Overdose Racial Gap Larger Than Ever

What does it mean?

In the early years of the overdose epidemic, Ohio’s White residents died at much higher rates than Black residents. Today, the opposite is true. Since 2019, Black resident overdose death rates have exceeded those for White residents. In 2021, the overdose death rate for Black residents exceeded those for White residents by 16.1 percentage points — resulting in a racial gap of extraordinary size. The previous record was a racial gap of 10.3 percentage points in 2016 — but back then it was White Ohioans perishing from drug overdoses at a much faster rate than Black residents.

In 2021, the overdose death rate for White residents was unchanged at 42.5 deaths per 100,000 residents — and slightly lower than in 2017. For Black residents, the overdose death rate increased from 51.3 in 2020 to 58.6 in 2021 — and that was more than 20 percentage points higher than in 2017. (Death rates extracted from the Ohio Department of Health’s online mortality database.)

We love all people who use drugs and grieve for all 5,200 Ohioans who died from an overdose last year. The folly of the drug war has taken a terrible toll on our state.

What do the charts shown here mean? The racial gap shown in these charts has profound meaning for drug policy, health equity and the civic character of our state. The conventional belief that the overdose epidemic is a primarily White phenomenon caused by overprescribing of opioids has been outdated for many years. Today, the spread of fentanyl adulteration into powder and crack cocaine (as well as meth) has created a stimulant and adulterant-driven overdose catastrophe. The demographics, geography and mechanism of overdose death has changed in ways that our institutional systems have barely recognized and entirely failed to adapt to.