The 4th Wave of the Opioid Epidemic and Its Impact on Black Texans

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The opioid epidemic and resulting overdoses have primarily afflicted White communities more than any other ethnic group. However, numbers of opioid related overdoses and ED visits have increased in Black communities in recent years given the rise of fentanyl-laced drugs, cocaine use and other stimulants nationwide. Data from the CDC indicated that in 2018-2019, rates of emergency department-treated suspected non fatal drug overdoses co-involving opioids and amphetamines increased (Liu, et al., 2020) with a near tripling of cocaine-involved overdoses (Hedegaard et al., 2020). In order to better understand the opioid epidemic and how it affects Black communities in Texas, research was done evaluating reported data from the Texas Department of State Health Services. The data used highlights different categories of important state and county level statistics under the umbrella of Drugs and Alcohol from the Texas Department of State Health Services. 


The publicly available data from 2011 through 2019 was explored to highlight different demographic trends related to opioid use in Texas, on both state and county level. Primarily, the research conducted involved evaluating Accidental Drug Overdose Deaths in Texas (by Race/Ethnicity), specifically focusing on All Opioids in comparison to Cocaine separately, Opioid-Related ED visits Over Time by Race, Ethnicity and Age. The demographics used were broken down by drug type and by populations per 100,000. Most of the data used primarily highlighted demographic trends looking at cocaine and differences/similarities compared to opioids altogether. All of this data was recorded and evaluated to assist with this research. 

Results: Findings showed that from 2011-2019, based on demographic trends in Texas, accidental drug overdose due to cocaine use has risen in Blacks. In 2019, Harris, Dallas, Bexar, Travis and Tarrant counties were among the highest in accidental drug overdose by cocaine. Data from 2019 shows that Blacks died at a greater percentage than Whites from cocaine use per 100,000 populations in both Harris and Dallas County. In Harris County, 41.7% of cocaine related deaths were in Blacks and in Dallas County, 61% of cocaine related deaths were in Blacks. Statistically, Whites had lower percentages of death related to cocaine in those counties. However, Whites held a higher percentage of deaths overall when looking at all opioids. The percentage of accidental opioid related deaths in Blacks did increase slightly when looking at all opioids in Texas. 


Opioid related deaths and ED visits are rising in Black populations throughout Texas. Alarmingly, cocaine is playing a major role in this health disparity in Black communities. Current education, treatment and prevention efforts are tailored to White populations and are not as readily accessible to Black communities or not applicable. There is a need for culturally appropriate education and community based prevention to combat the opioid epidemic in Black communities. With the impact of the fourth wave of the US opioid epidemic, further competency and education needs to be investigated to assist with preventing and treating the growing number of polysubstance use in rural and urban areas.

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Student Worker - University of Houston
University of Houston

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