User:Justice Junky/Opioid epidemic in the United States

Race
In the US, addiction and overdoses affect mostly non-Hispanic Whites from the working class. The prevalence of opioid overdose deaths per 100,000 within the USA was highest for non-Hispanic White, followed by Black, Hispanic, and Asian/Pacific Islander individuals. During the first and second wave of the opioid epidemic, White American people were most affected by opioid overdose. While all groups were affected in the third and fourth wave of the epidemic, White Americans and non-Hispanic Black individuals saw the greatest rise in deaths.

Native Americans and Alaska Natives experienced a five-fold increase in opioid-overdose deaths between 1999 and 2015, with Native Americans having the highest increase of any demographic group. With the belief that there would be a low risk of addiction, Indian Health Service physicians, like doctors nationwide, readily prescribed opioids. In addition, structural health care deficiencies from the provider and cultural beliefs against receiving care from the patient, as well as inadequate community support structures for substance misuse, contributed to high mortality rates. In 2015, American Indians/Alaska Natives had the greatest drug overdose mortality rates of any U.S. population, comparable to White Americans. In 2018, the opioid crisis continued to disproportionately affect non-Hispanic Whites and Native Americans with the National Institutes of Health (NIH) reporting a rise in opioid morbidity and opioid related fatalities.

During 2019–2020, non-Hispanic American Indian/Alaska Native and non-Hispanic Black individuals experienced the greatest increases in drug overdose mortality rates. Additionally, when accounting for the age-adjusted death rate, non-Hispanic American Indian/Alaska Native and non-Hispanic Black individuals in 2020 and 2021. The percentage of individuals with documentation of prior treatment for substance use disorders was low, especially among Black individuals, at 8.3%. Overall, Hispanic, non-Hispanic Native Hawaiians, and non-Hispanic Asians experienced the lowest rate of overdose deaths.

Though previous statistics show that non-Hispanic White Americans have been affected by the opioid epidemic more than other racial/ethnic groups in the United States, recent statistics show that non-Hispanic Black Americans are experiencing a sharper increase in opioid-overdose deaths. The annual percentage change of opioid overdose deaths among Black Americans increased to 26.16 from 2012 to 2018 while White Americans only experienced an 18.96 increase from 2013-2016 and even had an annual percentage change decrease to 5.07 from 2016 to 2018. The challenges that non-Hispanic Black Americans face have a disparate impact on the rates of opioid-overdose related deaths when compared to non-Hispanic White Americans who have not dealt with the challenges of structural racism. Recent research has linked the rise in opioid-overdose deaths among Black Americans to the lack of safety, security, stability, and survival in their communities. Those missing pieces in these communities can be linked to a host of things including exposure to structural racism, lack of access to resources, and widespread mistrust in the healthcare system.

Structural racism continues to have a lasting impact on predominantly Black communities in the United States. Racial segregation is one of the main forms of structural racism that has been linked to the increase in opioid-overdose related deaths among non-Hispanic Black Americans. Racial segregation does not only impact access to social and economic resources. It also has an impact on public health and disrupts access to health care. The impact that racial segregation has health care spills over to the access of substance use services. This leads to Black Americans having a more difficult time when seeking treatment for opioid use. Structural racism has also led to the consistent misdirection of funds and the over-funding of criminal legal systems within predominantly non-Hispanic Black communities. Instead of funding being used to improve substance abuse treatment and prevention, funds have been used to criminalize drugs and impose harsh penalties on Black community members. The policies put in place years ago have led to stereotyping and fear within Black communities that prevents Black Americans from seeking substance abuse treatment. In America there are continual concerns regarding racial biases against non-Hispanic Black Americans when it comes to drug enforcement. Black Americas have historically been more criminalized for opioid related offenses, and despite calls for change there are still lasting impacts of this today.

Recent studies have shown a real need for equality when it comes to opioid abuse treatment and prevention. Medication-assisted treatments like buprenorphine have been proven to help treat substance use. The facilities that offer this treatment tend to be in communities with predominantly non-Hispanic White populations and they are rarely seen in predominantly non-Hispanic Black communities despite their proven effectiveness. The national focus being on prescription of opioids for pain management is a leading cause for non-Hispanic Black Americans receiving unequal treatment opportunities. Data has shown that this is not the main issue in every city/state, which shows the need for a more local data driven approach to opioid abuse intervention.