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Black and brown communities had highest increases in drug overdose death rates during pandemic, study says

By Jacqueline Howard, CNN

Drug overdose death rates in the United States soared during the Covid-19 pandemic, and a new study suggests that Black and brown communities were hit hardest.

Black people had the largest percentage increase in overdose death rates in 2020 — overtaking the rate among White people for the first time since 1999 — and American Indian or Alaska Native people had the highest overdose death rate of any group in 2020, according to the study, published Wednesday in the journal JAMA Psychiatry.

Study authors Joseph Friedman and Dr. Helena Hansen, both of the University of California, Los Angeles, analyzed data on drug overdose deaths between 1999 and 2020 from the US Centers for Disease Control and Prevention’s WONDER database and the National Center for Health Statistics.

The data showed that in 2020, American Indian or Alaska Natives had the highest rate of overdose deaths at 41.4 deaths per 100,000 people, 30.8% higher than the rate for White people.

Black people had the second-highest overdose death rate in 2020, at 36.8 per 100,000. This is 16.3% higher than the rate for White people, which was 31.6 per 100,000.

Drug overdose rates among Hispanic or Latino people remained the lowest among the groups in the study, at 17.3 per 100,000 in 2020. However, Hispanic or Latino people had a large increase — 40.1% — in drug overdose rates in 2020.

“Drug overdose mortality is increasingly becoming a racial justice issue in the US,” the study authors wrote. “Our results suggest that drug overdose mortality has been exacerbated during the COVID-19 pandemic.”

All racial and ethnic groups in the study had increases in drug overdose death rates for 2020, and the increases were higher than any increase between 1999 and 2019, the data showed.

Black people had the largest percentage increase in overdose deaths, at 48.8%, according to the study, rising from 24.7 deaths per 100,000 people in 2019 to 36.8 in 2020. White people saw a 26.3% increase.

The researchers noted that in 2020, the drug overdose death rate among Black people was higher than that among White people for the first time since 1999. For instance, in 2010, the overdose death rate among White people was double that of Black people, according to the data.

“These shifts reflect that Black communities have experienced higher annual percentage increases in overdose deaths compared with their White counterparts each year since 2012,” Friedman and Hansen wrote.

The researchers wrote in their study that the US overdose crisis is worsening due to “an increasingly toxic illicit drug supply” that may disproportionately affect racial and ethnic minority communities.

The pandemic accelerated trends that had been heading in the wrong direction, and experts say that reversing course will require concentrated efforts — and it will take time, both strategically and ideologically.

“If and when Covid restrictions ease, you won’t see a reversal in the same way you saw the acceleration because these drug distribution networks and addiction become embedded in the community. And it’s not like they turn off overnight,” Katherine Keyes, an associate professor at the Columbia University Mailman School of Public Health whose research focuses on psychiatric and substance use epidemiology, told CNN last month.

Early in the pandemic, Keyes was part of a research team that modeled the potential impact of the Covid-19 pandemic on drug overdoses. They found that even if the pandemic ended overnight, its effects on drug overdoses would persist for at least a year.

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