Holy Sh*t, These Drug Overdose Rates For Older Black Men

Drugs are still winning the war on drugs.

Baltimore, ain’t it hard to live? Photo by Randy Laybourne on Unsplash

Well, this is unacceptable. A study that was a partnership between The New York Times, The Baltimore Banner, Big Local News and nine newsrooms in 10 cities across the country found that Black men ages 54 to 73 have been dying from overdoses at more than four times the rate of men of other races. And Baltimore is in the lead of the overdose race to hell by a wide margin, with 170 deaths per 100,000 people between 2019-2022, almost double that of the second place loser, Knoxville, Tennessee. Jaw-dropping numbers that add up to nearly three overdoses every single day in Baltimore! We all knew it was bad, but damn, what the hell?

Meanwhile, for everybody else, overdose deaths have been going down. The rate declined by about 10 percent nationally between April 2023 and April 2024.

What is going on? Statistics can’t answer “why” questions, correlation not equalling causation, and all that. But a few things have been driving down ODs: There’s over-the-counter availability of the overdose drug naloxone, and looser restrictions on the opioid/opiate treatments of buprenorphine and methadone. These things work!

And, there seems to simply be less fentanyl going around. Thanks, Joe Biden! He and Chinese President Xi Jinping met in November of 2023, and China agreed to do some internal enforcement to crack down on the flow of fentanyl ingredients. Fentanyl is involved in 69 percent of overdose deaths, because it’s as much as 50 times more potent than heroin, and people don’t know they’re getting it. Some type of long-term opiate user — like, say, William S. Burroughs or Robert F. Kennedy Jr. were previously — could have been using heroin for 14 years and developed a huge tolerance, and then some fentanyl that they don’t have the same level of tolerance for gets slipped into their naked lunch, and overdose happens.

Dealers have also been adding the horse tranquilizer xylazine to their zombie cocktails, which is not an opioid, so naloxone doesn’t reverse its effects. In February the Biden administration made xylazine test strips more available through Health and Human Services grants. Thanks again, Joe! Did he just not toot his horn about this stuff, or was the screaming about Hunter Biden so loud that no one heard it?

But why are these helpful things not helping older Black men? And why men? About 75 percent of overdoses are men, and men use illicit drugs at a much higher rate than women do, for reasons unclear.

Why Black men? Might it have something to do with the big difference between how people with substance use disorders from different demographic groups are treated? Black people being the intended target of the “war on drugs” and “zero tolerance” is no secret. While Black people and white people possess and sell drugs at similar rates, Black people from 1980 to 2007 were 2.8 to 11.3 times more likely to be charged. This was not a coincidence! In 1994, John Ehrlichman, counsel and Assistant to the President for Domestic Affairs under Richard Nixon, blithely told Dan Baum of Harper’s magazine:

You want to know what this [war on drugs] was really all about? The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying?

We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news.

Did we know we were lying about the drugs? Of course we did.

Black men in their 50s and older have been living on the frontlines of the Ehrlichman drug war for most of their lives.

Contrast that to the experience of a certain HHS nominee, Robert F. Kennedy Jr., now age 70. It’s rather funny (and not ha ha funny) how he can openly talk about being addicted to heroin for 14 years, and that’s never seemed to disqualify him for anything, or even slow his career down. He even treats it like a point of pride.

“I’ll tell you something about heroin,” he rambled on the Shawn Ryan Show in July. “I did very, very poorly in school until I started doing narcotics, then I went to the top of my class because my mind was so restless and turbulent and I could not sit still.” Nothing like nodding out to help you study! (Kids, do not take his advice.)

In 1970, at age 16, RFK Jr. was arrested for marijuana possession in Massachusetts, and the case was continued “without finding,” effectively giving him a year of probation. His record was sealed because he was a juvenile, and he was returned to the care of Ethel. Strokes of luck when it came to time, location, and parentage. By the 90’s, 46 states plus DC allowed juveniles to be tried in adult court for drug offenses, and drug offense cases were more likely to be waived to adult courts than any other offense category.

Harvard admissions would have perhaps had questions about Kennedy’s application if his transcript had a gap in it, on account of him being in prison. But for him, arrest was nothing more than a minor inconvenience. Having a felony drug possession charge in one’s background check usually locks somebody out of scholarships and all but the most menial jobs, but no problem when your juvenile record is sealed, and you don’t need scholarships to go to private school, college or law school.

In 1983 RFK Jr. was arrested again, in South Dakota, with heroin in his luggage, and was charged with felony drug possession. And he dodged prison again. He was sentenced to probation and community service, spent five months in a treatment center in New Jersey, went on to graduate from law school and in 1985 was admitted to the bar in New York.

But for people who aren’t situated like RFK Jr., having a record with even one arrest can be life-ruining, and creates a snowball effect of lost opportunities from being in prison, fines and court costs that can be bankrupting when you’re poor, getting disqualified for loans, and in many states being disqualified from social programs like food and housing assistance, too. Also, five months in a treatment facility, holy privilege, Batman! Wonder how much that cost the family? Insurance certainly did not cover it.

Back to Baltimore, why is the overdose rate so superlatively bad? It certainly has the reputation as the heroin capital of the world (or hair-ron, as it is locally known). David Simon made an excellent entire HBO series, “The Wire,” all about it. And the overdose-fighting strategy, obviously not going great! The Health Commissioner, Dr. Ihuoma Emenuga, was fired in July under unclear circumstances, and a permanent replacement still hasn’t been found yet. The city was going to hold some hearings about the overdoses, then the mayor abruptly canceled them. As the NYT and Banner found, “much of Baltimore’s once-aggressive overdose prevention strategy had stalled, and that city leaders had been preoccupied with other issues.” The city is due $402.5 million for various opioid settlements, and if it ever shows up in the bank, how that money will be spent is unclear.

Love my city, but it sure is a hot mess sometimes.

Sure would be nice if that opioid settlement money went to treating all the older Black men with substance use disorders like a bunch of RFK Juniors. Five months of luxury New Jersey live-in treatment! Days spent strolling the Nantucket shore, looking for interesting whale parts! Falconry! Medical treatment for chronic pain that actually helps! Sexts from thirsty journalists that keep the blood a-stir! A sense of being very important to the world!

But life ain’t fair, kid. Maybe someday we’ll have a better cure for pain.

[New York Times archive link, “Drug Overdose Deaths Are Dropping” / Baltimore Banner archive link / New York Times archive link “How Drug Overdose Deaths Have Plagued One Generation of Black Men for Decades” / New York Times archive link, “Kennedy, Shriver Boys on Probation” / South Dakota Searchlight / Harper’s Magazine / New Yorker archive link / New York Times archive link, “As Opioid Deaths Plague Baltimore, the City’s Strategy Is Silence” ]

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