We call them addicts. Users. Drug seekers — and we see them as less than human.
We often assume unhoused people living in tents under freeway overpasses are substance users. But it’s our neighbors, our loved ones, and our family. The reality is that most Americans know someone who struggles with substance use. And for Black America, there’s a drug overdose epidemic.
“We have historically criminalized substance use in Black and Brown communities — the view has been very harsh. It’s almost as if it’s a throwaway population,” says Saeeda Dunston, CEO of Elmcor Youth & Adult Activities, a Queens, New York-based nonprofit service agency focused on substance use, prevention, and recovery.
In the United States, the mortality rate for drug overdoses reached an all-time high in 2022. Over the past two years, deaths have declined by approximately 10% nationwide. But when broken down by different ethnicities, Black Americans are still dying at alarming rates.
Late last month, Trust for America’s Health, a nonprofit health policy, research, and advocacy organization, released its annual report, Pain in the Nation 2025: the Epidemics of Alcohol, Drug, and Suicide Deaths.
It’s almost as if it’s a throwaway population.
Saeeda Dunston, CEO of Elmcor.
In a 5-year snapshot, Black or African American people had the second-highest mortality rate of drug overdoses. Still, American Indian and Alaska Native people have the highest rates, nearly double the rate of white Americans.
Why Do Black folks keep dying?
Tekisha Everette, executive vice president of Trust for America’s Health, explains why overdose death rates are going down for white Americans but not Black Americans. Part of the problem is a lack of access to culturally relevant care and behavioral health services — which often work in tandem. And there aren’t enough prevention investments in Black neighborhoods, which include programs that support Black families vulnerable to substance use.
“We know what to do,” she says. “We just need to be able to properly fund those trainings and activities.”
Dozens of cities across the country have implemented programs to dispatch trained mental health professionals instead of police for certain 911 calls. Stanford researchers found it reduced criminalization of individuals struggling with substance use.
Synthetic opioids like fentanyl are leading the drug overdose epidemic — within five years, death rates doubled due to synthetic opioids. To reduce mortality rates, increased access to naloxone, methadone, and buprenorphine, all examples of harm reduction strategies, has been shown to reduce overdose deaths.
On the other hand, the 988 Suicide and Crisis Lifeline expanded two years ago to support individuals with substance use and mental health needs. But with threats to cut specialized services from 988, it’s unclear where this resource stands. In April, the Trump Administration terminated hundreds of grants, many of which provided federal support for substance use and mental health treatment.
“We’re going to have a huge loss there. My crystal ball is not clear. I can’t see into the future. But what I do know is that we stand to lose the progress that we have seen.” Everette says. “African Americans, American Indians, and Alaska Natives will be hurt the most and the worst from the impact of these cuts in their communities.”
What’s the Way Forward?
Melicia Whitt-Glover, CEO of Council on Black Health, an organization working to advance Black health equity, says the substance use epidemic in the Black community intersects with structural racism and access to housing and education. Oftentimes, substance users and their support people are left to navigate a system that is unnecessarily complicated.
No one’s gonna save us. We have to save ourselves.Saeeda dunston, ceo of elmcor
To mitigate these challenges, Whitt-Glover says, it’s important to practice trauma-informed care and holistic support strategies. Part of that includes identifying the trauma that led people to substance use. It’s not just about abstinence or punishing people, she says; it’s about addressing folks’ individual needs.
“There have always been resources in our communities who have been working for the betterment of us. But we need to invest in Black-lead and community-based organizations,” she says. “They’re often not the shiny organizations people throw money at. We need to remember these are the tried and true that are going to be here.”
Last month, Elmcor, the Queens-based organization, held a media briefing on the State of the Overdose Epidemic in Black America. Dunston, who leads the organization, says that to decrease drug overdose deaths in the Black community, substance use needs to be seen as a public health issue and not a criminal justice issue.
“You can’t address any public health issue if you’re not going to discuss it, talk about it, or hide it,” she says.
Within the last three years, the mortality rates from substance use have declined for white Americans by about 3%. In part, Dunston says, is due to the awareness raised in that community — that same level of intensity needs to be applied in the Black community.
“No one’s gonna save us. We have to save ourselves,” she says. “It’s up to us to do the saving. We have to step up and be proactive. We have to be honest about what’s happening and have compassion for people in our communities that are using.”
