Opioid addiction has recently become a hot button issue across America. While communities have been devastated by this epidemic for years, policymakers and the media are finally waking up to the realities of the crisis. Much of this attention is focused on white communities, especially in rural and suburban areas, where addiction to legal painkillers has soared in recent years. Yet African American communities have long suffered from the diseases of addiction with little to no help.
The “Godfather of Soul” James Brown released his cautionary anthem “King Heroin” back in 1972 citing its devastating effect on black communities and 45 years later the harsh truths he spoke of remain true. Instead of treatment for this disease, black communities have seen increased incarceration rates – resulting in broken families, few opportunities and an endless cycle of addition.
Greater Cleveland is no exception. A recent report called Ohio “the face of the nation’s opioid epidemic,” with one in every 100 people in the state dependent on opioids and 79 people dying from opioid overdoses every day. In Cuyahoga County, despite targeted efforts, deaths due to overdoses of heroin and other opioids have gone up 400 percent since 2007. Sadly, for communities of color this issue is only compounded by a myriad of other issues including lack of access to healthcare, poverty and homelessness.
Black overdose victims tend to be older, with the largest share occurring among users between 40 and 59. Yet the public health implications of opioid addiction go even deeper. Since 2004, Ohio has seen a 750 percent increase in the number of babies born to mothers with opioid dependency diagnosed with neonatal abstinence syndrome (NAS) having developed an addiction in the womb. This issue disproportionately affects African American communities where infant mortality rates outnumber that of white 3 to 1.
The opioid problem extends to our jails and prisons where addiction is rampant – one report found that more than 7 in 10 inmates suffer from substance abuse addiction. Once again we see black people disproportionately over-represented in Ohio’s prisons and black women being incarcerated at twice the rate of a fast-growing female prison population. This leaves minorities especially exposed to the violence that inevitably follows the smuggling and misuse of opioids behind bars while the substance abuse goes undertreated.
As lawmakers address this crisis, they should examine the status quo for treatments that are currently in use among the affected population. Buprenorphine, or bupe, has become a standard pharmacological treatment for opioid addiction. Unfortunately, the most widely available buprenorphine treatment, Suboxone, is one of the most controversial prescriptions in America. Suboxone comes in film strip form, which makes it easy to cut, resell, and smuggle. Jails and prisons have been forced to add staff to cut stamps off inmate mail, which Suboxone can be pasted behind.
Unintended use and resale only exacerbate the cycle of addiction and relapse that prevents communities from recovering and rebuilding. One state recently moved Suboxone off the its preferred drug list in considering a growing criticism from public health experts.
While Ohio has taken steps to combat the misuse of Suboxone, with our Attorney General Mike DeWine joining 41 other states in a lawsuit against the makers of drug, Ohio continues to pay for more than 49 percent of buprenorphine prescriptions through Medicaid funds. This means Ohio’s taxpayers are paying for prescription drug coverage with their right hand, and suing the maker of the drug with their left. It simply doesn’t make sense.
If we are to truly combat this problem in Ohio and especially in communities of color, state officials must improve coordination in their public health and law enforcement policies by removing film strips from the state’s Medicaid formulary and replacing another less problematic prescription. Additionally, the implicit bias within our systems must be addressed on all levels if we are to make any inroads in the opioid crisis.
James Brown in his song urged us to “get our mind[s] together, and get away from drugs.” We want to end the opioid crisis, not replace it with a more pervasive one. Our communities demand greater action on this issue. We must take action now.
Yvonka Marie Hall is the Executive Director of the Northeast Ohio Black Health Coalition. NEOBHC is the first organization in Ohio dedicated to addressing health disparities in the African American community.