Pharmaceutical marketing strategies may have protected Southern rural blacks from opioid epidemic

Overdose rates (left) are lower in rural Southern counties with more African Americans and higher in counties with more whites (right). (Walsh Center on Rural Health Analysis map; click the image to enlarge it.)

"Rural counties in the South with a high percentage of African Americans tend to have lower drug-overdose rates, leading to speculation that racism may have had the unintended consequence of insulating blacks from some of the opioid epidemic," Tim Marema reports for The Daily Yonder.

The lower overdose rate can't be explained by economics or social conditions, so race is the most likely factor, according to Michael Meit, co-director of the Wash Center for Rural Health Analysis, which recently released a map of county-level overdose deaths.

"I do think that the pathway into opioids for many rural communities was prescription drugs," Meit told Marema. "And I think, for whatever reason, the prescription drugs were not marketed towards rural African American populations."

That goes back to the beginning of the opioid epidemic in the mid-1990s, when Oxycontin maker Purdue Pharma marketed the drug heavily to doctors who already prescribed large amounts of opioids. According to former Roanoke Times reporter Beth Macy, author of Virginia opioid epidemic chronicle Dopesick, those doctors tended to be in rural, white communities with blue-collar jobs that cause more injuries, like logging, mining and fishing.

Another reason for the lower overdose rates among rural black residents: "Doctors are less likely to prescribe painkillers to African Americans because of conscious or unconscious stereotypes about blacks and drug abuse, numerous studies have shown," Marema reports. "Nationally, whites were more than 50 percent more likely to die from an opioid overdose than blacks in 2016, according to the Centers for Disease Control.