St. Louis combats opioid crisis as overdose deaths skyrocket among Black Americans

More Americans died from drug overdoses last year than ever before. And while deaths are up across nearly every demographic since the start of the pandemic, there’s been an especially alarming spike in overdose deaths among Black Americans. John Yang reports from St. Louis on the growing public health crisis.

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  • Judy Woodruff:

    More Americans died from drug overdoses last year than ever before.

    And while the number of lives lost is up across nearly every demographic since the start of the pandemic, there has been an especially alarming spike in overdose deaths among Black Americans.

    John Yang reports from St. Louis on what's behind a growing public health crisis.

  • Dr. Kanika Cunningham, Family Care Health Centers:

    I'm going to take a listen to your heart and lungs.

  • John Yang:

    In a St. Louis clinic, 52-year-old Gerord Rowe has a routine appointment with Dr. Kanika Cunningham. She makes the usual checks.

  • Dr. Kanika Cunningham:

    Give me a deep breath. And blow out.

  • John Yang:

    And asks about another issue she's monitoring.

  • Dr. Kanika Cunningham:

    You said you're still kind of using a little bit. Are you using safe? I know we had talked about that before?

  • Gerord Rowe, Patient:

    Yes.

  • Dr. Kanika Cunningham:

    OK, snorting, not doing anything, I.V.?

  • Gerord Rowe:

    Yes. No.

  • Dr. Kanika Cunningham:

    OK.

  • John Yang:

    Cunningham, a family practice physician, treats drug addiction in her patients just like any other medical condition like high blood pressure or diabetes. If they're not ready to stop using drugs, she wants them to use them safely.

  • Dr. Kanika Cunningham:

    And I am also concerned, the last time that happened, you had an overdose.

  • Gerord Rowe:

    Yes.

  • Dr. Kanika Cunningham:

    So, I don't want you to overdose again.

    My treatment plans incorporate safe use tips, safe consumption tips, a 1-800 number, to never use alone, reviewing how to use Narcan. So I want people to leave feeling empowered and equipped with the information, because it is a chronic disease. Recurrence of use is going to happen.

    So, if we know that it's going to happen, why don't we give the individual in front of us — share that knowledge that I have, so that I can you next week at your next appointment, see you two weeks later?

  • John Yang:

    It's an approach she believes could help stem the soaring number of drug overdose deaths, especially among African Americans.

    Here in the St. Louis area, since 2015, deaths from drug overdoses are up nearly 400 percent in the Black community, a rate of increase that's eight times higher than the rise among white residents. It's a public health crisis that's largely been over overshadowed by the pandemic.

  • Dr. Kanika Cunningham:

    In 2020 and 2021, we lost over 400 Black men, over a two-year span. We lost more people to overdoses than to COVID-19. This is a civil rights issue. It's a human rights issue that we need to change. It's a chronic disease. And we have stigmatized a chronic disease.

  • Gerord Rowe:

    Yes.

  • John Yang:

    Rowe has been battling addiction since 2016, when he was depressed over losing his job and someone offered him heroin.

  • Gerord Rowe:

    So, I was in the dumps. And I thought maybe that would make me feel better if I snort a couple of lines. That hooked me. And it hooked me for five years, I mean, hooked me bad.

  • John Yang:

    Heroin gave way to fentanyl, a synthetic opioid 50 times more powerful. Eventually, he was taking up to 35 pills a day.

    Was it just the wanting it, or was it needing it?

  • Gerord Rowe:

    Needing it. I even stopped paying bills just to get that. You know, the nice apartment I was renting that I was at for five years, that's gone. I mean, it really took me through some things.

  • John Yang:

    Two overdoses of his own couldn't convince him to try to stop, but the overdose deaths of two others close to him did.

  • Gerord Rowe:

    I lost a son. He overdosed. I lost a brother, all in one year, overdosed on fentanyl. And that woke me up. No ifs, ands, buts, no second-guessing, I got to stop.

  • John Yang:

    Rowe has been Cunningham's patient for three months.

  • Gerord Rowe:

    I mean, some days, it is like up here. I mean, it is so intense that I can't get past it.

  • John Yang:

    She's put him on Suboxone, one of the main medicines used to treat opioid addiction.

  • Dr. Kanika Cunningham:

    Let's see how you do. That should really help control your cravings and withdrawals.

  • John Yang:

    He says it's helped him cut down to a single fentanyl pill a day.

  • Dr. Kanika Cunningham:

    I know where the need is, and that's where I like to go.

  • John Yang:

    To reach people like Rowe, Cunningham teams with other health care providers and community groups to take treatment out of doctors' offices and clinics and into neighborhoods, like this one in North St. Louis.

  • Person:

    Get it cleaned up. What are your thoughts about that?

  • Person:

    I would love to have that.

  • John Yang:

    Mobile treatment centers offer things like the overdose reversal drug Narcan and offer tips on how to safely use drugs.

  • Dr. Kanika Cunningham:

    This is one effort to bring treatment, bring everything into the community, not always rely on the community to come to us.

  • John Yang:

    And what are people getting here? What's being handed out?

  • Dr. Kanika Cunningham:

    Food. They're given Narcan that is there, fentanyl testing strips as well. If people need access to sign up for Medicaid, so we get them — at least start the initial process. We will sign them up for Medicaid.

  • John Yang:

    It's part of an effort to build trust and break down barriers in neighborhoods that Cunningham calls treatment deserts.

  • Dr. Kanika Cunningham:

    Where our treatment centers are situated, sometimes, people have to catch two and three buses to get there. So imagine the burden we put on people to come to us to see us.

    And then you have a small window of getting there on time, if your bus is late and then you're told you can't be seen. There just are so many different issues.

  • John Yang:

    Also part of the neighborhood effort, clergy, like the Reverend Rodrick Burton.

  • Dr. Kanika Cunningham:

    This is Narcan. This is what we use to reverse an overdose. Definitely need to get this into the hands of the community.

  • John Yang:

    Cunningham advises them how to talk about substance abuse in ways that show compassion.

  • REV. RODRICK BURTON, New Northside Missionary Baptist Church:

    The church, unfortunately, has been — many leaders and members have had a judgmental view of people suffering from addiction.

    We can learn, number one, what's the right way to talk to people who are experiencing this, so we're not doing so in a judgmental way, but also how can we acutely address when people do fall out? How can we save their lives?

  • Dr. Kanika Cunningham:

    I mean, I remember walking the street with my grandmother, going to the corner store, and…

  • John Yang:

    It's a shift in attitude that Cunningham knows first-hand. She grew up in the St. Louis area and recalls how her grandmother spoke about people in the neighborhood who used drugs.

  • Dr. Kanika Cunningham:

    I was also raised to view substance use as an issue, drug use problem that's on the individual. And now, the more knowledge and education, I see that it's more of a systemic issue. It's not on the individual. It's trauma. It's systemic racism. It's all of that.

  • John Yang:

    And all that can be a hurdle between people who use drugs and finding treatment.

    Devin Banks, University of Missouri-St. Louis: The overdose crisis is disproportionately affecting Black people because they can't get their basic needs met.

  • John Yang:

    Devin Banks is a psychologist at the University Of Missouri-St. Louis.

  • Devin Banks:

    There is a stigma associated with being a person who uses drugs, and there's a stigma associated with being Black. So, the people who are being affected recognize that stigma, that discrimination, and that prevents them from feeling safe in treatment settings.

  • DEANTHONY HENDERSON, Community Health Worker:

    Have you been taking your medication?

  • Person:

    Yes, I have been taking it.

  • John Yang:

    Cunningham says getting patients into treatment is only half the battle. Often an even bigger challenge can be keeping them there.

  • DEANTHONY HENDERSON:

    You know when your next appointment is?

  • Person:

    It's the 3rd of next month.

  • DEANTHONY HENDERSON:

    OK.

  • John Yang:

    Community health worker DeAnthony Henderson crisscrosses the city, checking on patients and being an extra set of eyes and ears for Cunningham.

  • DEANTHONY HENDERSON:

    Sometimes, in the doctor's office, they don't feel comfortable with sharing a lot of things. So, when I come out, they usually share more with me, and I will be able to share it with the doctor.

  • Dr. Kanika Cunningham:

    We need to get you up to a good dose to help treat it.

  • John Yang:

    It's all part of Cunningham's approach to treating addition, one that Gerord Rowe credits for the progress he's made.

  • Gerord Rowe:

    She don't scold me. She gives me — she lets me make my own decision. Either you are going to stop or not, but I'm going to tell you, if you don't stop, this is the result. And if you do stop, this is the result.

  • John Yang:

    Can you put into words what they give you?

  • Gerord Rowe:

    Hope. Confidence. They give me the power to overcome this. They give me an outlook on a better future.

    I really appreciate you. I do.

  • Dr. Kanika Cunningham:

    I appreciate you too.

  • John Yang:

    A future that he hopes will not include drugs.

    For the "PBS NewsHour," I am John Yang in St. Louis.

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