Episode 19: Increased Drug Use and Overdoses During COVID-19

Additional resources

COVID-19, Increased Drug Use and Overdoses

Q1: We’ve heard that during the pandemic, substance use has increased. In the news, we’re hearing that overdoses have gone up, too.

Yes. This month, the Kaiser Family Foundation reported that white individuals had higher rates of drug overdose deaths than Black individuals through 2013. But Black overdose deaths increased by 45 percent during 2020, nearly double the growth for white overdose deaths.

Oregon also had a spike in opioid overdose deaths in early 2020, with higher rates for Black people, American Indian/Alaska Natives, and males. Overdose-related hospitalizations in 2020 also showed higher hospitalization rates for Blacks.

Q2: Methamphetamine use is also going up, which might be surprising to some people.

Yes. For a long time, methamphetamine use has been higher among white people, and low among Black people. But a new study in the Journal of the American Medical Association reviewed national drug use survey data from 2015 through 2019 and saw a 10-fold increase in methamphetamine use among Black people.

This isn’t new to the pandemic. This increase has been going on for some time, but it does mean many overdose deaths are due to methamphetamine use.

Q3: Why are these disparities happening?

While Black and white people have similar rates of drug use for most substances, these groups do not have the same experiences or access to health care. The American Academy of Pediatrics has found that racial trauma is consistently associated with worse health, including substance use outcomes and preventing recovery. 

Black people are also more likely to experience severe consequences for substance use, such as arrest, conviction, sentencing, and incarceration. These experiences can lead to perceiving substance use disorder as a stigma, discouraging treatment. 

Black people are less likely to receive specialty treatment for substance use disorder, even though Black patients seek treatment at higher rates than white patients. These      higher rates are also observed in the initiation and engagement with specialty addiction treatment as compared to white patients.

Black people are also more likely to drop out of treatment if they believe their provider is being discriminatory or showing racial bias. They experience a system where racial trauma and socioeconomic circumstances may invite substance use. It also provides harsher punishment for drug use, and fewer effective resources to address the drug use.

Q4: What can we do to end this cycle?

The American Academy of Pediatrics study recommends that to address the role of racial trauma, substance use disorder treatment must address racism at multiple levels (systemic, organizational, and individual). This includes asking people about their experiences with racial discrimination or structural racism when evaluating them for treatment. 

The system itself needs to be diverse and reflect the people it serves—Black providers treating Black people, at every level, including primary care. OHA’s goal is to eliminate health inequities by 2030. Cultivating a diverse health care workforce is part of that goal.

Q5: That seems like a pretty long-term goal. What we can we as individuals, family members, health care providers, community members, do now? 

We can all listen to, learn about and affirm experiences of racial trauma. We can acknowledge the harm that such experiences cause. We can research, seek out and refer people to culturally specific health care providers and resources that understand and reflect our experiences and values. 

It’s also important to take care of our mental health and find healthy ways to cope with stress, and help our loved ones manage stress. We need to take the time for self-care, reaching out and making social connections—And if we can, help our friends and family make healthier choices for dealing with stress. For example:

We’ve included many resources related to coping with stress and building resilience in the “Additional Resources” this week.

Source: Monthly Opioid Overdose Report, 9/15/2021

Sex/Race/Ethnicity* | Deaths | Crude Rate | 95% CI
Male | 486 | 23.2 | 21.1-25.3
Female | 210 | 9.9 | 8.5-11.2
Non-Hispanic White | 568 | 17.5 | 16.1-18.9
Non-Hispanic Black | 37 | 34.4 | 24.2-47.4
Non-Hispanic Am. Indian/Native Alaskan | 27 | 46.3 | 30.5-67.3
Non-Hispanic Asian/Pacific Islander | 11 | 4.6 | 2.3-8.2
Hispanic | 63 | 11.1 | 8.5-14.2
* Race includes any mention (one or multirace). Hispanic includes all races. 
Rates are deaths per 100,000.
Source: State Unintentional Drug Overdose Reporting System (SUDORS) and CDC National Center for Health Statistics (NCHS)

Age Group (years) | Total deaths | Rate, deaths per 100,000
Males | Females | All
0-9 | 0 | 0.0 | 0.0 | 0.0
10-17 | 4 | 1.5 | 0.5 | 1.0
18-24 | 67 | 28.6 | 7.9 | 18.5
25-34 | 155 | 38.7 | 12.1 | 25.7
35-44 | 158 | 35.2 | 20.2 | 27.8
45-54 | 151 | 37.0 | 22.1 | 29.6
55-64 | 107 | 28.9 | 11.4 | 19.9
>=65 | 54 | 11.4 | 3.4 | 7.0
Source: SUDORS and NCHS | 

Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.