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What are Opioids?
What are Opioids?
Opioids are a kind of drug that acts on a person's opioid receptors to produce morphine-like effects. They are medically used for pain relief, (including anesthesia) diarrhea suppression, cough suppression. Common types are oxycodone, hydrocodone, methadone, and fentanyl (a synthetic opioid pain reliever. Opioids were first used in the U.S around 1860 to treat wounded soldiers, as morphine was the sole pain reliever of the time, and many developed dependencies and addictions to the drug in the years following the war.
Looking at the OD rates broken down by opioid type, race, and year
Looking at the OD rates broken down by opioid type, race, and year
The line graph displays the total overdoses per year, subdivided into heroin, cocaine, prescription opioids, and synthetic opioids. As our data set doesn't include how such people acquired heroin, cocaine, or synthetic opioids, a majority of our narrative focuses on prescription opioids.
Over the 20 year span, the OD rate due to prescription opioids for white individuals increased from 1.3 in 1999 to 5.5 in 2019 (peaking at 7.0 in 2016). For black individuals, increases from 0.8 in 1999 to 3.5 in 2019, more than quadrupling over the span of 20 years. For hispanic individuals, there is less noticeable increase from 1.6 to 2.0 from 1999 to 2019. Even more drastic for American Indian or Alaskan Native individuals, there is a steep increase from 1.3 more than quadrupling to 5.4 from 1999 to 2019, peaking at 7.5 deaths per 100,000 people in 2012 (which is slightly higher than the 20 year white OD rate in the same category)
Transitioning into our next topic, let's start by analyzing the drug overdose breakdown by race, then compare it to the overdose rate from strictly opioids. Keep in mind, the data used for the visual is limited to what appears in the Corgi's dataset, unlikely reporting all drug related deaths in 2019.
In looking at the new pie chart, we see the slices have changed a bit. 'Black' and 'Hispanic' both dropped a few percent while 'Asian or Pacific Islander' dropped off the chart completely. However, 'American Indian or Alaskan' and 'White' both increased by a noticeable amount. Why is this?
About Prescription Opioids:
About Prescription Opioids:
Opioid prescribing patterns have shown disparities by race, with higher prescription rates among white Americans as compared to black and hispanic Americans. It states that black individuals were 29% less likely to receive opioid analgesics (painkiller drugs) than white individuals with similar reported pain conditions, while Hispanic individuals were 22% less likely. This translates to a widening gap in overdose rates due to prescription opioids, with white prescription overdoses being about double that of black prescription overdoses from 1999 to 2019 and about triple that of Hispanic Americans prescription overdoses over the same time period (from our Corgi’s dataset).
This is likely due to differential prescribing linked to healthcare providers’ “Inaccurate, negative stereotypes of racial/ethnic minorities (e.g., belief that racial/ethnic minorities have a greater likelihood of becoming dependent or selling medication, a lower accuracy of pain reporting, or a higher pain tolerance” as the National Library of Medicine puts it in an article (link in bibliography). While to some it may seem that such discriminatory medicine practices ‘spare’ such minority groups the same larger prescribed opioid overdose rate as white individuals, the mistreating or complete lack of treating for these ethnic groups to acquire potentially lifesaving drugs cause an unknowable number of deaths for said groups who are systematically less able to acquire such drugs despite similar circumstances (which may be beyond the scope of our narrative).
Besides differences in treatment and drug access limited by medical practitioners, there are many other systemic barriers for minority groups to acquire treatment. For example, it is important to consider social and economic factors that contribute to these disparities, such as limited access to healthcare, income inequalities, differences in health literacy (due to differences in education or access to technology), and geographic differences to name a few.
Approach with Caution!
Approach with Caution!
These statistics should be approached with caution and not taken at face value, as data collection and reporting methods can vary, meaning inaccuracies or underreporting may be an issue. For example, our Corgi’s dataset where we drew most of our data from 1999 to 2019 doesn’t account for potential underlying health conditions or other drugs that individuals were taking upon time of OD’ing, which may inflate the deaths attributed to strictly opioids.
While the scope of the data collection was ‘in the US’, the opioid overdoses over this time period were likely not uniformly distributed across the US, as certain cities or states must have contributed more to the opioid use and overdose rate than others, although this is beyond our dataset.
While the dataset doesn’t include individual cities like our city of interest, San Francisco, we can assume that national trends remain the same in SF, as overdose rates generally (both by total and by race) increased from 1999 to 2019. We can use our other sources to form a narrative using the numbers released in the (https://sf.gov/news/accidental-overdose-deaths-decline-san-francisco-second-consecutive-year-fentanylopioid) page to illuminate the prevalence of opioid overdoses in San Francisco.
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