As Philadelphia faces a deadly pandemic and its effects on the existing opioid crisis, it appears that black residents have been particularly affected by fatal overdoses since the inception of COVID-19.
Fatal overdoses among black residents increased by more than 50% in the months following Pennsylvania’s home series compared to the same period in the previous year. Overdose deaths among white residents decreased significantly during the period.
Researchers at Penn Medicine analyzed trends in opioid overdose published last year by the Philadelphia Department of Public Health and the Philadelphia Fire Department after seeing indications of an increase in deaths among black residents. Their findings suggest a reversal of trends commonly seen in the opioid epidemic.
“Philadelphia has been devastated by the opioid crisis, which was previously felt more sharply in the white community,” said Dr. Utsha Khatri, an emergency medicine physician and lead author of the study, in the JAMA Network Open. “Recently, however, we have detected a disturbing trend toward higher doses of lethal and non-lethal overdoses among residents of Black Philadelphia. These differential trends in opioid overdose suggest that racial inequalities have been exacerbated by the pandemic.”
The study examined three separate periods:
• Period A – April to June 2019
• Period B – December 2019 to February 2020
• Period C – April to June 2020
Researchers chose Period C to coincide with the full months after the home order, while Period A offered a year-to-year comparison and Period B gave a look at the months before the pandemic.
Overall, fatal overdoses in Philadelphia remained relatively unchanged in a year-to-year comparison between period A and period C. The city had an average of 94 deaths per overdose in Period A and 98 deaths per month in period C.
But among black individuals, overdose deaths rose from a monthly average of about 30 in periods A and B to about 49 in period C.
Fatal overdoses among Philadelphia white residents have decreased from a monthly average of 46 and 45 in periods A and B, respectively, to just 35 in period C. It has a 31% year-on-year decrease and a 22% decrease. means pandemic time frame.
Among Spanish residents, the monthly deaths from Period A to Period B dropped from about 16 to 12, but in Period C then rose to about 14.
Similar racial trends have been shown in Philadelphia among non-fatal overdoses.
Source / JAMA network open
Penn researchers published their demographic findings on opioid deaths in Philadelphia in JAMA Network Open.
“The results of this study are sobering, “said senior author Eugenia South, an assistant professor of emergency medicine at Penn.” The Black community has been hit incredibly hard since the start of the pandemic – both with the disease itself and the social and economic downturn, which includes increased gun violence, job losses and the closure of small businesses. We believe that the increase in fatal and non-fatal opioid overdose is a symptom of it. ‘
The release of the study comes as the city’s health department struggles with shifting causes and demographics of the opioid epidemic.
Preliminary statistics from 2020 contain a total of 950 deaths from January to September. When all information is recorded and verified, 2020 is expected to be the city’s deadliest year for opioid overdose.
Much of this is attributed to the constant rise of the deadly synthetic opioid fentanyl, which in addition to heroin is increasingly found in drug mixtures with methamphetamine, PCP and cocaine. The health department warned this week that “fentanyl is in everything”, which provides statistics on fentanyl-related overdose deaths, combined with other drugs in recent years.
The Penn research team believes that the growing prevalence of fentanyl may partly explain why fatal overdoses have increased among black residents.
“How this translates to an increase in accidental drug overdoses is unknown, but may be related in part to the purchase of more economical drugs from lesser-known sources,” said co-author of the study, Kendra Viner, section leader on the use of drugs in the health department said. prevention. “We are concerned that fentanyl, a potent synthetic opioid that is cheaper to produce and distribute, is increasingly found in non-opioid drugs. This could put the drug-addicted populations at greater risk of overdose without prior exposure to opioids.”
The researchers also felt that access to opioid treatment remained unfair. Buprenorphine, a prescription medication used to soothe cravings in opioids, remains more available to white patients than black patients.
And while research shows that drug use across racial boundaries is fairly similar, black people are likely to receive more legal penalties for it. Treatment was not effective enough to reach people already involved in the criminal justice system.
The study was limited to Philadelphia, but researchers believe similar trends in deaths from overdose opioids in other U.S. cities may be clear from further investigation. The study authors advocate that health departments publicly report overdoses of opioids per race.
“Cities across the country need to examine trends in overdose in different socio-demographic groups to have a more detailed understanding of who is affected and the best way to direct response efforts,” Khatri said.
The health department is currently developing a community education initiative to spread awareness and prevent overdoses with mixtures of fentanyl. The program will include the distribution of fentanyl test strips and naloxone, the drug against overdose used to counteract the effects of opioids.
The city will also expand public training on the recognition of opioid overdose and naloxone use, advocate for wider access to buprenorphine and provide more support for so-called ‘hot handovers’ to drug treatment from health care, prisons and community institutions.
The Penn study was supported by grants from the U.S. Centers for Disease Control & Prevention and the Robert Wood Johnson Foundation.