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Opioids are killing more Black men — largely due to the spread of fentanyl


For years, white men have been the people most likely to die from an opioid overdose in this country. Now that's changing. The drugs are killing more Black men than ever before, largely due to the spread of fentanyl. This crisis is taking a toll on communities like Birmingham, Ala. Mary Scott Hodgin with member station WBHM in Birmingham and al.com reporter Cody Short talked to people impacted by the epidemic.

CODY SHORT: Rickey Smiley is a well-known comedian from Alabama, famous for his nationally syndicated radio show where he often jokes about Southern culture. But lately, Smiley has been consumed by a much more serious issue - drug overdose.

RICKEY SMILEY: I walked a lady to her car at the last karaoke night at the StarDome, and she looked me in the eye and said, my son died the week before your son died.

SHORT: Earlier this year, Smiley's son Brandon died after taking a combination of drugs, including fentanyl.

SMILEY: It's bad here. A lot of young people are showing up at the funeral home, dying of fentanyl.

SHORT: Since 2019, the number of Black men who've died from an opioid overdose in the Birmingham area has quadrupled. It's a key issue for Birmingham's coroner, Bill Yates.

BILL YATES: This is our website.

SHORT: My colleague Mary Scott talked with Yates to learn more.

MARY SCOTT HODGIN: Bill Yates has seen the death toll up close - from prescription opioids, heroin and fentanyl. Fentanyl is up to 50 times stronger than heroin. It's often used to lace other drugs to increase their potency. That's what Yates has seen in many autopsies.

YATES: Cocaine and typically fentanyl. And then we started seeing, well, it's methamphetamine and fentanyl or it's cocaine, methamphetamine and fentanyl, and they're all at toxic levels.

HODGIN: He says in some cases, it's clear people didn't even know they were using fentanyl. That was a story Cody and I heard from several people at True Vine Evangelical Ministries. True Vine is a small operation run out of a church nestled in a Black neighborhood in North Birmingham. The program offers housing and addiction recovery support. During a group session earlier this year, Freddie Perkins (ph) celebrated several weeks of sobriety.

FREDDIE PERKINS: I just had three consecutive clean drug tests. Glory be to God.

HODGIN: For years, Perkins used cocaine, then heroin. He first had fentanyl mixed with cocaine, and he almost died.

PERKINS: It's a real bad drug. Like, it's a scary drug. Like, I never ODed in my life. Like, I never - until this fentanyl stuff came around. That's a spooky drug.

HODGIN: Paramedics saved him after he overdosed.

SHORT: Churches like True Vine often try to fill in the gaps where medical treatment isn't available. That's according to Kady Abbott. She's the clinical director of an alcohol and drug treatment program in Birmingham. She says many people facing addiction need services like detox and medication-assisted treatment. Black men often face more hurdles in finding that kind of care.

KADY ABBOTT: Access to care, cost, affordability, awareness of a program that can actually help me, all of those are barriers, and they greatly impact Black males.

SHORT: Abbott says Black men often experience racism in the medical system and don't trust it.

ABBOTT: It's ultra devastating, and it is compounding because we've already - experiencing disparity.

SHORT: Comedian Rickey Smiley says he did all he knew for his son, Brandon. He entered him into rehab programs and treatment facilities, but Brandon continued to struggle with addiction.

SMILEY: And I felt like it was just a matter of time before he'd either end up in prison or dead.

SHORT: Now Smiley is using his platform to speak out about how opioids are affecting Black families.

SMILEY: It's about trying to save lives, because you just can't let your son die in vain.

SHORT: Addiction experts in Alabama say the state needs to invest in more medical treatment services and expand Medicaid. They also say treatment providers need to better connect with Black men struggling with addiction. For NPR News, I'm Cody Short.

HODGIN: And I'm Mary Scott Hodgin in Birmingham. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Mary Scott Hodgin
Cody Short