Racism is a Public Health Crisis

What You Need To Know

• The American Public Health Association and the CDC have named racism as a threat to public health.

• “White supremacy and racial bias are ingrained in how drugs and drug use are viewed in the United States; these biases persist within public health, public policy, and education.”*

• Racism creates barriers to health and well-being by creating differences in power and access to resources for minoritized or marginalized racial or ethnic groups.

• Social determinants of health such as poverty, criminalization, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities. -CDC

• A recent nationwide study found that Black people were significantly less likely to be prescribed buprenorphine than White people, and another found that, while access to buprenorphine has increased, it has increased more in areas with higher concentrations of White people. 

• Black people disproportionately access methadone, a treatment that, while effective, is extremely constrained by both federal and state laws. Studies also demonstrate other racist attributes of MOUD treatment, with Black people more likely to have treatment discontinued if they use other drugs while in OUD treatment.

• “There’s never been a time, not a single year, where the [U.S.] population of African descent hasn’t been sicker or died younger than whites,” Bassett said.*

What We Need to Do To Save Lives (From DPAs Fact Sheet: The Impact of the Overdose Crisis on Black Communities in the United States)

• Increase culturally sensitive services. Black people who use drugs need services that are culturally sensitive to their needs and acknowledge their histories of mistreatment. We also need more Black harm reduction, treatment, and medical providers in communities. 

• Improve access to Medications for Opioid Use Disorder (MOUD). In other countries, people can access methadone in pharmacies. We must explore options beyond the OTP model to make methadone easier to access for people with OUD. We must provide access to methadone and buprenorphine in jails and prisons. We must also make it easier to start patients on MOUD while in the emergency room and in other medical settings. 

• Expand and fund more harm reduction and overdose prevention services. Harm reduction services must be available in all communities. This can include brick and mortar programs, but also mail-order and mobile outreach programs. Drug checking, including fentanyl test strips and more advanced methods, are an important tool to save lives. Overdose prevention centers are needed in communities across the nation. They provide lifesaving services and help connect people to other services too.

• Decriminalize drug possession and harm reduction tools. Drug use is a health issue and should not be treated as a criminal issue. If drugs were no longer illegal, people who use drugs would not face arrest and incarceration. People who use drugs would not get a criminal record that would create future obstacles in life. It is important to decriminalize syringes, smoking equipment, and drug checking tools in all states. When supplies are decriminalized, harm reduction programs can distribute them in the community. 

Where to Go for More Information

• Fact Sheet: The Impact of the Overdose Crisis on Black Communities in the United States

• Native Harm Reduction Toolkit

• Black Harm Reduction Network

• Structural Racism and the Opioid Overdose Epidemic: The Need for Antiracist Public Health Practice

• Collaborative for Anti-Racism and Equity (CARE)

• Healing Through Policy: Creating Pathways to Racial Justice

• Uprooting the Drug War

• Whitewashing of the Opioid Crisis from the Chicago Reporter

• Opioids and Race from Changing the Narrative

• Building Black Feminist Visions to End the Drug War

• Action pack to help your community declare racism a public health crisis

Programs To Know

• Black Harm Reduction Network

• Indigenous Harm Reduction

• National Native Harm Reduction Summit

• Movement For Family Power

• VOCAL

• CEPA

• Red Canary Song:

• BIPOC Work Plan - Next Distro 

Leaders to Know

• Black Harm Reduction and Drug Policy Leaders Centering Public Health’s Role in Drug Use

• 5 Black Harm Reductionists You Should Know

Research

• Structural racism, economic opportunity and racial health disparities: Evidence from U.S. counties

• Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

• CDC Declares Racism a Public Health Threat

• Health Disparities and Access to Health

• Racial disparities in the quality of care for enrollees in medicare managed care

• Race, ethnicity, and emergency department post-overdose care

• Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients

• Buprenorphine Treatment Divide by Race/Ethnicity and Payment

• Growing racial/ethnic disparities in buprenorphine distribution in the United States, 2007-2017

• Permanent Methadone Treatment Reform Needed to Combat the Opioid Crisis and Structural Racism

• Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients