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Commentary: It’s Time to Address the Disproportionate Impact of the Opioid Crisis on Black Californians

The opioid crisis, once perceived as predominantly affecting rural, White communities, disproportionately impacts Black Americans. This is a result of long-standing health equity barriers, documented in both local reports and federal studies. As overdoses continue to rise statewide and fentanyl continues to wreak havoc in our communities, California policymakers must take action.

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Le Ondra Clark Harvey, PhD, is the Chief Executive Officer of the California Council of Community Behavioral Health Agencies and Executive Director of the California Access Coalition.
Le Ondra Clark Harvey, PhD, is the Chief Executive Officer of the California Council of Community Behavioral Health Agencies and Executive Director of the California Access Coalition.

By Dr. Le Ondra Clark Harvey, Special to California Black Media Partners  

The opioid crisis, once perceived as predominantly affecting rural, White communities, disproportionately impacts Black Americans. This is a result of long-standing health equity barriers, documented in both local reports and federal studies.

As overdoses continue to rise statewide and fentanyl continues to wreak havoc in our communities, California policymakers must take action. Slight declines or plateaus are not “wins.” We need proactive, comprehensive solutions that improve education, provide wraparound services, and increased access to proven treatment methods like medication assisted treatment and overdose reversal agents.

As an advocate, psychologist, and mother of two young children, today’s fentanyl crisis is difficult to process. On one hand, I understand how challenging it can be to pass meaningful policies that will save more lives — whether those of individuals injecting drugs on sidewalks or suburban teenagers poisoned by counterfeit pills they bought on Snapchat. These challenges are compounded by critical deficits, such as workforce shortages, minimal treatment beds and facilities, and a lack of culturally competent care, all of which disproportionately affect Black Californians.

I have witnessed the devastating impact of fentanyl on Black families. These deaths shatter families, destabilize communities, and perpetuate cycles of trauma and socio-economic hardship. For Black Californians specifically, grief is compounded by helplessness and frustration, knowing that more could – and should – have been done to prevent these tragedies.

As I sit in numerous health policy workgroups, task forces, and legislative hearings, I hear policymakers request more studies to better understand how vulnerable communities are impacted. This is critical, and it is not enough.

We don’t have time to waste.

Naloxone, a well-known opioid reversal medication, has saved hundreds of thousands of lives. However, as the opioid landscape evolves, so too must our response. California must adopt flexible policies that evolve with the rapidly changing drug landscape. We cannot rely on outdated, product-specific policies when the illicit drug landscape is changing faster than we can blink.

Efforts to do just that at the statewide level have been aggressively rebuffed by the Administration. Last year, Senate Bill 641, authored by Sen. Richard Roth (D-Riverside) would have expanded California’s statewide standing order for naloxone to encompass all FDA-approved opioid reversal agents. It passed out of the Legislature unanimously, yet Governor Newsom vetoed the bill.

Several months after the veto, Assemblymember Jasmeet Bains, (D-Delano), a physician who treats substance use disorder (SUD), led a sign-on letter among her colleagues calling on the California Department of Public Health to update the statewide standing order to no avail.

Fortunately, Los Angeles County has stepped up in the absence of statewide legislation being signed into law.

For decades, Dr. Brian Hurley, Medical Director of the Bureau of Substance Abuse Prevention and Control for the Los Angeles County Department of Public Health and President of the American Society of Addiction Medicine, has taken a comprehensive approach to addressing substance use disorder.

He has increased access to proven treatment models and implemented innovative initiatives to save lives. His department’s efforts have contributed to the plateau in overdose rates, and we hope to see further improvement through the expanded standing orders for the Los Angeles Unified School District and the LA County Sheriff’s Department, ensuring access to all FDA-approved reversal agents.

The time for action is now. With a united and informed approach, we can turn the tide on the devastating impact of opioid overdoses in Black communities.

About the Author 

Dr. Le Ondra Clark Harvey is the Chief Executive Officer of the California Council of Community Behavioral Health Agencies and Executive Director of the California Access Coalition.

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