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As the pandemic filled American hospitals and brought life to a near standstill in 2020, the longstanding opioids epidemic was only intensifying, essentially out of sight. As Amna Nawaz reports, the death toll from that epidemic, once centered on rural, largely white parts of the country, appears to have shifted more heavily to urban, African-American communities.
As the pandemic filled American hospitals and brought life to a near standstill in 2020, the longstanding opioids epidemic was only growing worse, essentially out of sight.
As Amna Nawaz reports, the death toll from that epidemic, once centered mainly in rural, largely white parts of the country, appears to have shifted more heavily to urban African American communities.
Judy, the Centers for Disease Control and Prevention estimates that more than 92,000 Americans died of overdoses in the 12 months ending last November. It's the highest number ever recorded and a 30 percent jump over the prior year.
Now, the CDC data is not broken down by race, but researchers at the University of California found the largest increase in overdose deaths was in African Americans, a 50 percent jump from 2019. In Missouri alone, Black men are now four times more likely than a white person to die of an overdose.
Dr. Kanika Turner is a Saint Louis physician whose work centers in neighborhoods hard-hit by addiction. She joins us now.
Dr. Turner, welcome to the "NewsHour," and thank you for being here.
Those numbers are just striking. Tell us a little bit, especially over this past pandemic year. What should we understand about them? What's been driving those numbers?
Yes, I think what's driving those numbers is definitely multifactorial, I think a few things on the streets, with the drug supply changing, with the pandemic.
So, when we went through the shutdown, we saw a significant change in the drug supply. And whenever you see a change in drug supply, that that definitely increase someone's risk for an overdose.
On the streets, we typically saw a lot of fentanyl and fentanyl analogs. With the shutdown across the world pretty much, we started to see heroin return on the streets. Well, heroin is not as potent as fentanyl. So whenever you have a significant change like that, and then people go back to using fentanyl, we then increase someone's risk for an overdose.
And I think other things that took place, the stay-at-home order, people were no longer able to safely use. We needed to get into the hands more Naloxone to reverse overdoses, because, unfortunately, there were significant delays with 911 or emergency response services being able to respond to overdoses at the home.
I think the other thing, too, is just, when we look at the health care system, we had to quickly transition to telemedicine. And that was something that was unheard of in the addiction medicine world being able to offer telemedicine for substance use services.
So, unfortunately, the pandemic pretty much ripped this Band-Aid off of our health care system, and unroofed many, many disparities and inequities that we are dealing with right now. And, unfortunately, our Black males have continued to suffer during this time.
So, you live and serve patients in a neighborhood where all of this is playing out in a very real way. Tell me about what you're hearing among your patients, what you're seeing on the front lines as a doctor.
A lot of my patients are telling me — in the Black community, the substance of use is pretty much cocaine, a stimulant.
And people are inadvertently are being exposed to fentanyl, not knowing this. We need to start educating about testing for drugs. And that's something that's unheard of when you — in the streets. But that's one huge thing that we need to start talking about, because you just don't know what supply you're getting right now.
What about access to treatment and the treatment for those patients once they're in any kind of treatment facility? What about that?
Yes, that's a huge issue as well, just when you think about access.
If we look at the location of treatment centers, and where those are located at, now there is a big push to do more on the primary care level, specifically at my clinic and a few other clinics. But just access, just transportation, getting from one place to another, that's a huge issue.
And then you have to think about how many doctors are actually waivered to want to prescribe and practice in this area. So it's another huge issue. Of course, I can't leave out the issues with systemic racism that's inherent and embedded in our health care system.
So even if you get somebody to show up to care, now we have an issue. If they're feeling like they're not being welcomed, they're being stigmatized, they're less likely to come back to you and see you.
So we have issues getting people to care, and then keeping people in care. It goes back to when we think about the — how the laws, the policies, federal policies that were put into place that disproportionately affected our Black and brown community, the draconian laws, the mandatory sentencing laws.
To me, we need to start humanizing this and stop criminalizing this and coming from a perspective of being punitive. So, looking at it from that perspective, that we need to start focusing on the people that matter, and not being dictated by the laws and policies that are put in place to care for people, because no law or policy should be able to speak for someone's care.
So, you are among those leading the charge to stem these soaring death rates.
We now have teams going into jails on the ground, into churches. There are mobile van units, Narcan backpacks being handed out, those overdose reversal drugs. Is it enough? Is enough happening on the ground?
You know, I will say I am definitely appreciative of all those efforts.
I — personally, I think we need to move more towards teaching people how to safely use. Narcan is just one aspect for harm reduction and definitely reverse an overdose. I think that's great. We do know that overdoses occur about 80 to 85 percent of the time in someone's home.
But I think we need to start educating people on how to safely use. And that's something that's uncommon. We don't talk about that. But we need to teach people how to safely use, so that you won't die and we can see you again.
That is Dr. Kanika Turner, a physician in Saint Louis, Missouri, joining us tonight.
Dr. Turner, thanks so much for your time.
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Amna Nawaz serves as co-anchor of PBS NewsHour.
Mike Fritz is a video journalist and producer for the PBS NewsHour.
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