Opioid overdose deaths nearly tripled among black Virginians

By LUCA POWELL, Richmond Times-Dispatch

RICHMOND, Va. (AP) — Darryl Cousins ​​has three friends who died of drug overdoses in the past two months.

Some were people he dated years ago when he was in active addiction. He tried to help others in his role as a counselor in several East End recovery homes.

“You get three or four deaths, maybe in a week now, in Richmond, Henrico and Chesterfield, instead of one or two a month,” Cousins ​​said. “There is not much light on the situation.”

The largest spike was recorded in the black population of Virginia. Over the past four years, the state has seen more than triple opioid overdose deaths among black Virginians — the highest death rate, by far, of any demographic group. The figures underscore the lethality of a fentanyl-polluted drug supply, as well as the structural barriers to entry into recovery – an essential first step in preventing a fatal overdose.

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The figures – made public by the Centers for Disease Control and Prevention’s Death Certificate Database – tell the story of a stark increase, particularly in the Richmond metro area. Chesterfield County recorded 34 deaths in 2021, compared to 11 in 2018. Henrico County saw a similar spike, up to 44 of 14 deaths, and Richmond recorded 135 deaths, compared to 41 deaths in 2018.

The spike was sharper in Richmond than in any other county in the state.

“It desensitizes you to death,” Cousins ​​said.

Cousins, a black man, works for Starfish Recovery and Wellness, a Richmond-based addiction recovery residence. He was born in the South End of Richmond, where he attended George Wythe High School. He’s been sober for 15 years, he says, and shares a long view of how the city has changed in that time. The scariest thing is the drugs that seem to be everywhere these days.

“All of a sudden, it’s in every drug sold,” Cousins ​​said. “Fentanyl has taken the drug world by storm.”

Fentanyl, a synthetic opioid developed in the 1950s for the management of severe pain, has overtaken the illicit drug supply.

At 50 times the potency of morphine, it is deadly and easily overconsumed in powder form.

The drug delivers a stronger version of the same full body euphoria associated with heroin. At the same time, it depresses respiration in the lungs to dangerously low levels, depriving the body of oxygen.

“This explains why fentanyl is so deadly: it stops people breathing before they even realize it,” said Dr. Patrick L. Purdon, lead author of a fentanyl lethality study conducted. by doctors at Massachusetts General Hospital and published in August.

This year, Virginia epidemiologists have linked the drug to 76% of fatal overdoses in Virginia. Every day, more than five Virginians die from overdoses explicitly linked to fentanyl.

Forensic scientists have come to expect fentanyl, finding it often mixed with the drugs that were once thought to be the most deadly, such as heroin, cocaine and methamphetamine.

Overdoses of these drugs have also increased, but now four out of five toxicology reports of cocaine overdoses show that fentanyl also played a role.

What’s also scary is how the drug is researched, Cousins ​​said. Active addicts seek heroin containing fentanyl, he said, because their bodies have normalized heroin in its most regular form.

“I was trying to figure out too, I was trying to figure out, why would you go looking for something that literally takes you to the edge of death?” said the cousins.

Tisha Wiley, a researcher at the National Institute on Drug Abuse, says the path to the current opioid crisis in the black community has been paved by historic racism in health care.

As white patients were easily prescribed drugs like OxyContin in the late 1990s and early 2000s, black patients had a much harder time convincing doctors of the legitimacy of their pain, Wiley said.

“One of the things we hypothesized at the start of the pandemic was that black patients were less likely to be prescribed pain medication, which would translate to black patients having a harder time getting medication. prescribed” for opioid use disorder, Wiley said. “It amounts to an implicit bias.”

The practice is continuing into 2021, according to a recent study published in the New England Journal of Medicine, and has disturbing second-order effects.

Pain patients sought doctors more willing to write prescriptions or cheap street substitutes, such as heroin.

The bias, Wiley said, also arises when addicted black people seek medically assisted treatment for addiction, such as drugs like methadone, an FDA-approved opioid used to curb cravings.

And while white drug addicts are more likely to be diverted to treatment, such as rehab, black and Hispanic drug addicts are more likely to be arrested, Wiley said.

This has made prisons a key focus in reducing and equalizing the opioid epidemic.

The resources needed to recover, such as housing and insurance, are also skewed along racially divided lines. Walter Randall, recovery facilitator at High Council Services, said Richmond’s main recovery residences target what he described as “a white demographic”: patients with private insurance or the ability to pay out of pocket. .

Many don’t take Medicaid, said Randall, who is black and has been recovering for 22 years. He says the downwind effect of this choice has been a separate recovery space.

“White has McShin, True Recovery, Starfish,” Randall said.

“Black people have” Narcotics Anonymous and community service advice.

Jimmy Christmas, a licensed therapist with River City Comprehensive Counseling Services, which provides addiction and mental health services in Richmond, said some of those divisions are blurring as the opioid epidemic in the black community has received More attention.

“When I look at what the white community has had access to, this physical apparatus of recovery homes, compared to the black population — it even makes me sad to look at that,” said Christmas, who is black and in recovery. “I sit here and watch our country fail.”

Christmas says Richmond’s black community needs “guerrilla outreach,” not just to warn of the lethality of fentanyl, but to build community buy-in that recovery works.

“What’s missing is that some of these pockets, like the East End, need more outreach,” said Christmas, who is 61 and has treated generations of drug addicts in the Richmond area.

“For 20 or 30 years in the white community, there have been white families willing to pay for the treatment of their loved ones. I would like to believe that there is a pocket in the black community that is willing and able to pay for their treatment as well,” he said.

Christmas said recovery residences, the “gold standard” of addiction treatment, cost around $5,000 a month — a price that can be prohibitive without a family to foot the bill. And most have white owners and staff, he said.

But increasingly, more funds have become available to state legislators and health agencies. Through several grants, Virginia has already received more than $70 million in federal funds intended to support recovery services. These funds have been essential in breaking down the financial barriers that have entrenched the racial divide in access to care.

The grant money helped the Virginia Association of Recovery Residences diversify its customer base by establishing a fund for indigent customers.

Recent data shared by the organization shows that more than 40% of admissions are for non-white people.

Millions of dollars have also been directed to jails and prisons, which have begun providing drug withdrawal treatments for inmates with opioid use disorder.

But the lion’s share of incoming funds intended to curb Virginia’s opioid epidemic has yet to be distributed. That money, about $610 million, will come from opioid distributors and manufacturers, such as Purdue Pharma, Janssen Pharmaceuticals and others.

Beneficiaries, like the City of Richmond, will decide how it should be used.

Jim Nolan, a city spokesman, said decisions on the money would be made in the coming weeks, pending an appropriation process and approval from the mayor and city council members.

The city is expected to receive at least $4 million over 16 years, according to records shared by the Virginia Attorney General’s Office, which funnels funds to Virginia locations from distributors.

Copyright 2022 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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