'A crisis ignored': Overdose deaths surge among Black population as opioids extend reach

Standing before about 50 people in Living God Church in Avondale on a recent Saturday, Rashida Pearson explained how to use specially treated, thin paper strips to detect fentanyl in cocaine, meth and other drugs. She urged everyone who showed up to take some and to get a free box of Narcan before leaving.

Tables of the overdose prevention supplies lined the walls of the large meeting room, where mostly Black harm reduction workers talked to mostly Black neighbors about how fentanyl is killing Black loved ones and how overdose deaths can be prevented.

“It takes seconds to let you know whether your product contains fentanyl,” said Pearson, an expert in reducing the harm of drugs to prevent overdose and HIV at nonprofit Caracole in Northside.

“I am thinking about our children," she said. "We have the tools to keep you alive.”

Living God Church is among 11 primarily Black churches in the Cincinnati area that have joined a voluntary effort to ensure their members recognize that overdose deaths from fentanyl are a serious threat to their community and their families.

Overdose deaths among Black people are spiraling in Hamilton County, reflecting a nationwide shift in the opioid epidemic – and demanding new local strategies to try to stop the dying.

Hamilton County coroner’s records show a count of 47 overdose deaths of Black people here in 2016, compared to 135 in 2021 – a 187% jump.

The numbers are far lower than the toll on white people (the total overdose deaths in Hamilton County in 2021 reached 515), but the rapid growth over the years is alarming, experts across the country say. In comparison with the nearly 200% jump among Black residents here, white people and others saw a 7% increase in overdose deaths in Hamilton County during the same period. And even as the deaths dipped in one year's time in 2022, according to incomplete records, the decline among white people is far greater.

The figures match a national trend. After years of primarily impacting white drug users, the opioid epidemic is extending its deadly reach to Black and other people of color. The Centers for Disease Control and Prevention, which tracks overdose deaths, reported "significantly" higher death rates in 2020 of Black Americans than white Americans.

Black overdose death toll results from historical disparities

The rise in deaths of Black people started after fentanyl became the dominant opioid on the illicit drug market. It is frequently found tainting cocaine and other stimulants. The previous wave of the opioid epidemic stemmed from prescription pain pill misuse, then moved to heroin use, which primarily hit white communities. Now, there is a new market for Mexican cartels: Everyone.

The invasion of fentanyl into Black Americans' lives is worsened by disparities in health care, the criminal justice system and other systemic racial inequities, said Kamaria Tyehimba, co-chair of the African American Engagement Workgroup, created in 2018 as part of the Hamilton County Addiction Response Coalition.

“I would characterize this as a crisis ignored,” said Tyehimba, who is also the director of addiction services at Talbert House.

“I don’t think that people are really paying attention to the fact that these numbers are going up and how pervasive it really, really is in the Black community.”

Her team is working to end the disparity with face-to-face engagement with Black residents combined with apologies for past inequities.

New strategy: Meet people where they are

The African American Engagement Workgroup was created as a direct response to a surge in overdose deaths in Black residents in 2017. Tyehimba told The Enquirer then that the approach must be in-person, direct engagement by Black advocates to establish trust with Black residents.

More:A legacy of distrust: The racial disparities that mean many can be reluctant to seek help

"Trust is an issue. You have to deal with (past) failures,” she said. “The disparity is just huge because of a lack of trust in all of our services."

That disparity leaves Black people more vulnerable to harm, she said. So much so that they might be hesitant to get involved if they see someone who appears to be experiencing overdose.

"They're not calling the paramedics,” Tyehimba said. "They don't want to be arrested. They don't want to be treated like a criminal."

Volunteers with the workgroup recruited pastors at churches in Cincinnati's mostly Black neighborhoods to engage their congregants, Tyehimba said, explaining, "They are relationship-builders and experts."

The group also asked permission to talk to people in the neighborhoods and to hand out Narcan and explain laws that prevent police from arresting those who help save lives.

The strategy is gaining ground and has had an impact, records show:

• Eleven churches have joined African American Engagement Workgroup community efforts and have referred 150 people with substance use disorder directly into treatment in the past year.

• With part of a federal opioid response grant, the Hamilton County Quick Response Team added two new Black team members to work with Black residents who need help for substance use disorders. The team also added visits to places where Black people live and work to hand out Narcan and fentanyl test strips and to offer other health-related services.

• In 2019, the Quick Response Team had one Black person referred for its services. In 2022, the team had 583 Black people referred to or reached by the team's efforts. Another 33 Black people were provided services in January this year for a total of 952 referrals since the work started.

• Corinthian Baptist Church in Bond Hill, among the 11 churches, expanded its Mind Over Matters counseling ministry, engaging 12 new people last year who either had a substance use disorder or had a family member with addiction. "One family, a mother, brought in three of her children," said the Rev. KZ Smith, pastor of the church.

"Everyone is doing something," Smith said.

“Even we, as pastors, we’re learning a whole lot about what we didn’t really know about and how it impacts the congregation … even though people don’t want to admit it," said the Rev. Donald Jones, pastor of Greater New Hope Missionary Baptist Church in Avondale. "This is part of our ministry."

Family members of overdose death victims speak out to 'end the stigma'

Robin Nixon, of Colerain Township, stood up at Living Church of God at its harm reduction fair on Feb. 11 to tell those attending that her son Johnathan Nixon, a bass player who was not suffering from substance use disorder, died from fentanyl-tainted cocaine in 2018. He was 29.

"What was intended to be a typical night of fun for him and his friends turned out to be shock and pain," Nixon said.

Keiana Rogers, an advocate with Your Life Matters, who lost her daughter to violence, asaid Black people need to help each other prevent Black overdose deaths.

“We talk about substance abuse in white communities. What we don’t see here is how it happens to us," she told the crowd. "Be the village."

'A beachhead against a tsunami'

The African American Engagement Workgroup's strategies bolster other programs. Hamilton County Mental Health and Recovery Services Board received $3.2 million in Ohio opioid response funds in 2022 and 2023. It has distributed the funding to several community agencies, including Talbert House and Greater Cincinnati Behavioral Health Services, for evidence-based, overdose prevention and services to African American residents.

But unless the breadth of work is sustained over time and embedded into all communities across Hamilton County, it will not be enough to stop climbing overdose deaths among Black residents, said John Young, co-chair of the African American Engagement Workgroup.

"This is just the beginning of what I would consider a genuine, authentic outreach into a community that’s been underserved," Young said. "People are working extra hours. It's an effort of passion.

"It has to expand," Young said. "We've got a beachhead against a tsunami."