Doctors, officials say help is available
Scott Cook, M.D., has been pretty much everywhere in town when it comes to addiction recovery centers.
And as an African American, he’s seen thousands of people, helped thousands of people overcome their drug and alcohol addictions.
Just one problem, he told the New Pittsburgh Courier: hardly any of the patients are Black.
“I’ve been with many outpatient places, a couple inpatient places,” Dr. Cook said. “In the last 10 years, I’ve seen less than 100 Black patients, but 10,000 White patients.”
For decades, the word “opioid” has been associated with “White,” as in, it’s a White person’s problem. But whether it’s heroin, fentanyl, or prescription meds like OxyContin, Vicodin, morphine, and methadone, doctors and therapists are trying to get the word out that it’s a Black person’s problem, too.
A study released Sept. 9 conducted in partnership with the National Institute on Drug Abuse at the National Institutes of Health analyzed overdose data and death certificates from four states (Kentucky, Ohio, Massachusetts, New York). It found that the rate of opioid deaths among African Americans increased by 38 percent from 2018-2019. Rates for other racial groups did not rise.
“You would think that crack cocaine is primarily the main drug African Americans use because it’s in movies,” Dr. Cook told the Courier exclusively. “We use opioids at the same rate as our White counterparts. That’s seen by society as a White problem. We need to get more African American patients in our doors because we have the problem, but we’re not getting the help.”
The study found that African Americans’ opioid overdose death rates rose from 31.3 to 43.2 per 100,000 adults.
Part of what’s fueling the rise in Black overdose deaths is the presence of fentanyl, the highly-powerful synthetic opioid that’s often laced in heroin. And it’s happening close to home. In 2020, 84 percent (584) of all overdose deaths in Allegheny County were related to fentanyl. Compare that with 2014, when fentanyl-related overdoses accounted for just 33 percent of the 424 total overdose deaths in the county. The findings prompted Mayor Bill Peduto to sign an executive order calling for the use of fentanyl test strips, which have been proven to prevent opioid overdoses and save lives as they allow users to identify the presence of fentanyl in unregulated drugs including injectable drugs, powders and pills. Mayor Peduto also ordered on Aug. 31 that the city’s Office of Community Health and Safety work with city employees and the public to educate them on the benefits of these lifesaving tools and to reduce the stigma associated with possessing them.
The mayor’s executive order highlighted that the rate of overdose mortality for Black residents of Allegheny County is “significantly higher” than White residents, “thereby deepening racial inequity,” and that Black men experienced a “200 percent increase” in overdose deaths from the third quarter of 2019 to the second quarter of 2020, compared to Q3 of 2018 to Q2 of 2019.
Across Pennsylvania, officials were alarmed to the fact that Black overdose deaths jumped 63 percent from 2018 to 2020; for Whites, it increased just five percent.
“Limited access to medical resources to treat opioid use disorder, combined with inadequate community infrastructure — including unreliable transportation, food and housing insecurity, and insufficient insurance coverage — have all contributed to the disproportionate rise in opioid overdose deaths among Black people in the U.S.,” said, William Soares, M.D., the director of harm reduction services and an assistant professor of emergency medicine at the University of Massachusetts Medical School Baystate in Springfield, in an article published in the online publication Everyday Health.
“If you are Black American and you have an opioid use disorder, you are much less likely to be prescribed medications for opioid use disorder,” added Dr. Nora Volkow, director of the National Institute on Drug Abuse, in a National Public Radio report.
Dr. Edwin Chapman has been a specialist in drug addiction in Washington, D.C., for decades. As an African American, he has been on the forefront of alerting the public that what once was a White, suburban problem that has the attention of Congress has become a Black, inner-city problem that no one wants to discuss.
“Sometimes we’ll have a cluster of folks outside selling drugs,” Dr. Chapman said in a WAMU (Washington, D.C.) radio report in 2018, referring to the Medical Home Development Group building he leads in D.C. “We’ve had overdoses right outside, right under the building, right next door to the building.”
“People who’ve even been lifelong heroin users are dying because they don’t understand how to titrate those doses,” added Dr. Melissa Clarke, who also works in the building. “That’s a huge part of the challenge. It’s always been impossible for addicts to know the potency of street drugs, but with fentanyl in the mix, they’re even more dangerous now. “We feel like we have a fire underneath us — people are dying every day.”
And in St. Louis, Mo., the Courier has learned that Black men are now four times more likely than White men to die of an overdose, after Black overdose deaths increased by 33 percent in 2020.
Dr. Cook, a 1984 Allderdice High School graduate who earned his M.D. from Drexel University in Philadelphia in 1998, is one of the leading African American doctors in the region specializing in addiction medicine and recovery. He’s now the medical director at Recovery Centers of America–Monroeville, which has 138 beds available for inpatient services and also offers outpatient services. He and the center’s CEO, Michael Ogden, told the Courier they are adamant about getting more African Americans into treatment. Ogden said African Americans “deserve the same level of care of anybody else in America.”
Ogden also said that oftentimes, regular private insurance covers the cost of regular treatment at Recovery Centers of America and elsewhere, debunking the myth that professional addiction treatment is too costly. For those without insurance, some outpatient services are covered by Medicaid, and there are community health centers across the region that offer low-cost addiction treatment.
Dr. Cook said that when it comes to addiction, there is a perception that Black people just have to “deal with it,” rather than getting professional help that their White counterparts are often afforded.
“We believe we should pray about everything, go to the pastor, which is wonderful because that is a component of recovery,” Dr. Cook, himself a minister before becoming a physician, told the Courier exclusively. “But we have to do more than that. We also sweep things under the rug. When I was a kid, instead of saying, Uncle Bob’s in jail, they’ll say he went down south. Well, Uncle Bob was down south for like five years. He wasn’t down south, he was in jail. We need to start talking about problems, not sweeping it under the rug. Certainly leaning on spirituality, but not making it the only thing.”
SCOTT COOK, M.D., is one of the leading addiction medicine doctors in the region. He urges African Americans who are suffering from drug and alcohol addiction to seek professional help. (Photo by Rob Taylor Jr.)