Opioid and Stimulant Deaths in Black Community

How the Study was Conducted

To identify deaths caused by opioids in combination with stimulants, the team of investigators analyzed individual death certificate data for all deaths coded as overdose from the 2007-2019 National Center for Health Statistics. Deaths were grouped by race and ethnicity (non-Hispanic white, non-Hispanic Black, Hispanic, and non-Hispanic Asian American and Pacific Islander) as well as by state. The researchers analyzed deaths from opioids in combination with cocaine, as well as with methamphetamine and other stimulants (MOS). In order to disaggregate data by racial groups and states, the scientists used special statistical modeling to account for small sample sizes. The analysis found:

• From 2007 to 2019, Black Americans experienced sharper increases in both cocaine/opioid and MOS/opioid mortality compared to white Americans, particularly in eastern states. 
• The largest Black/white disparity was in MOS/opioid mortality in the Midwest. 
• By 2019, rates of cocaine/opioid mortality in Black Americans were considerably higher in 47 states than among white Americans. 
• In the South, deaths from cocaine and opioids grew 26 percent per year in Black people, 27 percent per year in Hispanic people, and 12 percent per year in non-Hispanic white people 
• MOS/opioid death rates among Black people increased 66% per year in the Northeast, 72 percent per year in the Midwest, and 57 percent in the South. 
• MOS/opioid death rates among Asian Americans and Pacific Islanders increased faster than in white people along the West and Northeast. 
• Among Hispanic people, MOS/opioid death rates grew faster than among white people in the West, Northeast, and upper Midwest.

The study’s findings raise some important public health challenges, says Townsend. People who primarily use stimulants may not identify as people who use opioids, making them less likely to obtain opioid-related harm reduction services such as fentanyl test strips and take-home naloxone.  

“Our findings bolster the argument that overdose prevention efforts should target not only people who use opioids, but also those who primarily use cocaine, methamphetamine, and other stimulants,” said Magdalena Cerdá, DrPH, professor and director of the Center for Opioid Epidemiology and Policy in the Department of Population Health at NYU Langone Health, and the study’s senior author. “Because of structural and systemic racism, adequate access to harm reduction and evidence-based substance use disorder treatment services is lacking in Black and Hispanic neighborhoods. More state and federal funding for these programs are needed.”