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New research looks at who is dying of drug overdoses during the pandemic. Studies done in Philadelphia and California show more Black Americans are dying of overdoses than white Americans. NPR addiction correspondent Brian Mann wondered why. And he talked to experts who told him about a problem of racial bias embedded in the way people with addiction are treated.
BRIAN MANN, BYLINE: When Latoya Jenkins talks about her mom, she likes to focus on good memories, playing games together with simple things like dish soap.
LATOYA JENKINS: Rainy days, she would take us outside, and we would make bubbles.
MANN: Jenkins family lives in upstate New York. She says her mom, Sonya Hughey, had a hard life and started using drugs as a teenager. The loneliness and isolation of the pandemic made things worse. Her mom was using meth, and in November, she was arrested. Jenkins says that might have been a chance to get help.
JENKINS: She asked, you know, can I get the rehab? I have a drug problem. They said, no, rehab wasn't an option for her.
MANN: Jenkins says a month later, Sonya Hughey, who was 48 years old, overdosed on meth contaminated with fentanyl.
JENKINS: We got a phone call from my mom's boyfriend that he found her dead.
MANN: Scientists at the Centers for Disease Control and Prevention say fatal drug overdoses nationwide spiked 20% during the pandemic; more than 83,000 Americans died. The CDC doesn't track drug deaths by race, but Dr. Utsha Khatri at the University of Pennsylvania says it's clear the surge is hitting some communities harder than others.
UTSHA KHATRI: It wasn't until we started looking at the level of race and ethnicity that we realized that Black and brown communities were being disproportionately affected.
MANN: Khatri's peer-reviewed study published in the Journal of the American Medical Association focused on data gathered in Philadelphia. What she found shocked her. Overdose deaths among Black residents surged more than 50% during the pandemic. Among white residents, overdose rates didn't rise at all. In some months, they actually went down.
KHATRI: COVID acted as salt in the wounds of health and social inequities that are perpetuated by structural racism, both in Philadelphia and across the country.
MANN: Other scientists report similar findings - drug deaths rising faster among Blacks than whites. Dr. Ayana Jordan at Yale University is part of a team studying overdose data collected in California.
AYANA JORDAN: It is really concerning. The COVID-19 pandemic has sharply exacerbated the inequities of the overdose crisis even within the last year, which is really, really scary.
MANN: Those inequities can be traced to the war on drugs, which distorted the nation's response to addiction long before the pandemic hit. White Americans are far more likely to be treated for addiction with health care and lifesaving medications while people of color are more often punished for drug use.
STEPHEN TAYLOR: The prototype of a criminal - people who were involved in a criminal behavior - arrests and incarcerations - that was the way it was dealt with.
MANN: Dr. Stephen Taylor is with the American Society of Addiction Medicine, which issued a statement last week condemning racial bias in addiction care and calling for reform. Taylor says in many Black communities, people with addiction are still more likely to encounter police than a health worker.
TAYLOR: That's what has been in place for a long time. I don't see that we've made progress in that.
MANN: Access to care is so limited in some Black communities, experts describe them as addiction treatment deserts. Dr. Nzinga Harrison runs a Black-owned addiction recovery network based in Massachusetts. She says even when Black Americans do find treatment, they often face more bias and stigma from care providers who are overwhelmingly white.
NZINGA HARRISON: You can hear it in the tone. You can see it when you're waiting in line and a person who's not Black comes in and they address that person before they address you.
MANN: Harrison says that bias often skews medical decision-making in ways that put Black lives at risk. She points to another JAMA study published in 2019 that found Black patients with opioid addiction were 35 times less likely than white patients to be prescribed buprenorphine. That's a medication that prevents relapse and overdose.
HARRISON: These experiences add up time and time and time and time to say this system does not have my best interests at heart.
MANN: Another JAMA study published last month found overdose deaths in urban communities could be cut nearly in half in just two years. But researchers acknowledge that would take sweeping changes, including much more access to medication and long-term treatment. Latoya Jenkins says people in her family who still struggle with addiction are wary of seeking help.
JENKINS: They have that fear if you go to get help, then people want to turn you in and have your children taken away. If they are seen somewhere using drugs, instead of, hey, can I get you to a treatment center or get somebody to help you, no, we're going to throw you in jail.
MANN: Jenkins says she wishes a real safety net had been there for her mom.
JENKINS: If they would have listened to her pleas for treatment, I feel like strongly that she would be alive right now.
MANN: Researchers say without major reforms, high rates of overdose death will keep ravaging Black communities long after the pandemic is over. Brian Mann, NPR News.
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