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Black opioid overdose deaths in St. Louis are up 500% in 6 years

Lethal doses of heroin, left, and fentanyl, right. Fentanyl, a synthetic opioid painkiller, is up to 50 times more potent than heroin.
New Hampshire State Police Forensic Lab
Lethal dosses of heroin, left, and fentanyl. While heroin deaths have decreased in recent years, fentanyl and opioid-related overdoses are on the rise.

Opioid overdoses have been on a devastating climb for Black drug users in St. Louis and St. Louis County, with the latest data showing a 560% increase in deaths in the region since 2015.

Data released Wednesday by the Addiction Science Team of the University of Missouri-St. Louis shows 405 Black people died of opioid-related overdoses in the region in 2021, a notable increase over the previous year’s already high death toll of 379. During that period, white overdose deaths decreased.

Researchers and treatment specialists say that the region hasn’t done enough to change its approach to reaching Black drug users before their lives are cut short.

“The increases in death among Black St. Louisans continue to rise disproportionate to those of non-Black St. Louisans,” said Devin Banks, an assistant professor of clinical psychology at UMSL. “I think it is beyond time for us to really focus and be intentional about our efforts, because our people are dying. Our Black people are dying.”

Dr. Kanika Cunningham, right, and Devin Banks, left, of the CENTER Initiative.
Danny Wicentowski
St. Louis Public Radio
Dr. Kanika Cunningham, right, and Devin Banks are working with the CENTER Initiative to stop the spike in overdose deaths among Black drug users.

On Wednesday’s St. Louis on the Air, Banks discussed the new data on overdose deaths in the region. The numbers give researchers a more complete picture of how drug users are faring after 2020 saw alarming increases in fatal overdoses, particularly among Black people.

Banks noted that while the numbers show a slight decrease in overall overdose deaths in 2021, that’s only the case when looking at total cases. Isolated by race, Black overdose deaths have continued a spike that, by now, is more than six years in the making.

White drug users in St. Louis City and County have seen a roughly 200% increase in overdose deaths since 2015, less than half the increase seen among Black drug users.

Why the disparity? Banks points to the lack of resources in predominantly Black areas of the region, especially for treatment involving medications like Suboxone or Methadone. She argues that the influx of millions of dollars in pandemic aid should now be used to correct the oversights of the past that have led to the current overdose crisis.

“We can't blame it on a pandemic,” Banks said. “We have to blame it on us, institutions, organizations.”

Behind St. Louis' 500% rise in Black opioid overdose deaths

In 2021, multiple organizations came together to found the CENTER Initiative, a collaboration of nonprofits, advocates, treatment professionals, physicians and community groups. Banks leads the initiative’s research arm. Also part of the leadership team is Dr. Kanika Cunningham, a family medicine doctor at Family Care Health Centers of Carondelet. She is trying to better understand the lives of St. Louis-area Black drug users — and how to help them.

“That means not just people who use drugs, but also their families and communities,” Cunningham told St. Louis on the Air. 

Central to Cunningham’s work is the strategy of “harm reduction,” a broad concept that can include programs like needle exchanges and distributing NARCAN, or just giving people safe, supervised places to use drugs. The point, Cunningham noted, isn’t to encourage drug use, but to keep people alive long enough to receive treatment in the future.

“Harm reduction, just very simply, is meeting somebody where they are,” Cunningham said. “This idea that somebody's going to get started on treatment and never use again, that's unrealistic.”

Instead, Cunningham says it’s important to see drug use as what it is: a chronic condition. If people are going to continue to use, she suggests that a harm reduction strategy could involve using in smaller amounts, or using among other people so that someone can get help in case of an overdose. She also suggests that drug users should implement testing strips to ensure their drugs have not been cut with fentanyl, as the substance can be fatal even in tiny amounts.

“What we've done in the past has not worked, because we're continuing to see that people are dying,” Cunningham said. “So now we need to do something different.”

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Emily Woodbury, Kayla Drake, Danny Wicentowskiand Alex Heuer. Jane Mather-Glass is our production assistant. The audio engineer is Aaron Doerr.

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Danny Wicentowski is a producer for "St. Louis on the Air."