public health workforce are “particularly sensitive to the epidemiological reality” that the authors at the NCI, which is part of the National Institutes of Health (NIH), uncovered. “This report demonstrates why African Americans and other people of color in the public health workforce are essential to the public health paradigm,” said Clark.
“I commend the NIH researchers for asking the question about race and drugs,” he said. “Their paper provides some of the answers. Now we need to do something. The public health effort should not be to focus on younger whites while ignoring older blacks,” he told the weekly.
Clark called for Congress to “look for solutions that address the broader epidemic, not just those aspects of the epidemic that affect white people,” said Clark. “The Congressional Black Caucus and its Health Braintrust should mobilize its colleagues on the Hill to make sure that future legislation addressing drug use includes provisions dealing with the drug use landscape, so that the deaths of African-American drug users due to cocaine are not ignored by public policy.”