This post was originally published on Word In Black.
By any measure, it’s good news: the number of overall drug overdose deaths in the US fell significantly in recent years from an all-time high in 2022.
But that overall decline does not include Black people in general — and older Black men in particular. In fact, the overall drug overdose rate for older Black men increased nearly fivefold from 2015 to 2023.
And in 2023, the death rate for Black men age 55 and older was nearly triple the national average for that age group. The vast majority of the nation’s overdose deaths in 2023 were likely connected to heroin, fentanyl and cocaine.
The decline in white overdose deaths as Black overdose deaths continue to rise, experts say, is evidence of healthcare disparities between the two demographics. It also hints that programs to stem overdose deaths among whites has bypassed the Black community — and has for decades..
Generational Problem
“Black men didn’t just start dying,” Mark Robinson, a Washington, D.C. native who runs a syringe exchange program in his hometown, told The New York Times. “We’ve been dying for decades as a direct result of opioid use disorder.”
Robinson estimates he knows some 50 people who have died over the years from overdoses, including one of his best friends.
There has been much attention paid to drug use in America, specifically deaths stemming from opioid use disorder. Experts point to fentanyl — a synthetic opioid that has flooded the illegal drug market during the last decade – as a source of the problem.
When he took office, President Joe Biden prioritized curbing fentanyl use and bringing down overdose fatalities. The strategy included allowing naloxone, an overdose rescue drug, to be sold over the counter and increasing federal funding for harm reduction.
Over time, the overall overdose death rate fell, and the White House took credit for it.
““This is no coincidence,” Neera Tanden, director of the White House Domestic Policy Council, said during a recent media briefing. “Efforts taken, investments made, and policies put in place for this administration are having a positive and real impact.”
But the larger data picture suggests that overdose deaths in Black communities have been overlooked.
According to the Centers for Disease Control and Prevention, as many as 111,000 Americans overall died from drug overdoses in 2022. Between July 2023 and July 2024, however, drug overdose deaths nationwide fell by about 17%; by December 2023 there were 20% fewer deaths than there were in December 2022, according to a KFF analysis.
The KFF analysis also notes that opioid death rates have varied widely by race, ethnicity, age, and sex: “In the second half of 2023, white people saw the largest decline (-14%) while declines in other racial and ethnic groups were much smaller.”
Data from the National Institute on Drug Abuse puts a finer point on it: between 2015 and 2023, overdose deaths among non-Hispanic Black men aged 55 and older nearly quintupled.
The year 2020 was particularly brutal: in that year alone, drug deaths among older Black men were roughly seven times higher than for white men. By 2023, the death rate for this demographic was nearly triple the national average for all demographics in that age group, including white men.
The disproportionate overdose death rate between Black and white people is a chronic problem that doesn’t receive much attention. In cities with large Black populations, such as Baltimore, high drug overdose rates have plagued Black communities for decades.
Crisis Becomes Clear
In 2023, Baltimore recorded some 1,000 drug and alcohol-related deaths of Black people — 921 of which were fentanyl related, according to preliminary data from the city’s health department.
The extent of the city’s drug crisis didn’t come into focus, however, until a lawsuit forced the state’s medical examiner to produce complete autopsy reports. The updated data show the same alarming trend among older Black men.
At the same time, Georgetown University analysis of state-level data indicates that overdose deaths among Black Americans overall have been rising sharply.
Researchers found that, in 22 states that track drug overdoses by race and ethnicity, the number of fatal overdoses among Black Americans increased between 2022 and 2023, even as the number of deaths among whites often decreased.
Disparities in the number of deaths mirror healthcare disparities overall, including patients’ actual and perceived barriers to substance abuse treatment.
In a study from Boston University and Medical Center, almost 100% of Black respondents surveyed said they didn’t pursue treatment because they believed they should be able to manage their drug or alcohol addiction by themselves. At the same time, just under half of Black respondents reported their health insurance wouldn’t cover enough of the treatment costs.
“The question becomes: What are we doing wrong?” Jennifer Martinez, a researcher at the O’Neill Institute for National and Global Health Law at Georgetown University who analyzed the findings, told The New York Times. “Why aren’t we designing policies that are targeting the populations that need it the most? Something is working, but it’s not working for the people that need it most.”