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Opioid Abuse Among African Americans

Opioid Abuse Among African Americans

Sample Answer 

Opioid Abuse Among African Americans

Introduction

Opioid drugs are designed to be painkillers that offer relief, but however, there are numerous deaths and injuries because of their intense marketing and their inappropriate prescription (Lessenger & Feinberg, 2008). Modern medicine has brought an alarming reality where patients are dying in unexpected numbers from prescribed therapies meant to treat pain; a reality witnessed all across the globe. Prescription opioid painkillers are among the leading medicines in the world that are abused and misused. In New Zealand, Australia, and North America, the illicit use of opioids is far higher compared to heroin. Similar to heroin, an opioid used for recreational purposes poses serious health risks and fatalities as well (CDC, 2018a).

The global rise of the opioid epidemic began in the 1990s at a time when advocacy organizations and pain specialists in the US began to argue that the country had an untreated pain epidemic. The American Pain Society pushed for pain to be recognized as the ‘fifth vital sign’, which was backed by a number of consumer groups and professionals that wanted opioid use to be increased with regard to pain management (Wilkerson et al., 2016). At the same time as opioid use was being advocated, OxyContin (oxycodone) was extensively marketed for the treatment of pain that was non-malignant. Sales representatives for OxyContin were aggressive in visiting doctors across the US and left them with free patient samples, gifts, and all-expense-paid invitations to symposiums, all of which were actions that aimed at impacting the prescription of the drug (Alam & Juurlink, 2016). The wide adoption of opioids for pain relief was also facilitated through marketing that did not fully disclose and downplayed the addictive potential of OxyContin. The marketing targeted doctors in primary care who, to this day, continue to prescribe most opioid painkillers across the globe (Alam et al., 2016). This paper will discuss the opioid epidemic in the US and, more specifically, among African Americans. The paper will also give recommendations on the way forward in combating opioid abuse among African Americans.

Opioid Abuse Statistics in the US

In 2017, there were more than 58 opioid prescriptions that were written for every 100 Americans (CDC, 2018a). There have been more than 700,000 deaths related to drug overdose between 1999 and 2017, with approximately 68% of the deaths reported in 2017 linked to opioid involvement. The deaths linked to opioids in 2017 were six times higher than those reported in 1999 (CDC, 2018a). On average, there are 130 deaths reported daily caused by opioid overdose in the US. The rise of deaths linked to opioid overdose can be described in three phases, as shown in Figure 1. The first phase commenced with the increase in opioid prescriptions in the 1990s, which resulted in an increase in deaths related to opioids since 1999. The second phase commenced in 2010, with heroin overdose deaths contributing majorly to overdose deaths. The third phase commenced in 2013 with deaths related to synthetic opioids and, more so, those that are illicitly manufactured Fentanyl (IMF) (CDC, 2018a). IMF is dynamic and is often combined with cocaine, counterfeit pills or heroin (CDC, 2018a).

FIG. 1 The 3 Phases of opioid overdose deaths. Source: (CDC, 2018a)

Approximately 21-29 percent of patients who use prescription opioids for pain management end up misusing the drugs. These patients develop a disorder of opioid use and make up 8-12 percent of the patients on prescription opioids. Approximately 4-6 percent of persons who misuse prescription opioids later transition to using heroin. Close to 80 percent of persons addicted to heroin first started off with prescription opioids (Vowles et al., 2015; Muhuri et al., 2013; Cicero et al., 2014; Carlson et al., 2016).

Opioid overdoses increased by 30 percent between 2016 and 2017 in July and September, respectively, in 45 states covering 52 areas. The highest percentage increase was 70 percent recorded in the Midwestern region within the same period. In large cities, opioid overdoses increased in 16 states at a rate of 54 percent (CDC, 2018b). Figure 2 shows the epidemic pattern in diverse regions.

Fig. 2 Opioid overdose per region in the US. Source: (CDC, 2018b)

A US News Analysis using CDC data showed that after adjusting for age, the rate of deaths related to opioid overdose among African Americans was 3.7 deaths for every 100,000 persons for the years 2005-2013 (Sternberg & Galvin, 2019). This figure is far below the average rate of 7.6 for Whites in the same period. The death rate following opioid overdose increased by 130 percent in 2014-2017 among African Americans and was also more than double that of Whites within the same period. Additionally, the deaths among African Americans living in urban areas increased to 7 for every 100,000 persons in 2017 from 5 deaths per 100,000 persons in 2012 (Sternberg et al., 2019).

Opioid Abuse: An African American Problem

For the past few years, the attention of American opioid addiction has been fixated on fighting the epidemic in cities that are largely populated by Whites, where reports on the increasing number of fatalities reveal communities that are in social and economic distress (Dasgupta et al., 2018). Opioid abuse in these cities stems mainly from economic instability as well as an increase in prescriptions for drugs such as OxyContin, which is a gateway to heroin addiction. However, on-the-ground specialists, academics, and health analysts state that heroin, as well as the death and crimes related to its use, have stalked African Americans for decades with little attention given to the same. The few times that the government has attempted to address the opioid problem in cities such as Chicago, it is often through police crackdowns on dealers and users rather than increasing access to economic aid, drug treatment, and interventions (Council on Foreign Relations, CFR, 2019). The attention disparities and differences in long-term strategies and resource allocation have resulted in two different opioid crises in the US. The first is a mental and medical health crisis that gathers the attention of the White House’s task force. The second level of crisis is the largely ignored black criminal crisis despite African Americans dying at high rates from the epidemic (CFR, 2019).

The country has searched for solutions after raising alarms for places such as Vermont, Burlington, Ohio, Chillicothe, West Virginia, and Parkersburg, yet this goes unnoticed in majorly minority and poor communities such as the Washington DCs areas of Baltimore’s, West Garfield, among others (Williams, 2019). As a shorthand for gun violence in urban centers scourge, President Trump has, as an example, cited the city of Chicago yet data indicates that in 2017, the drugs that made their way in Windy City were far more deadly than the gun-related crimes. In 2017, Chicago recorded 670 homicides, yet 796 persons succumbed to death related to opioid overuse. Of the reported persons, approximately 400 were African American, while 290 were whites. Although overdose-related deaths increased by 11 percent among African Americans and 18 percent among Whites, the statistics showed that the highest death rates were among blacks in Chicago (Williams, 2019).

The Causes of Opioid Abuse among African Americans

Heroin and other non-opioids, such as cocaine, have been in circulation in urban inner-city black communities from as early as the 70s (Murray, 2018). The main contributing factors include racial discrimination and inner-city life-challenging circumstances, and substance availability in black communities. The financial struggles characteristic of inner-city life have pushed some people to peddle drugs which has contributed to the availability of the drugs and consequent addiction to opioids among African Americans (Murray, 2018). The widespread availability of cocaine creates an escape from everyday hardships, with some community members exposed to heroin for the same reasons. In their study, Mars et al. (2017) showed that community members who consume cocaine are likely to ingest opioids such as Fentanyl and heroin unknowingly. Drug dealers are notorious for lacing cocaine with Fentanyl, a substance that is 100 times more addictive compared to morphine. Persons addicted to opioids can easily transition to Fentanyl or heroin to replace Codeine or Hydrocodone.

Additionally, there is a widespread stereotyping of African American patients by doctors who believe that African Americans have a higher tolerance for pain, and this has impacted how the black community has abused prescription opioids (Wyatt, 2013). Many doctors falsely believe that black patients have a higher pain tolerance and therefore prescribe them with lesser pain medication dosages. Further, many doctors are often reluctant to prescribe painkillers and other medications to black patients due to racial-based assumptions that the patients would sell the pills rather than use them to minimize their painful conditions (Om, 2018). These subtle forms of racism and discriminations impact how black patients respond to severe pain, and the lack of treatment may encourage them to seek out street-available synthetic opioids, which are often laced with Fentanyl. Finally, because of the strained relationship black communities have with law enforcement officials, they are less likely to seek opioid abuse treatment or even report overdoses (Green et al., 2013).

The Effects of Opioid Addiction on African American Communities

The opioid epidemic among black communities has had social effects with visible impact. The first of these impacts is family disintegration, especially following drug crackdowns. The judicial system and the government display racial stereotyping when fighting the drug use crisis. The crisis has continuously pushed the black communities into incarceration and devastation, which separate them from their family members (Griffith et al. 2018). Despite Blacks and Whites having similar chances of drug abuse, Backs are 13 times more likely to be arrested by law enforcement for purchasing or using drugs. Additionally, Blacks receive longer prison sentences for drug-related offenses than other citizens despite the weight of the crime being similar (Rosenberg, 2017). This contributes greatly to broken families among black communities.

Another consequence is the lack of adequate representation in the judicial system, which can argue for a reduction in charges compared to other races. Consequently, individuals addicted to opioids and are of African American descent get arrested and are quickly convicted because of insufficient resources to hire a competent legal defense (Griffith et al., 2018). Often, blacks frisked for drugs and arrested must wait very long before they receive a trial. Most police officers and lawyers are White, resulting in a ten times likelihood of Blacks being arrested and convicted than Whites (Griffith et al., 2018).

Recommendations and Conclusion

In response to the crisis of opioid abuse in the US, the Health Human Services department has focused its efforts on five key priorities, and these are improving access to services that offer treatment and recovery, promotion of the use of drugs that reverse the opioid overdose; strengthening understanding through improved public health surveillance; offering support for addiction and pain research; and advancing improved pain management services (National Institute on Drug Abuse, 2019). However, these steps are insufficient in curbing the rising deaths related to opioid abuse among black communities. The inherent polyfactorial biases present in pain management offered by medical practitioners and in the treatment of opioid abuse are linked to the trends, causes, and difficulty in resolving the epidemic. In 2000, the Drug Addiction Treatment Act allowed for the prescription of Suboxone (buprenorphine) by physicians to patients with opioid abuse disorder. However, DEA requires physicians to be certified and trained and can only prescribe to up to 30 patients in a year (Netherland & Hansen, 2017). In addition, physicians should have lesser access regulation to the prescription and utilization of medications such as buprenorphine and methadone so as to increase access to care for substance abuse.

The Black Community needs programs that are aimed more at health awareness. This can be achieved through awareness programs conducted in schools, law enforcement, churches, community organizations, and the courts. Real change will call for all the aforementioned to be utilized in tandem and new resources incorporated as well. Awareness is the initial step in the elimination of addiction stigma. Lastly, greater access to mental health care and addiction treatment will need to be enhanced. Closing the disparity in access gap is the best solution to the opioid abuse epidemic among African Americans. In conclusion, a nation is only as strong as its weakest link. Eliminating the opioid abuse epidemic in Black communities will require that the government first acknowledges that it is a nationwide struggle and not a White epidemic, after which the government should and must put in place programs that are viable and effective such as those recommended herein, in reducing and hopefully eliminating the opioid abuse epidemic totally in the country.

References

Alam, A., & Juurlink, D. N. (2016). The prescription opioid epidemic: an overview for anesthesiologists. Canadian Journal of Anesthesia/Journal canadien d’anesthésie63(1), 61-68.

Carlson, R. G., Nahhas, R. W., Martins, S. S., & Daniulaityte, R. (2016). Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study. Drug and alcohol dependence160, 127-134.

CDC (2018a). Opioid Overdose. https://www.cdc.gov/drugoverdose/epidemic/index.html

CDC (2018b). Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses–United States, July 2016-September 2017. https://www.cdc.gov/mmwr/volumes/67/wr/mm6709e1.htm

Cicero, T. J., Ellis, M. S., Surratt, H. L., & Kurtz, S. P. (2014). The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA psychiatry71(7), 821-826.

Counciul on Foreign Relations (2019). The US Opioid Epidemic. https://www.cfr.org/backgrounder/us-opioid-epidemic

Dasgupta, N., Beletsky, L., & Ciccarone, D. (2018). Opioid Crisis: No Easy Fix to Its Social and Economic Determinants. American journal of public health108(2), 182–186. doi:10.2105/AJPH.2017.304187

Green, T. C., Zaller, N., Palacios, W. R., Bowman, S. E., Ray, M., Heimer, R., & Case, P. (2013). Law enforcement attitudes toward overdose prevention and response. Drug and alcohol dependence133(2), 677-684.

Griffith, C., France, B., Bacchhuss, C., & Ortega, G. (2018). The Effects of Opioid Addiction on the Black Community. International Journal of Collaborative Research on Internal Medicine & Public Health10(2), 843-850.

Lessenger, J. E., & Feinberg, S. D. (2008). Abuse of prescription and over-the-counter medications. J Am Board Fam Med21(1), 45-54.

Muhuri, P. K., Gfroerer, J. C., & Davies, M. C. (2013). CBHSQ data review. Center for Behavioral Health Statistics and Quality, SAMHSA, 1-17.

Murray, K. (2018). The Tinge of the drug crisis: Black American and Opioids. https://www.addictioncenter.com/community/the-tinge-of-the-drug-crisis-black-americans-and-opioids/

National Institute on Drug Abuse, (2019). Opiioid Overdose Crisis. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#ten

Netherland, J., & Hansen, H. (2017). White opioids: Pharmaceutical race and the war on drugs that wasn’t. BioSocieties12(2), 217-238.

Om, A. (2018). The opioid crisis in black and white: the role of race in our nation’s recent drug epidemic. Journal of Public Health40(4), e614-e615.

Rosenberg, A., Groves, A. K., & Blankenship, K. M. (2016). Comparing Black and White Drug Offenders: Implications for Racial Disparities in Criminal Justice and Reentry Policy and Programming. Journal of drug issues47(1), 132–142. doi:10.1177/0022042616678614

Sternberg, S. and Galvin, G (2019). America’s Deadly New Normal. https://www.usnews.com/news/health-news/articles/2019-01-28/opioid-crisis-points-to-deadly-new-normal-for-america

Vowles, K. E., McEntee, M. L., Julnes, P. S., Frohe, T., Ney, J. P., & van der Goes, D. N. (2015). Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain156(4), 569-576.

Wilkerson, R. G., Kim, H. K., Windsor, T. A., & Mareiniss, D. P. (2016). The opioid epidemic in the United States. Emergency Medicine Clinics34(2), e1-e23.

Willimas, J. (2019). Separate, Unequal and Overlooked. https://www.usnews.com/news/health-news/articles/2019-01-28/black-americas-opioid-crisis-separate-unequal-overlooked

Wyatt, R. (2013). Pain and ethnicity. AMA Journal of Ethics15(5), 449-454.

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Question 


Opioid Abuse Among African Americans

Students will write a 7 or 8 page final paper on any issue related to any social problem. Chose a social problem.

Opioid Abuse Among African Americans

Opioid Abuse Among African Americans

The social problem I chose is recent opioid problems among African American. This is a research paper, you can give your thoughts about opioid problem as well, but mainly in the conclusion of the paper.

You need to use 5 academic sources such as journals or book.

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