Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
February 24, 2016 12:00 AM

The racial divide in the opioid crisis

Steven Ross Johnson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    The city of Huntington, a community of nearly 50,000 located in western West Virginia, over the past several years has felt the harsh impact of the nation's drug abuse crisis.

    The state's rate of death from drug overdose rose by 65% between 2009 and 2013. Huntington lies within one of the most heavily affected counties (PDF), where more than 900 people overdosed in 2015. Seventy of them died.

    Jim Johnson has seen, firsthand, how the face of drug abuse in Huntington has shifted over the years.

    “I came onto the police department in 1972, and the people ... on heroin were that part of society that you were walking down the street, and you would want to go to the other side,” said Johnson, who is now the director of the Mayor's Office of Drug Control Policy for Huntington. “Now there has hardly been a family that has not been affected.”

    That reflects the scope of the epidemic. The rate of heroin-related overdose deaths throughout the country has nearly quadrupled since 2002. An estimated 30,000 people every year die from opioid overdoses.

    But unlike drug epidemics of the past, minority populations have seen a less dramatic increase in addiction and deaths when compared to white young adults. The rate of heroin use among white adults increased by 114% between 2004 and 2013, according to the Centers for Disease Control and Prevention, while the rate among nonwhite adults remained relatively unchanged during that same period.

    Heroin use flat among non-Hispanic whites

    Dr. David Rosenbloom, professor of health policy and management at Boston University's School of Public Health, thinks he knows why. “Blacks have been undertreated for pain for decades,” he said.

    The stark rise in addiction can be traced back to the increased the use of the prescription pain relievers OxyContin and Vicodin. Prescriptions of opioid analgesic medications have skyrocketed since the introduction of OxyContin in the mid-1990s. In 2012, the number of prescriptions written for opioid drugs reached 259 million.

    Regulators only a few years ago began implementing stricter limits on the number of pain pills doctors could prescribe, which resulted in lower prescribing rates for opioids, but also led to a subsequent rise in heroin use, a cheaper and easier option than prescription pain medicines.

    A 2008 JAMA study found minorities were less likely to receive opioids for pain in an emergency department compared to whites.

    Some say physicians' prejudice leads many to prescribe opioids at a lower rate to black and Latino patients than to whites.

    “It would appear that the prescriber may be more concerned about the possibility of the patient getting addicted or maybe the possibility that the pills will be diverted and sold on the street if the patient is black. If the patient is white, they may feel like there's nothing to worry about,” said Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing.

    Still others contend the problem may have more to do with white patients having traditionally had greater access to healthcare services compared to minority patients, increasing the likelihood of receiving pain treatment.

    “It could be that overall ability to be able to be prescribed these medications has resulted in more exposure among whites and more risks in terms of addiction and overdose,” said John Kelly, an associate in psychiatry at Massachusetts General Hospital, Boston.

    When addicts reported first opioid use

    Many believe the changing face of drug abuse is behind the urgent call to action among presidential candidates, lawmakers and law enforcement officials. That would also be true for the increased call for treatment rather than the previous “war on drugs,” which concentrated on mass arrests and incarceration.

    “I think it was pretty clear that our response during the crack cocaine epidemic was largely a criminal justice response,” Kolodny said. “Whenever you hear people talking about our opioid crisis, within the first few minutes you hear someone say to the effect that we can't arrest our way out of this problem.”

    Democratic presidential candidates Hillary Clinton and Vermont Sen. Bernie Sanders have both called for plans that include “rehabilitation and treatment” over prison for low-level and nonviolent drug offenses.

    Republican presidential candidate Texas Sen. Ted Cruz, whose half-sister died from a drug overdose, has called for faith-based treatment. GOP frontrunner Donald Trump supports treatment and prevention efforts, and like Cruz, has advocated for securing the U.S. border to disrupt the drug supply.

    Treatment-based solutions to address addiction have already begun to take shape. A total of 42 states and the District of Columbia have passed legal protections for medical professionals who dispense naloxone, a prescription drug that counters the effects of an opioid overdose. Controversial measures, such as needle exchange programs for drug users, have gained support in states and municipalities across the country.

    For places like Huntington, needle exchange programs have helped combat another health issue related to intravenous drug use. In 2013, West Virginia had the highest rate of hepatitis B infections in the nation with 10.5 cases for every 100,000 residents, according to the CDC. By comparison, the state with the second highest rate of hepatitis B infections that year was neighboring Kentucky, which had 4.9 cases per 100,000.

    Nationally, rates of hepatitis C infection have increased as more Americans have turned to using intravenous drugs. Rates of infection in four states—Kentucky, Tennessee, Virginia and West Virginia—rose by 368% between 2006 and 2012, according to the CDC. Intravenous drug use was cited as a risk factor in 73% of those cases.

    Johnson admits he was not initially a big supporter of programs aimed at harm reduction for substance abusers. What changed his mind toward adopting more of a public health approach was witnessing the devastating effects the drug epidemic was having throughout the entire community.

    “In our county we were spending at a minimum of $50 million to $100 million a year just on the healthcare,” Johnson said. “When we started talking about syringe exchange it was like, 'Why aren't we doing this.' ”

    Changes in the country's approach to drug abuse have also come from a national level. President Barack Obama earlier this month proposed allocating $1.1 billion over two years as part of his fiscal 2017 budget toward fighting heroin and opioid drug abuse; $920 million of that would expand medication-assisted treatment.

    But the question remains whether the country has truly turned a corner in how it perceives addiction and whether the current approach will be applied to any future drug epidemics affecting all racial groups.

    “I would like to think it would help to shift the climate somewhat, but I am not overly optimistic,” said Marc Mauer, executive director for the Sentencing Project, a research organization that advocates for reforms in the criminal justice system. “We still have a ways to go I think to broaden that perspective on how we approach substance abuse.”

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    BurnoutUnsplash.jpg
    Health systems bet on employee mental health initiatives
    young doctor medical resident
    10 things to know about 2023 Match Day
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing