By Scott Blair
The latest data from the Center for Disease Control (CDC) shows that Blacks are experiencing the highest increase in opioid overdose deaths in America. The CDC says that from 2019 to 2020, the opioid overdose rate increased by 86% for Black Americans aged 15-24 and 44% in the Black community as a whole.
There’s a drug that was approved for clinical use by the Food and Drug Administration (FDA). Buprenorphine, which is critical to prevent death in opioid addicts, was approved for clinical use over 20 years ago, but it’s hard to get. Here’s why.
Circumstances Often Control Fate
Often what we want or need contradicts our circumstances. Unfortunately, life isn’t so simple, and for those dealing with opioid addiction, that’s never been more apparent. Those who are opioid dependent need help and resources to not only better themselves, but to stay alive.
A solution for many opioid-dependent Americans could be readily available (and for some, it is). However, for the Black community, it’s not that easy.
Access to Buprenorphine
- Price
- Required Monitoring
- Stigma
Price, required monitoring, and stigma are issues that keep buprenorphine from being accessed by Black Americans.
According to the latest statistics, buprenorphine costs $246.11 a month or $8.15 daily for a prescription. If you have insurance, out-of-pocket costs are $96.47 per month or $4.01 daily. Some might read that stat and say it’s “only the cost of Starbucks,” however, many Americans can only dream of the luxury of a daily trip to Starbucks.
Suboxone is a pharmaceutical that has buprenorphine and another medication called Naloxone combined. Some believe that Suboxone is just as dangerous as opioids themselves. However, Harvard Medical School contributor Peter Grinspoon, MD, writes otherwise:
It is extremely difficult to overdose on Suboxone alone. It is much more difficult to overdose on Suboxone compared to other opiates, because Suboxone is only a partial opiate receptor agonist, so there is a built-in “ceiling” effect. This means there is a limit to how much the opioid receptors can be activated by Suboxone, so there isn’t as great a risk of slowed breathing compared with potent opiates such as heroin, oxycodone, or morphine. When people overdose on Suboxone, it is almost always because they are mixing it with sedatives such as benzodiazepines, medicines that also slow breathing.
According to Michelle Sproule, a licensed professional counselor, and chief clinical officer of Scottsdale Recovery Center, “Access to quality treatment, access to quality providers can be dictated so much by financial resources, their insurance resources, and their local community.”
Ms. Sproule says, “From my perspective of being a clinician that has worked in treatment … being able to understand what the differences are in the inequity of care, especially for people of color and getting access to appropriate health insurance coverage and treatments, can be very challenging for individuals.” Suboxone is often prescribed for six months or longer, and costs can really add up.
The X-Waiver
According to the Substance Abuse and Mental Health Services Association (SAMHSA), Section 1262 of the Consolidated Appropriations Act, 2023 (also known as Omnibus bill), removes the federal requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD).
In addition, practitioners are no longer limited in the number of patients they can treat with Buprenorphine. However, they’ll still need to adhere to state guidelines.
Opioids in Texas
Figures from 2020 show Dallas had 6.5 opioid-related deaths per 100,000 people, while Houston leads the state with 9.5 opioid deaths per 100,000 people. El Paso experienced 7.6 deaths, and Austin saw 5.6 per 100,000 residents.
In 2021, there were 9,078 Emergency Department (ED) visits for any opioid in Texas and 30.8 visits per every 100,000 people. On top of that, accidental drug deaths for any drug were at 12.5 per 100,000.
Treatment Programs in Texas
Opioid addiction is a serious issue in America and Texas, and the sooner someone gets treatment, the better chance for recovery. According to SAMHSA, Texas has 95 opioid treatment programs throughout the state. You can also find 15 free drug treatment programs here.