Health

The Impact of Racial and Class Lines on the Opioid Epidemic

Andrew Wyka

(10/2020) The Opioid epidemic in our society is real and has been validated by numerous studies. Some of the findings suggest that both race and social class have a significant impact on the opioid epidemic. It is also apparent that the availability of treatment options and facilities vary as well.

Other contributing factors to the opioid epidemic appear to include low income, often within minority populations, coupled with limited economic resources and opportunities for assistance. The unintended consequences suggest an increase in use of prescription opioids for pain. However, the differing access to prescription drugs has also resulted in extensive addiction of street drug among the poorest communities.

Prior research related to the opioid epidemic has compared suburban verses rural communities. However, more attention should be focused on minority communities which appear to be experiencing significant increases in opioid misuse and overdose deaths. According to Joseph Friedman at the David Geffen School of Medicine at UCLA, "the systematic racism within the health care system has led to increased addiction and overdoses in low-income white areas, but also insufficient treatment among communities of color." A US News Analysis using the Centers for Disease Control and Prevention data found the "rate of fatal opioid-related overdoses among African Americans averaged 3.7 deaths per 100,000 population between 2005 and 2013, compared to a 7.6 average rate for whites. However, from 2014 to 2017, the fatal overdose rate among African Americans rose by 130 percent, compared to 61.5 percent surge for others during this timeframe." This is more than a double the increase in fatality rates.

There are multiple variables contributing to the opioid abuse in minority communities. One key variable of opioid misuse and overdose is caused by the excessive prescription of opioid drugs for pain management. Second, the dependency on these pain medications often lead to the use of cheaper and more readily available illicit opioids such as heroin. Many of these street drugs have been found to be laced with fentanyl, which contributes to even more overdoses and opioid related deaths.

It is also a reality that minorities living in lower income areas do not have the same level of access to prescription drugs as wealthier Americans. A study of emergency departments found that minorities are significantly less likely to be prescribed opioid prescriptions for pain from medical providers. Wealthy Americans are much more likely to receive medication for their addiction than minorities and the poor. (The Opioid Crisis and the Black/African American Population: An Urgent Issue was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), May 2020)

There is the concern that stereotyping opioid use as not being prevalent among minority communities may lead to inaccurate results. This information may then limit opportunities, resources, and even deflect attention away from minority communities, when in fact they may actually need more community support to avoid serious health and addiction related problems.

In order to reduce the opioid crisis in minority communities, often leading to overdoses, there needs to be a concerted effort from multiple agencies at all levels. Community leaders, faith-based organizations, local agencies and educators must work together with their respective communities and treatment centers. A collective effort is needed to deliver drug prevention and treatment services, as well as to develop policies to ensure they incorporate relevant racial assessments. All these factors are necessary in order to reduce the opioid crisis.

There are gaps in the health care system when it comes to the access of quality treatment opportunities, and this affects the use of opioids in pain management. As discussed in the May 2020 SAMHSA Report referenced above, the federal and state governments should develop more culturally targeted programs to benefit minority communities in the opioid crisis. The report also suggests that programs should include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and a formal consideration of effective interaction with the criminal justice system in designing treatment options.

In an interview with Dr. Gregg Pane, the former District of Columbia Health Commissioner, he stated that "certainly minority communities are disproportionately affected and more likely to have more severe problems and addiction. This is a multifaceted problem that needs action in terms of better prescribing and patient follow up, better monitoring by pharmacies, education for providers and patients, and better funding and access to addiction treatment." Dr. Pane has over 35 years as a senior health administrator.

Andrew Wyka is a Senior at West Virginia University in a Multi-Disciplinary Studies Program including Drug Addiction, Sociology and Marketing