Many opioid deaths are not overdoses—they’re being poisoned

A report from the Centers for Disease Control and Prevention (CDC) reveals that in 2020, the opioid-related death rate among Black Americans exceeded that of their white counterparts for the first time since the opioid crisis was declared in the United States some two decades ago. 

In fact, during 2020 alone, deaths among Black Americans due to opioids increased by 44%, according to the CDC. For those between the ages of 15 to 24, the death rate nearly doubled. And the numbers keep rising.

Similar national studies have been published recently by the NYU Grossman School of Medicine, Harvard Medical School, Journal of Racial and Ethnic Health Disparities, and the Substance Abuse and Mental Health Services Administration (SAMSHA), just to name a few.

Likewise, the latest data from the Minnesota Department of Health shows that Black Minnesotans are more than three times as likely to die from an “opioid-involved overdose” than are white residents in the North Star State. And Indigenous Minnesotans are dying at approximately 10 times the rate of whites.

Many researchers have cited the flood of fentanyl-laced drugs, which now account for more than 70,000 American deaths each year, as a principal contributor to this shift. But at the end of the day, “How many studies do we need?” is one of the questions posed by Dr. Ronda Chakolis, president of the Minnesota Board of Pharmacy.

“When I was in graduate school, we learned that it might take 10 years from the time something is studied before strategies and solutions are being implemented,” she continues. “Although disparities have accelerated in the past few years, this trend is not new.”

Also of particular concern to Chakolis is the continuing use of the term “overdose” when addressing deaths caused by synthetic opioids.

“We’ve normalized the word overdose, suggesting that it’s something that can be simply reversed by Narcan. But I don’t believe that there are a lot of people who set out to use drugs like fentanyl or xylazine. We must distinguish these from prescription opioids. 

“And the truth is so many are not overdosing—they’re being poisoned. So I believe we need to shift the language.”

Chakolis proposes a comprehensive “poison control model” to address the issue, noting that existing racial disparities in pain management and general health care make it very easy for people to turn to much cheaper and readily available street pharmaceuticals, not knowing where those drugs are sourced from or what they may be laced with.

As it relates to the same inequities that Chakolis mentions, Lester Bentley, a Twin Cities-based mental health clinician, says we must start by addressing the different levels of access to health care, including treatment and other resources for addiction.

“By and large, for people of color, systemic racism impacts every aspect of their lives,” he says, “be it in housing, education, economics…and health care. And when it comes to health, the access points are different, not to mention scarcer for Black people and other communities of color.”

Likewise, Bentley stresses that we must rectify the incongruity when addressing the issue of substance use in different communities. “In one community, it’s considered a ‘medical’ matter and often treated privately. In others, it’s labeled a social, cultural, and moral issue pre-loaded with certain stigmas and associated pathologies.”

Citing the desperate need for more Black medical professionals, including pharmacists, psychologists, and substance abuse counselors, Bentley also observes that there is hope, and there are successful models out there that can be replicated.

“It is easy to say that nothing has changed,” he remarks, “but that’s simply not true. There are programs out there that are making a real difference in people’s lives. They’re just isolated.”

Among the examples, Bentley names are the Morehouse School of Medicine’s Substance Use, Prevention and Treatment Division, the groundbreaking work of Dr. Kanika Cunningham in St. Louis, and culturally based treatment services in Detroit.

And then, of course, there is Turning Point, Inc., right here in the Twin Cities. “Turning Point is the gold standard for culturally competent treatment in Minnesota,” says Bentley. “But do they have enough funding? Do they have enough staffing? And are we doing enough to amplify the treatment and outreach programs they provide?”

It’s also vital, as Chakolis asserts, to directly involve the communities we seek to serve. “It is paramount that we go where the people are. To ask the right questions. To find out what the issue might be here or there, understanding that things aren’t always the same in different neighborhoods, or for that matter, across generations.

“We must learn their stories. Identify the needs,” she adds. “Consider our young people, for example. Kids will tell you everything. We just have to listen.”

For more information on the programs and services offered by Turning Point, Inc., go to https://ourturningpoint.org/. For treatment and other supportive resources across Hennepin County, contact their Addiction and Recovery Services Unit at 612-879-3671 or visit the Minnesota Department of Human Services at https://mn.gov/dhs/people-we-serve/seniors/health-care/alcohol-drugs-addictions/get-help/.