Decades-long opioid epidemic kills Black men in Chicago and other areas.

Latricia Walker-West, an outreach worker with the West Side Heroin and Opioid Task Force, hands Narcan nasal spray to residents on West Congress Parkway. This scene, captured by the *Sun-Times*, highlights a devastating trend: the disproportionately high rate of opioid overdose deaths among Black men born between 1951 and 1970 in Chicago and other major U.S. cities. This demographic has faced this elevated risk for decades, even during their younger years.

James Stewart, 60, is a recovering heroin addict who credits Cook County drug court with saving his life. His story underscores the scale of the problem. He began using heroin in 1987, initially as a “functional addict,” managing his addiction alongside his job. He’s now sober and works at the Haymarket Center, helping others. But Stewart’s survival is an exception. Data analysis from a collaboration of news organizations, including *The Baltimore Banner* and the *Chicago Sun-Times*, reveals that Cook County ranks fourth nationally in overdose deaths within this specific group of Black men. Their death rates are nearly ten times higher than the county average and fifteen times higher than the national average. In Cook County through November 10th of this year, this group accounted for nearly one-quarter of all opioid overdose deaths, nearly all involving fentanyl, often mixed with other drugs.

Despite this persistent crisis, targeted assistance for this population remains largely absent. While Chicago has implemented broader prevention efforts focused on high-risk neighborhoods, these programs lack the specific focus needed to address the unique needs of older Black men. Medical experts attribute this disparity to several factors, including lower rates of addiction treatment offered to Black men compared to white patients, often resulting in lower medication doses and feelings of disrespect within healthcare settings.

Billions of dollars are flowing to states through opioid settlement lawsuits against pharmaceutical companies and retailers. Illinois expects over $1.3 billion, yet healthcare professionals report a lack of initiatives specifically addressing this vulnerable population. Dr. Tanya Sorrell of Rush University Medical Center notes that while efforts to reach underserved groups are discussed, she hasn’t seen targeted programs for older Black men.

The reasons behind this disparity are complex and rooted in historical injustices. Cook County Board President Toni Preckwinkle highlights how many societal inequities, including overdose rates, are concentrated in Black and Brown communities, a consequence of systemic racism. Segregation, the aftermath of the 1968 riots, and job losses contributed to a cycle of poverty and despair in these communities, where heroin became a widespread coping mechanism. West Garfield Park and Austin now bear the brunt of this opioid crisis, with Chatham also experiencing a surge in overdose deaths among this age group. This disproportionately affects life expectancy for all Black Chicagoans, compounded by factors like homicides and chronic diseases. Dr. Olusimbo Ige, the city’s health commissioner, points to the stark reality: improving health outcomes for all Chicagoans except Black residents.

The lack of access to adequate treatment further exacerbates the problem. Black patients are less likely to be offered addiction medications, even with insurance, and receive lower doses when prescribed. Dr. Sorrell emphasizes the opportunity for intervention during multiple emergency department visits before fatal overdoses occur. Even when medication is available, mistrust of the healthcare system hinders access. Recovering addicts like James Stewart express concerns about medication-assisted treatment, highlighting the complexities of addiction and the need for tailored approaches.

Outreach efforts, like those by the West Side Heroin and Opioid Task Force, are attempting to address the immediate crisis by distributing Narcan and raising awareness. However, these efforts alone are insufficient. Involving former users in outreach programs, particularly within the jail system, shows promise, as highlighted by James Stewart and James “Jo Jo” Russell. The Community Outreach Intervention Projects uses a mobile unit model, but faces bureaucratic and funding challenges.

The high overdose rate among this group may also be linked to a lack of fear surrounding heroin use among earlier generations, compared to younger generations more wary of addiction. While the opioid crisis peaked during the COVID-19 pandemic, a decline is observed this year, attributed to expanded outreach and reduced fentanyl seizures.

The autopsy reports of 90 Black men who died from opioid overdoses in Cook County this year reveal common factors, offering insights for targeted interventions. Increasing access to Narcan is a key strategy. The West Side Heroin and Opioid Task Force exemplifies this effort, distributing Narcan directly to communities experiencing high overdose rates. This personalized approach, paired with programs within the criminal justice system, offers potential pathways to address this critical issue. However, systemic changes addressing the underlying causes of addiction, including historical inequalities and societal mistrust, are crucial to breaking the cycle of death. Ultimately, the daughter of a deceased opioid user eloquently captures the urgency: the crisis has been ignored for too long, and these men’s lives must be valued.