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Fatal Drug Overdoses Rose Among Black Women

— On average, overdose deaths resulted in more than three decades of life lost

Last Updated December 16, 2022
MedpageToday
A close up of a Black woman pouring pills from a prescription bottle into her palm

Fatal drug overdoses rose among Black women in recent years, CDC data showed.

Annual overdose deaths among Black women nearly tripled from 2015 to 2021 -- from 1,725 to 5,060 deaths -- according to Rebecca Arden Harris, MD, MSc, and David Mandell, ScD, both of the University of Pennsylvania in Philadelphia.

The number of years of life lost more than tripled from 58,170 to 178,822, Harris and Mandell reported in a research letter. On average, an overdose death resulted in 34.8 years of life lost.

During the study period, some of the burden of lost years of life shifted from older to younger women. The percentage of years of life lost attributable to Black women ages 25 to 34 rose from 21% to 30% (P=0.001), while the percentage attributable to Black women 45 to 54 years old fell from 30% to 19% (P<0.001).

"This study is an attempt to quantify the awful tragedy of premature deaths of Black women, and the younger women who are enduring a growing proportion of these deaths," Harris told 鶹ý. "They had decades of life ahead of them, and we can see the loss not only to their parents and partners and siblings, friends, and children, but also the devastating toll on their communities and to our society as a whole."

Little national attention has been focused on overdose deaths among Black women, as most news coverage tends to highlight drug-related deaths in other populations, Harris noted. "This was a huge and troublesome gap in the literature," she said.

While the first waves of the opioid epidemic in the 1990s and 2000s was driven mostly by prescription opioid deaths among white people, the burden of the more recent opioid crises -- heroin and illicit fentanyl -- has disproportionately affected people of color, noted Anna Lembke, MD, of Stanford University in California, who wasn't involved with the study.

This real-world change has still not been reflected in the literature on overdose deaths, Lembke added.

"There is a paucity more broadly in the medical literature of studies that focus exclusively on people of color, including Black women," Lembke told 鶹ý. "The drug-overdose literature is not immune. Beyond that, lessons from structural racism have taught us that when white people get addicted, it's a societal problem. When Black people get addicted, it's a 'them'-problem. Obviously, that's not okay."

The issue has had a chilling effect on research into overdose deaths among Black women especially, Lembke noted. "Scientific studies are the door to more research and public policy dollars. Highlighting the impact of drug overdoses in Black women may increase attention and funding for this problem," she said.

Harris and Mandell analyzed the deaths of 21,502 Black women between the ages of 15 and 64 who died of a drug overdose from January 2015 through December 2021. The team used summary-level death records from the mortality files and calculated the years of life lost by subtracting life expectancy and age at death, which was obtained from the National Center for Health Statistics life tables for 2020.

In total, Black women lost 748,289 years of life, which resulted in 59.3 years lost for women 15 to 19 years old, and 19.9 years lost for women 60 to 64.

Overdoses are now the fourth leading cause of death among Black women, following cancer, heart disease, and COVID-19, the researchers pointed out.

The research was intended to show the depth of the issue as it affects Black women, Harris noted. She believes it's a warning that more needs to be done to prevent these deaths from rising in the future.

"As a physician, I read the findings as an urgent call for action to increase access to opioid use disorder treatment, and eliminate barriers to remaining in treatment and expand access to harm reduction resources, such as naloxone and fentanyl test strips," she said.

Study limitations include possible inaccuracies in recorded causes of death and potential underestimates in 2021 provisional data, Harris and Mandell acknowledged.

Correction: An earlier version of this article cited incorrect percentages for increases in overall overdose deaths and total years of life lost.

  • author['full_name']

    Michael DePeau-Wilson is a reporter on 鶹ý’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news.

Disclosures

Harris reported no conflict of interest disclosures. Mandell reported grants from the NIH and personal fees from the Patient-Centered Outcomes Research Institute unrelated to the study.

Primary Source

JAMA Psychiatry

Harris RA, et al "Years of life lost to drug overdose among black female individuals in the us, 2015-2021" JAMA Psych 2022; DOI: 10.1001/jamapsychiatry.2022.4194.