The Opioid Crisis in Marginalized Communities

Overall increase this century

The dramatic rise in opioid deaths, especially attributable to synthetic opioids created for medical pain relief has been the dominant theme of drug use, addiction, and drug fatalities in this century. In overview, drug fatalities quadrupled for the general population between 2002 and 2022.

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Overall leveling off

As indicated, this sharp increase has peaked and now declined slightly, but is still higher than at prepandemic levels, to wit:

The estimated number of drug overdose deaths in the U.S. have been dropping for months and are now at their lowest levels in three years, according to data from the Centers for Disease Control and Prevention (CDC).
Deaths from overdoses dropped for the first time in five years in 2023, following a steady rise during the pandemic. However, the current number of overdose deaths still remains higher than pre-pandemic levels.
In April 2024, the latest month with data, the estimated number of deaths in the past 12 months was 101,168, according to the CDC. The last month with figures that low was in May of 2021, with 100,997 deaths.
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Unclear explanation

The reasons for this decline aren’t clear, thus handicapping public policy initiatives.

While experts continue to explore possible reasons driving the decline, there are a few public health initiatives to curb drug overdoses that may be showing signs of success.
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Uneven drug death rates

More troubling, this decline in drug deaths has not been observed in minority, Native and other marginalized communities.

This process has materialized for more than a decade. For instance, in New York,  fatalities and death rates among Black or African Americans increased about five-fold from 2010 to 2020, while deaths and death rates among Whites about tripled.

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Reasons for most recent decline are still not clear. This decline in drug overdose death has continued through 2024

As previously, the most recent decline in drug deaths (albeit still at over 100,000) has not been observed in all groups and locations — cf. specifically minorities, for whom deaths have actually increased.  This phenomenon has been observed for both Black and Native Americans.

 

Addressing the two-track demographic

Thus, a succinct summary of drug-related deaths in America is that, after a slight (10 percent) decline for white Americans, they have continued to grow for Black and Native Americans.

We clearly require a different conceptual and applied approach for these groups.

This proposal presents such an innovative approach, as indicated by by Rob Boyd, the CEO of Ottawa Inner City Health, where we are currently implementing LPP for marginalized groups.

Ottawa Inner City Health is piloting an innovative peer recovery coaching program through the Life Process Program. The LPP is a non-disease-based model to address substance use and addictions that we think is a promising approach to supporting marginalized people who use drugs. We have already trained a handful of our peer workers in the model, and they are in the process of registering interested clients in the program.

We invite you to come and learn from the LPP team and our peer workers about how the model works and why it is different from traditional “treatment” approaches.

We believe (as does Mr. Boyd) that this model has broad applicability in the communities of concern.

 

Section summary

• Drug (mainly opioid) deaths have increased dramatically in this century
• They have risen most rapidly in the ten or so years prior to the pandemic
• Even given this multiplicative rise overall, minority (Black) deaths have risen more rapidly
• In the years since the pandemic drug deaths overall have declined by around ten percent, but remain over 100,000 annually
• Drug deaths in recent years have not declined, or even leveled off, but rather have continued to increase for Black and Native Americans
• The reasons for this overall decline in drug deaths, and the increase in minority deaths, are not well understood and thus have not led to clear cut policy recommendations