The Changing Face of the Opioid Epidemic

Over the years, the opioid epidemic in this country has often been described as an issue that  mostly affects White and rural populations.

New evidence suggests that this is no longer an accurate depiction. A recent report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides data showing that opioid overdose deaths are skyrocketing among one specific population: non-Hispanic Black Americans.

The numbers mentioned in the report are alarming and they show that the characteristic of the epidemic is rapidly shifting. Between 2014 and 2017, fatal opioid overdoses among Black Americans that involved any opioid increased by 230%, and overdose deaths caused by synthetic opioids increased by 818%. This increase was highest for Black Americans compared to any other race/ethnic group. The report also lists adjusted opioid overdose death rates for the five US states that are affected the most, comparing rates of non-Hispanic Black Americans with the overall rate, painting a similar picture of the situation. One of the main reasons provided for this development is that other substances, such as cocaine, are increasingly being laced with the synthetic drug fentanyl.

A similar trend is emerging in Ohio. A study by Larochelle and colleagues that was published earlier this month revealed that between 2018 and 2019, the overdose death rate in Ohio for non-Hispanic Whites slightly increased from 42.0 to 45.2 per 100,000, while the rate for non-Hispanic Blacks jumped from 35.5 to 51.6 per 100,000. The SAMHSA brief leaves no doubt when it states that “regardless of how the data are represented, it is clear that Black/African Americans across the U.S. are substantially affected by the opioid crisis.”

The face of the epidemic is changing. Consequently, prevention and intervention efforts need to be adjusted to respond to this cultural shift of the epidemic.



Larochelle, M. R., Slavova, S., Root, E. D., Feaster, D. J., Ward, P. J., Selk, S. C., … & Samet, J. H. (2021). Disparities in Opioid Overdose Death Trends by Race/Ethnicity, 2018–2019, From the HEALing Communities Study. American Journal of Public Health, 111(10), 1851-1854.

Substance Abuse and Mental Health Services Administration: The Opioid Crisis and the Black/African American Population: An Urgent Issue. Publication No. PEP20-05-02-001. Office of Behavioral Health Equity. Substance Abuse and Mental Health Services Administration, 2020.