Black Americans may not be benefitting from efforts to reduce opioid-related overdose deaths as much as other racial and ethnic groups, a new study suggests.

Researchers at the National Institutes of Health analyzed data from death certificates for people 18 and over from 67 communities in Kentucky, Massachusetts, New York and Ohio during 2018 and 2019. They calculated rates and trends of opioid overdose deaths overall and for each state, as well as by race and ethnicity (non-Hispanic White, White, non-Hispanic Black, or other) for each state.

The study found that while opioid-related overdose deaths overall increased slightly, from 38.3 to 39.5 per 100,000 residents, the death rate among non-Hispanic Blacks grew by 38% overall, ranging from virtually no change in Massachusetts to 46% and 45% increases in Kentucky and Ohio, respectively.

Overdose death rates among non-Hispanic Black individuals in New York also stayed the same, but the rate among non-Hispanic Whites dropped by 18%.

Statewide, overdose death rates decreased in New York and Massachusetts by 4.2 and 0.7 per 100,000 residents, respectively, while increasing in Kentucky and Ohio by 0.3 and 4.8 respectively.

The communities in the study are participants in the ongoing Helping to End Addiction Long-term Communities Study (HCS), which NIH is conducting in partnership with the National Institute on Drug Abuse (NIDA) and Mental Health Services Administration. Its goal is to help communities implement evidence-based practices to treat opioid use disorder and reduce overdose deaths. It is the largest addiction implementation study ever undertaken. which looks at locales that have been disproportionately affected by opioid overdose deaths.

The authors note that while many evidence-based prevention and treatment interventions and support services exist for addressing the opioid overdose crisis, they have largely failed to gain widespread implementation in community settings such as schools, addiction treatment centers and the justice system.

“We must examine and address how structural racism affects health and leads to drug use and overdose deaths,” NIDA Director Nora D. Volkow, M.D, said in a press release. “Systemic racism fuels the opioid crisis, just as it contributes to other areas of health disparities and inequity, especially for Black people.

“We must ensure that evidence-based interventions, tailored to communities, are able to cut through the economic and social factors that drive disparities in substance use and addiction, to reach all people in need of services,” Volkow added.