As Cities Struggle, Don’t Forget the Opioid Crisis

A medic escorts a 39-year-old woman to an ambulance after she was revived from an opioid overdose in Salem, Mass., August 2017. (Brian Snyder/Reuters)

We may be just beginning to see how lockdowns, riots, and protests have worsened the mental-health and opioid crises.

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We may be just beginning to see how lockdowns, riots, and protests have worsened the mental-health and opioid crises.

P rogressives have achieved near omnipotence in American cities. In Chicago and Los Angeles and in smaller metropolitan areas such as New Haven, single-party politics dominates. Lawmakers doggedly seek progressive reforms for nearly every city institution. Police departments might be next. “Defund” the police and reinvest. Better yet, “abolish” the police. Hollow posturing can calcify into rigidity, and soon enough — maybe not today, tomorrow, but within a decade — radical positions become household platforms.

The many negative consequences of the progressive policy du jour would receive little or no media attention — unless, of course, structural racism could be blamed. Dire trends churn under the frothing news cycle, resurfacing occasionally when politically expedient. But the issue fraught with heart-wrenching drama blazes like a hot flare. Events with clear-cut victims and villains such as George Floyd and his killer Derek Chauvin ignite the progressive powder keg. A non-politicized issue — widescale and lethal, reported in data — receives far less media attention even as it plagues blacks in urban communities. Just as COVID-19 knows not the race of its victim, the opioid epidemic silently kills urban blacks at a high rate, another challenge for an already-challenged community.

According to the CDC, the widespread sale of illicitly manufactured fentanyl increased the number of opioid overdoses among blacks, previously low, as cities experienced a significant spike in opioid overdose deaths overall. From 2015 to 2017, the annual rate of opioid-involved overdose deaths in large central metropolitan areas increased by 103 percent — 1,518 to 2,503 to 3,161. Among black people, the annual rate of overdose deaths involving synthetic opioids increased by 361 percent: In 2015, 464 blacks died from overdoses involving synthetics, and in 2017, the number soared to 2,186. Staggering and tragic trends, but hardly a peep from the national media or Democrats.

In 2018, the CDC published a study highlighting evidence-based strategies that effectively combat the opioid crisis. Despite the study’s finding that the high urban death rates for blacks are driven by overdoses related to heroin and fentanyl, only one strategy addressed synthetic opioids and the illicit-fentanyl market. The CDC maintains that fentanyl ought to be included in the standard panel of substances screened in drug tests administered at hospitals, clinics, and treatment centers. This would allow early detection of contamination in the local drug supply — a step in the right direction, to be sure. However, since fentanyl is so deadly and proliferates in black urban communities, we need more strategies focused solely on its sale and use. Law enforcement could also help contain a drug market that has claimed far too many lives.

The calls for police defunding ostensibly represent a concerted effort to mitigate the loss of innocent lives and to prevent future injustices perpetrated by cops. But as protesters, media outlets, and city lawmakers feel their progressive oats, they fail to consider unintended consequences. What would happen if police presence hastily decreased in neighborhoods stricken by the sale of fentanyl and heroin? How might emboldened drug dealers expand their networks within those neighborhoods and into new ones? Would increased synthetic-opioid sales increase overdose deaths? One cannot say for certain. But common sense would suggest that an uptick awaits, if it hasn’t already begun.

There are other factors at play as well. What about the unintended consequences stemming from lockdowns (remember them)? How might they exacerbate the opioid epidemic in black communities? A recent study projecting deaths of despair in the COVID-19 era, using nine different scenarios based on research and data from past economic recessions, found between 27,644 and 154,037 additional such deaths. The mid-range expectation: approximately 68,000.

The 2007–09 “Great Recession” contributed to sharp increases in suicides and drug overdoses as the frequency and severity of household financial problems, job insecurity, marital strife, and child abuse all rose. Our current recession may match or surpass that trend, for the COVID-19 crisis is without parallel. Those worst-off before the drastic lockdowns became something of unwitting subjects in a social experiment. Isolation, the natural fear of those confronted with a potentially life-threatening disease, and even boredom acutely effect people with mental illness and drug and alcohol addictions. Then there’s the economic and emotional stress of riots, yet another issue for the urban black community as its overdose rates climb.

We may be just beginning to see how lockdowns, riots, and protests have worsened the mental-health and opioid crises. It might tank the Twenties for an entire generation. It will be nothing like the vivacious Jazz Age, but will be characterized, rather, by quiet melancholy — worse yet, despair. The other day, my sister, a nurse, cared for a black 19-year-old who had attempted suicide. The bullet shattered his jaw, deformed his face, and missed his brain. In anguish, he lies on his hospital bed, silent and alone. There is no fanfare for kids like him. There is not a sound — no anger, no movement. Just anguish and silence.

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