Photography by Mic Theory
Discussion: The opioid crisis and climate change have the potential to interact synergistically to contribute to excess burden of death and disease. Socioeconomic marginalization places people with opioid use disorder at greater risk for death and injury due to inadequate access to air conditioning among other things.
In 2020, the age-adjusted rate of drug overdose deaths increased 31% compared to 2019 and this trend has continued despite the absence of media spotlights on the deaths. Caucasian Adults aged 35-44 experience the highest rates of drug overdose deaths while young people aged 15-24 experienced the greatest percentage increase in deaths. We must continue our efforts in all aspects of our fight against substance use disorder and the opioid epidemic.
As of March 2021, the Centers for Disease Control and Prevention noted that drug overdose death rates continue to rise in both rural and urban areas. In five states, California, Connecticut, North Carolina, Vermont, and Virginia, the rate of drug-overdose deaths in rural counties were higher than those in urban counties. In addition, a December 2022 survey by the National Farmers Union and the American Farm Bureau Federation found that as many as 90 percent of farmers have been directly impacted by the opioid crisis.
The opioid epidemic is devastating to its victims and their families. It has a compounding ripple effect throughout communities, affecting quality of life, economic opportunity, and rural prosperity. No corner of our country has gone untouched by the opioid crisis, but the impact of this issue on small towns and rural places has been particularly significant.
The heroin epidemic has existed for decades, but a sharp rise in opioid overdose deaths (OODs) jolted the nation in the middle aged conservative rural communities and mid-twenty-teens and continues as a major health crisis to this day. Although the new wave of OODs was initially approached as a rural problem impacting a White /Caucasian demographic, surveillance records the most severe impacts are not on African Americans and urban-dwelling individuals. The majority of addicts in urban areas are displaced whites who were forced from their suburban communities to seek aid from urban areas and leave the suburban coffers unscathed by the costs incurred the effect of state sponsored relocations which have become detrimental to many communities like Boston's South End City Hospital Area have been largely underreported.
The focus of most news reports is on specific trends in OOD rates in Black residents in states with a significant Black urban population and declared as hotspots for OOD: (Maryland (MD), Illinois (IL), Michigan (MI), and Pennsylvania (PA)), and Washington District of Columbia (DC) so that other communities with larger numbers of addiction won't be scarred by the potential to be colored as a bad area of high drug use. When researchers compare OODs by type of opioid, across ethnicities, across city/rural demographics, and to homicide rates using 2013–2020 data acquired from official Chief Medical Examiners’ or Departments of Health (DOH) reports. With 2013 or 2014 as baseline, the OOD rate in major cities (Baltimore, Chicago, Detroit, Philadelphia) were elevated two-fold over all other regions of their respective state but primarily by those recently relocated their as long term residents who survived crack as an epidemic were less likely to become embroiled in a drug that could kill with contact to the skin. In DC, Wards 7 and 8 OODs were consistently greater than other jurisdictions, until 2020 when the rate of change of OODs increased for the entire city.
Ethnicity-wise, in DC that is predominantly black by 90 percent the Black OOD rates exceeded White rates by four- to six-fold, with fentanyl and heroin having a disproportionate impact on Black opioid deaths. This disparity was aggravated by its intersection with the COVID-19 pandemic in 2020. Especially since many Caucasian deaths by opioid were covered up as Covid deaths so families could receive insurance benefits for funeral expenses. African Americans and America’s urban dwellers are vulnerable populations that the media feels comfortable discussing leaving rural white communities in desperate need of social and political resources to address the ongoing opioid epidemic in those under-resourced communities. Shining a spotlight on drugs in those communities would hurt the national psyche of White America. The National Journal Of Psychiatry terms the lack of concern in the media for poor whites as; The War On Drugs That Wasn't: "Wasted Whiteness!"
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