Opioid Deaths Compounded by Medical Racial Bias

Disparities Health Care Policy Safety Net

            San Pedro Sula      Even as Covid recedes, there are other epidemics still raging, and the response is racially biased.  That’s the takeaway from a devastating article in Scientific American, appropriately entitled “Overdose Inequality.”

Let’s start with one-million opioid deaths in the last 30 years.  Then let’s move to the fact that in the last decade, “deaths have increased 575% among Black Americans.  In 2019, the overall drug overdose rate among Black people exceeded that of whites for the first time….”  Why? The finger points clearly at racial inequities.

There are effective treatment programs, but because of risks in housing, employment, and social service delivery, Blacks enter treatment late with less favorable outcomes and less likelihood of completion.  The government is part of the problem here:

Federal resources, such as grants to support local opioid use disorder clinics and programs, also tend to favor white populations. According to 2021 data from the Substance Abuse and Mental Health Services Administration, 77 percent of the clients treated with grant funding were white, 12.9 percent were Black and 2.8 percent were Native American. The disparity is even more pronounced in some states. For example, in 2019 North Carolina announced that white people made up 88 percent of those served by its $54-million federal grant, compared with 7.5 percent for Black people. Native Americans accounted for less than 1 percent of those served.

How about treatment centers?  Why aren’t they better advocates for equal care and the best available care?  You’re already prepared to be disappointed, and here it comes:

40 percent of the 368 U.S. residential drug programs surveyed did not offer MAT, and 21 percent actively discouraged people from using it. Many addiction treatment programs are faith-based and see addiction as a moral problem, which leads to the conclusion that relying on medication for abstinence or sobriety simply trades one form of addiction for another. Many general practitioners who lack training in addiction medicine have this misconception.

Congress passed a law in 2000 allowing certain scheduled narcotics to treat addiction, because that’s what works, but, and here we go again, doctors have to have special federal licenses and many of them “accept only commercial health insurance and cash, so the drug is usually only offered to a more affluent population, which in the US means white people.”  Add to that the fact that a lot of these same “do no harm” doctors don’t want recovering drug addicts in their offices, period.

When the hope for change offered by the reporters is that misconceptions might be altered by people coming out of prison, where the population is also majority minority, you know we’re in for more heartache.  The NIH says that the evidence indicates that recidivism when the formerly incarcerated get adequate treatment on release, but, gulp, that only occurs to one in 13.

For all of the multi-billions that pharma companies, drug stores and other suppliers are now paying, we better start asking how much of that money is being invested equitably to both stop addiction and assure equality while doing so?  Right this minute, I’m afraid I can guess at the answer, and it’s probably more of the same.