Building Outreach and Diversity in the Field of Addictions

Jordan, Ayana; Jegede, Oluwole

doi:10.1111/ajad.13097

“…We also found that experiences of racist mistreatment by health care workers are common among Black patients seeking addiction treatment and that a history of such experiences is related to medical mistrust, delay in seeking treatment for addiction, anticipation of racial discrimination during addiction treatment, and fear of discrimination-precipitated relapse . Further, it has been observed that the US addiction treatment workforce is predominantly White, and an increase in addiction treatment professionals of other races and ethnicities is needed . Taken together with Harris’s observations, we see that while rates of unintentional overdose are increasing among Black youths, systemic and interpersonal racism may limit their access to lifesaving treatment.…”

supporting

confidence: 65%

Race, Overdose Deaths, and Years of Lost Life—Reply

Hall

¹

,

Trimble²,

Garcia

³

2022

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To the Editor In their study of fatal drug overdoses among young people aged 10 to 24 years, Hall and colleagues 1 report 21 689 deaths from 2015 to 2019, which resulted in 1.23 million years of lost life (YLL). This averages to 57 YLL per overdose death, a devastating statistic.The authors' life expectancy data source, the Social Security Administration Period Life Table, did not include information on race; therefore, race-specific YLLs were not provided. However, we can be reasonably sure that the burden of YLL is rapidly changing in ways that are closely tied to race. From 2015 to 2020, the age-adjusted drug overdose death rate for young White male individuals increased by 37%, rising from 9.1 to 12.5 per 100 000 people. By contrast, the rate quadrupled for young Black male individuals, rising from 2.7 to 10.8. Similarly, for young White female individuals, the overdose death rate increased by 41%, rising from 4.1 to 5.8. For young Black female individuals, the rate more than tripled, rising from 1.4 to 4.6. 2 Young Black individuals have experienced a staggering increase in overdose deaths and YLL since 2015, with rates now approximating those of young White individuals. A better understanding of the race-specific drivers of overdose mortality among young people is an urgent priority.

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“…In this aim, greater funding and outreach efforts are required to increase access to telehealth visits. There are also a remarkably low number of addiction specialists in the United States, especially from underrepresented minority backgrounds ( Jordan and Jegede, 2020 ). Improving access to harm reduction, including overdose prevention sites and drug checking to detect the presence of fentanyl, represent important strategies that have been incompletely enacted in California ( Johnson and Beletsky, n.d. ; Zibbell et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Growing racial/ethnic disparities in overdose mortality before and during the COVID-19 pandemic in California

Friedman

¹

,

Hansen

²

,

Bluthenthal

³

et al. 2021

Preventive Medicine

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As overdose mortality is spiking during the COVID-19 pandemic, few race/ethnicity-stratified trends are available. This is of particular concern as overdose mortality was increasing most rapidly in Black and Latinx communities prior to the pandemic. We used quarterly, age-standardized overdose mortality rates from California to assess trends by race/ethnicity and drug involved over time. Rates from 2020 Q2-Q4 were compared to expected trends based on ARIMA forecasting models fit using data from 2006 to 2020 Q1. In 2020 Q2-Q4 overdose death rates rose by 49.8% from 2019, exceeding an expected increase of 11.5% (95%CI: 0.5%–22.5%). Rates significantly exceeded forecasted trends for all racial/ethnic groups. Black/African American individuals saw an increase of 52.4% from 2019, compared to 42.6% among their White counterparts. The absolute Black-White overdose mortality gap rose from 0.7 higher per 100,000 for Black individuals in 2018 to 4.8 in 2019, and further increased to 9.9 during the pandemic. Black overdose mortality in California was therefore 34.3% higher than that of White individuals in 2020 Q2-Q4. This reflects growing methamphetamine-, cocaine-, and fentanyl-involved deaths among Black communities. Growing racial disparities in overdose must be understood in the context of the unequal social and economic fallout from the COVID-19 pandemic, during which time Black communities have been subjected to the dual burden of disproportionate COVID-19 deaths and rising overdose mortality. Increased investments are required to ameliorate racial/ethnic disparities in substance use treatment, harm reduction, and the structural drivers of overdose, as part of the COVID-19 response and post-pandemic recovery efforts.

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“…3,4 Further, it has been observed that the US addiction treatment workforce is predominantly White, and an increase in addic-tion treatment professionals of other races and ethnicities is needed. 5 Taken together with Harris's observations, we see that while rates of unintentional overdose are increasing among Black youths, systemic and interpersonal racism may limit their access to lifesaving treatment. Another barrier in accessible treatment for Black youths is the criminal justice system.…”

mentioning

confidence: 71%

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2022

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To the Editor In their study of fatal drug overdoses among young people aged 10 to 24 years, Hall and colleagues 1 report 21 689 deaths from 2015 to 2019, which resulted in 1.23 million years of lost life (YLL). This averages to 57 YLL per overdose death, a devastating statistic.The authors' life expectancy data source, the Social Security Administration Period Life Table, did not include information on race; therefore, race-specific YLLs were not provided. However, we can be reasonably sure that the burden of YLL is rapidly changing in ways that are closely tied to race. From 2015 to 2020, the age-adjusted drug overdose death rate for young White male individuals increased by 37%, rising from 9.1 to 12.5 per 100 000 people. By contrast, the rate quadrupled for young Black male individuals, rising from 2.7 to 10.8. Similarly, for young White female individuals, the overdose death rate increased by 41%, rising from 4.1 to 5.8. For young Black female individuals, the rate more than tripled, rising from 1.4 to 4.6. 2 Young Black individuals have experienced a staggering increase in overdose deaths and YLL since 2015, with rates now approximating those of young White individuals. A better understanding of the race-specific drivers of overdose mortality among young people is an urgent priority.

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Building Outreach and Diversity in the Field of Addictions

Cited by 23 publications

References 7 publications

Race, Overdose Deaths, and Years of Lost Life—Reply

Race, Overdose Deaths, and Years of Lost Life—Reply

Growing racial/ethnic disparities in overdose mortality before and during the COVID-19 pandemic in California

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