Addressing Inequities: The Overdose Crisis Among Black Americans Event Summary

On Friday May 17, the Global Health Advocacy Incubator’s (GHAI) Overdose Prevention Initiative convened a congressional briefing to discuss the growing impact of the overdose crisis on Black Americans. Recent reporting from the Centers for Disease Control and Prevention (CDC) shows that on a national level, the United States is making progress in decreasing overdose deaths. However, overdose rates continue to climb among Black Americans—data indicate that in 2022, overdose deaths in White Americans decreased by 3 percent while overdose deaths in Black Americans increased by 7.5 percent.

Hosted in collaboration with the Congressional Black Caucus and Addiction, Treatment, and Recovery Caucus, the event went beyond these statistics. The expert panelists not only outlined both the scope and the root causes of the crisis, but most importantly, proposed solutions to mitigate racial inequities in overdose deaths.  

Panelists:

• Yolonda Richardson (moderator), President and CEO of the Global Health Advocacy Incubator
• Dr. Jerome Adams, MD, MPH, FASA, Purdue University Executive Director of Health Equity Initiatives, and former U.S. Surgeon General 
• Tracie Gardner, Senior Vice President of Policy Advocacy at the Legal Action Center 
• Dr. Kimá Joy Taylor, MD, MPH, Founder, Anka Consulting and Non-Resident, Fellow, Health Policy Center at the Urban Institute 
• Phil Rutherford, PLE, Strategy Lead for Substance Use at the National Council for Mental Wellbeing

Key Takeaways

1. Equitable outcomes, not just equitable access.

Substance use disorder is one of the most treatable chronic illnesses, but treatment is not readily available nor equitably provided in Black communities. Historically, healthcare systems and providers have not provided the same standard of care to Black Americans compared to their white counterparts. These existing inequities in our nation’s health care systems pervade into substance use treatment. Research shows that evidence of past substance use treatment was lowest for Black people, with just 8 percent of those who died from an overdose having engaged with substance use treatment.

Simply increasing access to treatment must not be the end goal. As a nation, we must focus on achieving equitable care and outcomes, not simply equitable access. 

2. It’s not just how, but who.

To effectively address the staggering increase in overdose death among Black Americans, we must change how we respond to the wave of illicit fentanyl that is now sweeping the nation. Policies designed more than 20 years ago in response to the rise of overdose from prescription opioids and heroin are inadequate to address the threat of illicit fentanyl that has made the country’s drug supply more lethal.

Heroin era policies are not as effective in a fentanyl-dominated world. We must change the rules that create barriers to methadone, the FDA-approved medication most effective in preventing fentanyl-related fatality. We must also address drug paraphernalia laws and other policies that inhibit access harm reduction tools, such as drug checking tools. And we must also adapt our current substance use systems to navigate an increase in polysubstance use.

Just as important as adapting how we respond is changing who is leading that response. Lack of community-based resources, support and peer representation contributes to lower rates of treatment completion for Black individuals in comparison to their White counterparts. Increasing peer recovery support and bolstering the Black healthcare workforce are critical to creating equitable and sustainable change. Black-led peer recovery support can relieve some of the stigma associated with and bridge the gap to treatment. 

3. Harm reduction as a bridge to care and a pathway to recovery.

At its core, harm reduction is an approach to drug use which focuses on providing community-based support in a culturally sensitive manner. Across the country, many Black-led harm reduction groups began because communities realized they had to help each other to save themselves.

Harm reduction services — such as naloxone distribution, fentanyl testing strips, syringe service programs and overdose prevention centers (OPCs)— are proven to prevent both the spread of infection and fatal overdoses. To effectively address the overdose death rate in Black communities, increasing resources for harm reduction and overdose prevention efforts is critical, and this expansion of services must be implemented in an equitable and culturally responsive way.

4. We must invest in recovery capital.

Structural determinants of health hinder one’s ability to recover. Non-medical factors, including economic, cultural, political and social structures, are the underlying causes of health inequities that create unfair and avoidable differences in health outcomes. 

To support the tens of millions of Americans who consider themselves to be recovering from a substance use disorder, we must invest in the resources necessary to achieve and sustain recovery, including housing, income and employment. These investments increase a person’s “recovery capital” and improve their health outcomes. 

GHAI is working to ensure this event was just the start of an ongoing conversation on Capitol Hill about Black overdose deaths. In the coming weeks, a series of blog posts featuring conversations with the panelists will be published to further discuss this important issue.