As overdose deaths for Black Philadelphians climb, we must expand access to treatment

This week, the Philadelphia Public Health Department released a report that focused on the increase in unintentional fatal overdoses among Black Philadelphians.

The news is grim. Of the record 1,413 people who died of an unintentional overdose in Philadelphia last year, 649 of them were Black. That represents an 87% increase from 2018. And while overdose numbers went up for Hispanics over the same time span, they actually decreased by 12% for white people.

I’m not surprised, because the old adage still holds true: When white America catches a cold, Black people will eventually contract pneumonia. That truth is tied to racist policies that create disparities in education, economics, housing, employment, and health care. One key inequality is the long-standing racial gap in medical coverage. As of 2021, Black people were 1.5 times more likely to be uninsured than their white counterparts. That means many white people have the resources to put their drug-dependent loved ones in well-appointed rehab facilities. Black people often don’t.

I suspect that’s the reason overdose numbers are going down among white people, while overdoses among African Americans and Hispanics are increasing. In addition, many substance users travel here from other cities to purchase drugs and then return to their homes. Those people rehabilitate in the high-end facilities that have sprung up in some communities during the opioid crisis. They can avoid overdoses because, in rehab, they can stop using.

I know there are those who hope Black people will see the numbers and opt for safe injection sites — places where people can use illegal drugs under medical supervision. But why do we need such sites when overdose numbers are already going down among the demographic that is most likely to have medical insurance and greater wealth?

To me, the numbers suggest that those with greater access to treatment are less likely to die of drug overdoses. So if we truly want to save African Americans and Hispanics from overdosing, we must make sure they have greater access to treatment, too.

We’ve already seen what happens when people try to solve a problem by doubling down on its cause. The National Rifle Association, the lobby for the gun industry, has responded to mass shootings during the last two decades by calling for more people to be armed. As a result, the carnage has continued — and there is no end in sight.

It was only when America realized that white people were overdosing in record numbers that the “drug war” transformed into the “opioid crisis.”

Similarly, progressives have told us that instead of taking the hard road and helping people abstain from drugs, we should help them to use drugs under supervision in order to reduce harm. Meanwhile, the number of overdoses has increased — especially among those least likely to have medical coverage. But among white people, the numbers went down. Not only because of resources, but also because of racism.

History makes it plain. No one cared about the lives lost to drugs when they believed it was a “Black problem.” It was only when America realized that white people were overdosing in record numbers that the “drug war” transformed into the “opioid crisis.”

In 2018, white Americans made up 75% of those who were overdosing on opioids. Back then, as the argument for safe injection sites ramped up, Black communities had already been ripped to shreds by crack, and America was perfectly happy to keep it that way.

I often wonder where the great concern for drug addiction as a public health issue was when my people were losing everything from their freedom to their lives. I wonder why I didn’t witness the same zeal for saving people when half my community was being jailed for the same thing progressives want to legalize now.

So excuse my skepticism, but I don’t believe the people who did nothing during the crack era are concerned about Black overdoses now. Rather, I think they’re anxious to save the white people who’ve become the face of the opioid crisis, and if they can use increasing Black overdose numbers to sway people to their side, they will do so.

There’s only one problem with their argument. Overdose numbers among whites are decreasing, and it’s not because of safe injection sites. In my view, it’s likely because access to insurance and treatment leads to better health outcomes. It’s because those kinds of resources can literally be the difference between life and death.