Black women lost an estimated 748,300 years of life to drug overdoses between 2015 and 2021, researchers have found. Overdoses are now the fourth-leading cause of death in this group, behind cancer, heart disease, and COVID-19, according to the study, which was published online December 14 in JAMA Psychiatry.
“This study is an attempt to quantify the awful tragedy of premature death among Black women,” said Rebecca Arden Harris, MD, MSc, an assistant professor of family medicine and community health at the University of Pennsylvania, in Philadelphia, and the first author of the study. “By using years of life lost, we can really highlight the younger women who are enduring a growing proportion of these deaths. They had decades of life ahead of them.”
Using data from the US Centers for Disease Control and Prevention (CDC), Harris and her Penn colleague, David Mandell, ScD, identified 21,502 overdose deaths among Black women aged 15-64 years from 2015 to 2021. (The study originally misreported the annual death increase as 393%. Annual deaths increased by 197% from 2015-2021, not 393%. The years of life lost increased by 207%, not 407%.)
In 2021, the CDC reported 107,622 deaths from drug overdoses, 75% of which involved an opioid. The CDC’s latest provisional data tallied 107,735 predicted deaths from opioids.
The researchers calculated years of life lost by subtracting the age at death from the average life expectancy. Life expectancy for 25-year-old non-Hispanic Black women was 77 years in 2020, according to the National Center for Health Statistics. On the basis of that figure, a woman who died at 25 would have lost 52 years of expected life, Harris said.
The researchers found 4293 overdose deaths among women aged 25-34 years during the study period, with 202,809 years of life lost.
Emily Einstein, PhD, chief of the science policy branch at the National Institute on Drug Abuse, part of the National Institutes of Health, said that the findings reveal a new phase of the opioid crisis.
“In recent years, we’ve seen the overdose epidemic worsening across demographics and beginning to impact groups with historically low overdose death rates, such as adolescents and older adults,” Einstein said. “The COVID-19 pandemic has also exacerbated health disparities and had a disproportionate impact on communities of color, which is reflected in measures of harm associated with drug use.”
Recent studies have documented widening disparities in overdose deaths between Black women and White women, according to Einstein. One such study found that rates of suicide by drug overdose have been increasing among Black women, even as intentional overdoses have decreased in White women and in men.
“This raises the question of what factors or unique circumstances could be driving this alarming trend in the past 5 years,” Einstein said. “It’s unclear at this time, but these findings are extremely concerning.”
Einstein said opioid users, and minorities in particular, struggle to seek help for their drug problems.
“It is completely understandable that seeking help can be a challenge, especially as drug use is incredibly stigmatized — and criminalized — and there is an even higher level of stigma and risk of penalization for people from racial and sexual minorities,” Einstein said. “This is a major issue that we must continue to tackle headfirst using research, and in the meantime, we must continue to educate on and expand access to care for Black women with opioid use disorders.”
Harris said that an urgent call to action is needed to increase access to equitable treatment.
“I read the findings as an urgent call for action to increase access to opioid use disorder treatment, eliminate barriers to remaining in treatment, and make harm reduction resources more readily available to Black women,” Harris said. “The data also speak to the importance of including the most vulnerable groups, such as Black women in their 20s and 30s, in the design of policies and strategies to prevent unnecessary drug deaths and to ensure these initiatives have the resources needed to be successful.”
Mandell reported grants from the National Institutes of Health and personal fees from the Patient-Centered Outcomes Research Institute outside the submitted work. No other disclosures were reported.
JAMA Psychiatry. Published online December 14, 2022. Abstract
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