Despite Decline in Opioid Deaths, Black Michigan Residents Still Feel Negative Effects
The global pharma industry is going strong, with a market predicted to reach $1.12 trillion in 2022. But one particularly problematic part of Big Pharma — prescription opioids — continues to negatively impact Americans. And while opioid deaths might be showing signs of decline, both nationwide and throughout the state of Michigan, there are demographics who are being disproportionately impacted.
There are approximately 472,560 primary care physicians throughout the U.S., many of whom have often prescribed opioids to patients for a variety of conditions. The makers of prescription opioids originally reassured medical personnel that the risk of addiction was low. But since more than 2 million Americans are affected each year by prescription opioid misuse, we now know those claims are false.
Despite the fact that U.S. manufacturing is the largest market of its kind in the world, producing 18.2% of the world’s goods, prescription opioid manufacturers aren’t in the clear. Since then, they’ve been taken to task (and to court) for the adverse impacts they’ve had on Americans. And fortunately, due to increased awareness and interventions on both the federal and state level, we’re starting to see declines in the number of opioid-related deaths that continue to plague the nation.
Michigan is seeing progress for the first time in six years, with the state’s Department of Health and Human Services reporting that overall overdose deaths decreased by 3.2% in 2018. Furthermore, opioid-related fatal overdoses declined last year.
Dr. Joneigh Khaldun, chief medical executive and chief deputy director of health for for the Michigan Department of Health and Human Services noted in a statement: “This is a step in the right direction, however, there is much work to be done, particularly when it comes to disparities and access to treatment.”
That’s because, while overdose death rates among white Michigan residents decreased by 6.5% last year, the overdose fatality rate among black Michigan residents actually increased by almost 15%. On a nationwide scale, the opposite has been historically true. Racial biases in medicine have prevented black patients from being prescribed opioids in the first place, largely because many doctors believed that African Americans were more likely to become addicted, to sell their prescriptions, or to have a higher pain threshold than white patients. Although none of those ideas are true, these harmful stereotypes actually protected many black patients from the dangers of opioids. Recent analyses have revealed that if African Americans experienced the same opioid-related mortality rates as white populations did, there would have been an additional 14,124 additional deaths within the black community from 1999 to 2017.
With that in mind, the recent increase of prescription opioid deaths among the black population in Michigan might seem puzzling. Tragically, the answer might be found in fentanyl, a much-feared substance that’s been responsible for driving the opioid epidemic for the last seven years or so. While fentanyl was a substance that used to be found only in heroin, it’s now showing up in a number of illegal and fake prescription drugs. As a result, deaths among older African Americans in larger metro areas have been on the rise. Nationwide, overdose fatalities among African Americans aged 45 to 54 have more than doubled between 2015 and 2017.
Those facts align with what Michigan officials are reporting: while fewer deaths are being attributed to heroin and prescription painkillers, deaths involving synthetic opioids (a category that includes fentanyl) are on the rise. Of course, Michigan state law now limits prescriptions for painkillers to a seven-day supply, which has reduced overall opioid prescriptions in Michigan by 25% since 2015. But while it helps that doctors are exploring treatment methods rather than prescribing an opioid to any patient who walks through the door, it’s going to take a lot more than that to ensure that Michigan residents receive the help they need.
The state has distributed thousands of naloxone kits to treat overdoses, as well, but since many black communities may have higher barriers to medical care and drug treatment programs, there’s still a huge gap that needs to be closed. Moreover, the stigma surrounding addiction and treatment for said addiction is strong in African American and rural communities, which makes it even harder to reach vulnerable individuals. Officials hope that a million-dollar statewide anti-stigma campaign, which was announced on November 14, will help to spread the word that addiction is a disease that can be treated (rather than a moral failing). How big an impact this campaign will have remains to be seen, but it’s likely that additional steps will need to be taken in order to see widespread, positive outcomes.