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

Abstract

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.

Racial Differences in Retention in a Community-based Addiction Reduction Program Implemented by Peer Recovery Coaches for Women of Reproductive Age

“…In contrast to the fear of being shamed and judged by traditional health care providers, 10 the participants and PRC were able to connect through their shared experiences and develop a trusting relationship. Literature suggests that traditional health providers tend to less proactively address the many social and structural determinants of health and/or provide passive referrals, 12 whereas CARE PRC embraced these as part of their primary roles.…”

“…Participants reported that they would be more likely to seek treatment earlier and adhere to treatment recommendations if they had not feared discrimination from the medical personnel. 10 Treatment motivation and the perceived need for treatment for SUD are also culturally different among patient populations. 9,11 In addition to discussing barriers to SUD treatment, assessing factors that influence retention are just as essential to improving patient outcomes.…”

“…Participants reported that they would be more likely to seek treatment earlier and adhere to treatment recommendations if they had not feared discrimination from the medical personnel. 10 …”