The overwhelming majority of overdose victims were older black men, according to the medical examiner. Since 2017, more than 8 in 10 deaths from opioid use have involved Black residents, according to city data.
This increase is consistent with trends seen in other large metropolitan areas across the country, where African Americans are succumbing to powerful synthetic opioids in disproportionate numbers as deaths of white users in rural areas stabilize, experts say.
Despite an infusion of tens of millions of federal dollars each year, observers say the district’s strategy of paying nonprofits and community groups to engage users and distribute fentanyl test strips and naloxone , an antidote to overdoses, does not make a difference in the crisis.
“The numbers tell the truth, and our numbers continue to rise,” said program manager Beverlyn Settles-Reaves. which organizes treatment for patients with substance use disorders at Howard University. “This situation is getting out of control.”
Experts say overdose rates continue to rise nationally due to barriers to accessing drug treatments, such as buprenorphine; social barriers such as housing instability; inadequate infrastructure to distribute resources; and the stigma faced by users.
Compared to states, the District had the fourth highest opioid overdose death rate behind West Virginia, Delaware and Maine, according to preliminary 2022 data from the Centers for Disease Control and Prevention, while Maryland ranked 12th and Virginia 29th. Only West Virginia surpassed the District in the rate of fatal overdoses from any drug, the data shows.
But experts warn that comparing DC with the states can be misleading, because the capital The city is entirely urban, lacking a mix of urban, suburban, and rural areas.
“Unfortunately, seeing an increase does not make this an outlier compared to other urban areas in this part of the country,” said Sheila P. Vakharia, deputy director of research and academic engagement at the Drug Policy Alliance and author of “The Harm.” Reduction gap.
Locally, opioid overdoses have claimed more lives than homicides, but other cities in the region are grappling with even higher overdose rates. The district ranks 10th among 66 large metropolitan counties with the highest drug overdose death rates, according to an analysis by the nonprofit research organization KFF of 2022 preliminary CDC data, l The most recent year for which national data is available.
Baltimore had the highest fatal overdose rate, followed by Richmond in fourth, ahead of Philadelphia, Nashville and Louisville. (The analysis omitted Alexandria due to insufficient data.)
Data is not available at the county level for opioid-related deaths specifically, but opioids are a cause of drug-related deaths, accounting for three-quarters of such deaths in the District and nationally , said Heather Saunders, health policy expert at KFF.
The District has struggled with opioid overdoses for years, but with the arrival of tens of millions of federal dollars, the death rate has continued to rise. Advocates and victims’ loved ones are frustrated by the pace of change and question why leaders haven’t studied current programs for results.
Barbara J. Bazron, director of the Washington Department of Behavioral Health, the lead agency in the fight against opioids, said the city is doubling down on strategies that have been in place for several years, noting that the District is a leader in free distribution of naloxone. .
The district and community groups have distributed 300,000 doses of naloxone, also known by the brand name Narcan, and plan to distribute 50,000 more this year, in part to those who text the 888-811 number to ask for free cartridges, Bazron said. But she acknowledges that naloxone has its limits.
“Naloxone is not good if you use it alone, and we know that more and more people are overdosing at home or at the homes of family members or friends,” Bazron said.
The city’s first sobering-up and stabilization center opened last year, but it primarily caters to alcohol users. Of the 1,340 patients transported by the D.C. Fire and Emergency Department to the center since it opened five months ago, about half had primarily consumed alcohol; 13 percent had used drugs other than opioids; and about 10 percent suffered from an opioid overdose or withdrawal, a Department of Behavioral Health spokeswoman said, citing fire department data.
The district formed a committee, the Opioid Reduction Advisory Commission, to recommend how government agencies should channel an estimated $80 million from multistate opioid-related settlements toward solutions to the crisis. Of the $23 million the attorney general’s office said the city has received so far, the Department of Behavioral Health has set aside grants of up to $500,000 to expand existing programs, such as distribution of naloxone, and piloting a new program through the fire department.
The agency received a grant to launch buprenorphine, a medication used for opioid use disorder, in the field, joining a handful of cities that have similar programs, in hopes of keeping users on treatment longer.
Chad Jackson, chairman of the advisory commission, said the city’s latest plan, known as Live.Long.DC. 3.0, continues to give money to community groups without an overall strategy for how to use health, behavioral health, and housing resources to make change.
“We have a siled approach in Washington, D.C., where individual groups get money and do their jobs very well,” he said. “The problem is there’s no way to move from one silo to another, so everything goes out of the system.”
Howard’s Settles-Reaves, who also serves on the commission, said it’s difficult to hold a fragmented system accountable.
“We cannot let this continue,” she said. “This is a public crisis. People are dying in the streets. People are seeing their family and friends die because of this.
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