Fentanyl is killing black people in Connecticut at the same rate as whites for the first time since state officials began tracking the epidemic around 2012, a CT Mirror analysis has found.
There is no clear consensus among experts in Connecticut as to what is driving up the death rate among African Americans. But some researchers and medical professionals point to the proliferation of fentanyl in inner cities and the state’s declining prison population as possible reasons for the increase.
Initially, fentanyl-related overdoses impacted whites at higher rates than blacks and Hispanics, but the most recent data from the state’s Office of the Chief Medical Examiner shows the gap between blacks and whites has vanished.
In 2018, the fentanyl-related death rate for both blacks and whites was around 23 per 100,000 residents in Connecticut, according to the Mirror’s analysis of records published by the state medical examiner. The rate among Hispanics in Connecticut was lower, around 18 per 100,000 — but still high compared with an overall rate for all groups of 6 per 100,000, according to a new report by the CDC.
The CDC report found, among other trends, that fentanyl-related death rates nationwide have risen fastest among black and Hispanic populations from 2011 through 2017.
The opioid crisis, once associated with predominantly white small towns and suburbs, has been moving to cities and claiming the lives of African Americans at unprecedented rates. A 2018 Washington Post investigation found that, unlike the white overdose victims who have been the focus of the national debate, the epidemic’s new casualties are seldom young and were not first hooked by doctors prescribing pain pills. Rather, they are veteran, urban drug users caught off guard by the sudden lethality of drugs like heroin that they once used with relative safety.
“Illicit synthetics like fentanyl have surpassed heroin as the leading killer,” said Dr. J. Craig Allen, an addiction expert and medical director of the Rushford Center in Connecticut. “Because of their inexpensiveness, their easy access and their potency, they have been adulterating other drugs and sometimes masquerading as other drugs.”
That has made it difficult for many users to know what they’re buying.
“You can’t tell what’s in it. People aren’t going out there and buying fentanyl. They’re buying whatever their local dealer happens to have available, some of which may be heroin, some of which may be fentanyl, some of which may be mixed,” .
“The trafficking of these drugs is more common in urban areas where there are concentrations of African Americans and other minorities relative to the whiter parts of the state,” he added, “so it’s not surprising that both in Connecticut and nationally, after a relatively long period of stable overdose deaths among African Americans, the rates are going up.”
In addition, the state’s rapidly declining prison population — disproportionately made up of minorities — has caused many to re-enter society with untreated opioid use disorder, experts said. The number of people behind bars dwindled to 13,228 in January, down from a peak of 19,413 in July 2008.
“We have found here in Connecticut and elsewhere in the world this is a problem — that the first three weeks or so after people are released from prison, their chances of dying are extremely high if they reinitiate opioid use,” Heimer said. “They come out … they go back to using opioids and use far more than is needed considering their state of lower tolerance. And because they are ashamed of relapsing, they tend to use those drugs alone, so there’s no one there to call 911 or administer naloxone and save them.”
The state correction department has cited some of its programs, like methadone initiatives for people in different stages of recovery, as progress, but officials in the academic and medical fields have pushed for more to be done.
The legislature is considering several bills that would require counseling or medication-assisted treatment for inmates with opioid use disorder.
In written testimony to lawmakers, Asadullah Awan, a doctor at Yale New Haven Hospital, said of the more than 1,000 residents who died of opioid overdoses in 2017, more than half of them were formerly incarcerated people.
Ex-offenders are eight to 11 times more likely to overdose during the first few weeks post-release, Awan wrote, yet most state prisoners have no access to medication-assisted treatment and there is little help in connecting those people with resources upon their departure.
This story originally appeared on the website of The Connecticut Mirror, www.ctmirror.org.