Black people who fatally overdose in Pennsylvania are half as likely to receive naloxone as white people

Black people who died of a drug overdose were 40-50% less likely than whites to have received the emergency opioid overdose reversal treatment, naloxone, according to a study of 11,000 overdose deaths in Pennsylvania, published in the scientific journal Addiction.

Lead author Dr Erin Takemoto, of the Pennsylvania Department of Health, says, “Our study shows that Black people were far less likely than white people to have any evidence they received a potentially lifesaving intervention when experiencing a drug overdose in Pennsylvania. The current drug overdose landscape is characterized by staggering racial inequalities; in Pennsylvania, the drug overdose rate in 2021 was twice as high for Black people as it was for white people. Given the magnitude of the US overdose epidemic, and the fact that naloxone can reverse opioid overdoses, we must develop ways to distribute naloxone and educate people in its use so that anyone who suffers an overdose has an equal chance of receiving this life-saving medication, irrespective of their racial or ethnic background.

“Effective strategies might include distributing naloxone through trusted sources, like community-based and faith-based organizations, and tailoring messaging and education for naloxone to reach specific communities.  Also, as people leaving incarceration are at increased risk of fatal overdose, it may be helpful to expand naloxone training and distribution among incarcerated people who are re-entering the community.”

Pennsylvania has been significantly affected by the US overdose epidemic. In 2020, it had the fourth highest number of overdose deaths in the country and a rate higher than the national average: 42.4 deaths per 100,000, compared with 28.3. Black people in Pennsylvania have been disproportionately affected: from 2019 to 2021, drug overdose death rates in Pennsylvania among the analytic sample increased by more than 50% among Black people, while the rate remained unchanged among white people.

Overdose data for this study were provided by the Bureau of Health Statistics and Registries, Pennsylvania Department of Health, Harrisburg, Pennsylvania and by Pennsylvania Coroners and Medical Examiners. Evidence of naloxone administration was defined using scene evidence and toxicology reports from coroner and medical examiner records, while race/ethnicity was based on the death certificate.  The study was supported by the Centers for Disease Control and Prevention (CDC), the national public health agency of the United States of America.

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For editors:

This paper is available online (https://onlinelibrary.wiley.com/doi/10.1111/add.16478), or you may request a copy from Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org.

To speak with co-author Dr. Ashley Bolton, please contact her at the Pennsylvania Department of Health by email (ra-dhpressoffice@pa.gov).

Full citation for article: Takemoto E, Bolton A, and Thomas Goetz C. Inequities in Naloxone Administration Among Fatal Overdose Decedents by Race and Ethnicity in Pennsylvania, 2019-2021. Addiction. 2024. DOI: 10.1111/add.16478

Primary funding: This publication was supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of the Overdose Data to Action (CDC-RFA-CE19-1904) cooperative agreement award totaling $31,723,058 with 100% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. Government.

Declaration of interests: None to declare.

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, gambling, editorials, and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.