Since the late 1990s, deaths from opioid overdoses in the U.S. have climbed relentlessly. In 2019, nearly 50,000 Americans died of an opioid overdose. Drivers of this crisis include prescription opioids, heroin, and fentanyl, a powerful synthetic opioid.

In 2018, NIH launched the Helping to End Addiction Long-term, or NIH HEAL Initiative, to help to stem the opioid crisis. As part of that initiative, the HEALing Communities Study (HCS) has been testing prevention and treatment strategies in communities disproportionately affected by opioid overdose deaths.

In a new study, researchers led by Dr. Marc Larochelle from Boston Medical Center and Boston University School of Medicine looked at racial disparities in recent opioid overdose deaths. They focused on four states covered by the HCS: Kentucky, Massachusetts, New York, and Ohio.

The team used state death certificate records from 67 communities to calculate the opioid death rate. They then looked for trends in death rates between 2018 and 2019 based on race or ethnicity. The study was funded in part by NIH’s National Institute on Drug Abuse (NIDA). Results were published on September 9, 2021, in the American Journal of Public Health.

Overall, between 2018 and 2019, the opioid overdose death rate remained relative flat in the communities studied. For both years, it was around 39 deaths per 100,000 residents. But when broken down by race, there were stark disparities.

From 2018 to 2019, the opioid death rate among Black people increased by 38%. These trends varied at the state level. Increases were highest in Kentucky and Ohio.

Opioid overdose death rates didn’t change for Black people in New York between 2018 and 2019. However, they declined by 18% for white people. This suggests that Black people did not benefit equally from prevention and treatment efforts during the years studied.

There are many tools for preventing and treating opioid overdoses. These include overdose education, naloxone distribution, medications to treat opioid use disorder, behavioral therapies, and recovery support services. But these aren’t always deployed in the communities that need them most.

“The more local and timely data communities have access to, the more tailored their approach can be for interventions,” Larochelle explains.

“We must explicitly examine and address how structural racism affects health and leads to drug use and overdose deaths,” says NIDA director Dr. Nora Volkow. “Systemic racism fuels the opioid crisis, just as it contributes mightily to other areas of health disparities and inequity, especially for Black people.”

This research brief was originally published by the National Institutes of Health on September 21, 2021.