Purple flags fluttering in the late summer breeze told a heartbreaking story on the west side of Charlotte, North Carolina. Each flag represented a life lost to opioid overdose in 2023. Where such gatherings once drew mostly white crowds, this year’s International Overdose Awareness Day was different. More Black patients and their families attended, drawn by a crisis that has increasingly placed their communities at its center. The Black patients opioid crisis highlights how it impacts Black communities and the significant barriers they face in accessing care, both in the US and the UK.

Opioid Crisis Has Changed Course

Only a few years ago, people widely believed the opioid epidemic mainly affected white communities. Terms like “Hillbilly heroin” were common, simplifying a complex epidemic and ignoring its spread. Yet the story has moved on. Data now shows opioid overdose deaths are rising quickly among Black patients in many parts of the world, especially since the introduction of fentanyl, a synthetic opioid up to 100 times stronger than morphine.

For example, in North Carolina, Black residents died from opioid overdose at a rate of 38.5 per 100,000 in 2021. Just two years earlier, that rate was less than half. This trend mirrors broader shifts seen not only in American states but also in parts of the UK, where Black patients increasingly find themselves affected by the opioid crisis.

Black Patients Face Greater Barriers to Care

Systemic Gaps Preventing Access

The rising fatalities among Black patients are not just a result of changing drug markets. Systemic issues mean support and treatment are harder to come by for these patients. Many resources are concentrated in predominantly white areas, and grants or government funding often don’t reach Black communities in proportion to their needs.

One stark example comes from North Carolina, where 88% of individuals served by a major opioid relief grant were white, despite Black people making up 24% of the population. Black patients more widely are less likely to be referred to, or receive, treatment after a non-fatal overdose. Nationally, Black people are twice as unlikely as white people to either be referred to or complete opioid addiction treatment programmes.

The Real Impact on Families and Communities

Personal stories bring these numbers to life. Terica Carter founded Hajee House Harm Reduction, a non-profit in Charlotte, after her teenage son died from a fentanyl-laced, unprescribed painkiller. Carter’s organisation provides Black patients in her neighbourhood with naloxone (the lifesaving overdose reversal drug), clean syringes, test strips, and direct links to recovery services.

She highlights a central failing in the fight against the opioid crisis for Black patients: “Nobody was acknowledging it, and I felt so alone. That pushed me into not wanting anybody else to go through what I went through.” Hajee House creates events that feel more like neighbourhood block parties, making them inviting for the Black community while quietly offering education, support, and harm reduction tools.

Medication Barriers for Black Patients in the Opioid Crisis

Why Are Some Treatments Harder to Get?

Gold-standard treatments for opioid use disorder include medication such as buprenorphine, methadone, and naltrexone. Each has its own pros and cons, but white patients are far more likely than Black patients to receive buprenorphine. This treatment can be obtained from an ordinary doctor’s office and picked up from a pharmacy, making it far more accessible.

By contrast, methadone—which is prescribed to most Black patients—involves strict conditions. Patients may need daily visits to specialised clinics, which often have long waitlists and are hard to reach without a car. Even if they overcome these hurdles, methadone programmes carry stigma, inconvenience, and higher dropout rates.

Research from the University of Michigan found white patients received buprenorphine three to four times more often than Black patients. The reasons? Wealth disparities, lack of local providers, and insurance restrictions all matter. Some insurance companies also put extra limits on urban patients, knowing they are more likely to be Black.

A Vicious Cycle of Delays and Mistrust

Even when Black patients want help, delays are common. Statistics show they are five years behind white patients in receiving treatment, on average. Five years risks a life lost. These delays are partly caused by a lack of culturally sensitive care, healthcare provider bias, and inadequate outreach to Black communities.

Cultural and Structural Barriers in the Black Community

Criminal Justice Fears

Societal issues play a giant role in blocking access to care. Many Black patients fear that asking for help with opioids may expose themselves to criminal prosecution, loss of employment, or even custody battles over children. Drug use rates don’t significantly differ between racial groups, but Black people are far more likely to face arrest or incarceration over drug offences.

Such fears often push Black patients and their families away from available services, be it in the US or UK, even as the crisis in their communities worsens. Without trust and locally accessible services, deaths will only continue to rise.

Overcoming Stigma and Building Trust

Addressing the opioid crisis among Black patients also means tackling deep-seated stigma. Carter’s events at Hajee House reflect this need. Instead of medical lectures, she organises block parties with music, food, and family activities, discreetly distributing resources in a comfortable setting. Her approach builds trust and ensures people return for support without shame.

UK Context for Black Patients and the Opioid Crisis

Though data and public attention are less comprehensive than in the US, many UK Black patients face similar dangers from opioids and barriers to quality care. UK health researchers stress that social exclusion, lower rates of health service access, and criminalisation combine to keep Black patients from services such as medication-assisted treatment or harm reduction schemes.

With the US crisis offering a cautionary tale, UK authorities and charities should take note and work to improve outreach, cultural relevance, and community trust among Black patients affected by opioid misuse.

Source: News-Medical.Net