| Sanchez Huntley |
| Terica Carter founded the Charlotte-based nonprofit Hazzie House Harm reduction after the death of her 18-year-old son Tahazy. |
The purple flag, representing nearly 300 Mecklenburg County residents who died of opioid overdose in 2023, hit the humid winds last August in recognition of the city’s international overdose awareness day, primarily on the Black West Side.
Five years ago, the event may have attracted overwhelmingly white crowds.
However, gathering on the last day of the month at Valerie C. Woodard Community Resource Center attracted attendees from black people who wanted to learn more about the crisis that is currently at the centre.
In recent years, opioid overdose death rates have been originally called “hillbilly heroin” due to the largely exclusive misuse of white people, but have increased significantly among black people. This is primarily due to the introduction of fentanyl, a synthetic opioid 50-100 times more than morphine, which is often mixed into the supply of heroin and cocaine, and can be consumed without your knowledge. In North Carolina, black people died of overdose in 2021 at a rate of 38.5 per 100,000 residents, according to data from the North Carolina Department of Health and Human Services.
Terica Carter, founder of Charlotte-based nonprofit Hazzie House Harm Reduction, is co-organizing the event with the county public health office to change its statistics. Seven years ago, she founded Hazy’s home after the death of her 18-year-old son, Tahazy. Her nonprofit has focused on addressing key issues in the fight against the opioid epidemic. Its resources, treatments and policy prescribing is not following the surge in black addiction and overdose.
“No one was acknowledging it, so I felt very lonely,” Carter said. “It pushed me so I didn’t want others to go through what I had been going on.”
Hajee House is trying to bridge the gap between resources and information regarding opioid overdose, substance use, and treatment. We also offer syringes, safety use toolkits, overdose inverted drug naloxone, fentanyl test strips, and recovery referral services.
Despite efforts by groups like Hajee House, much work remains in North Carolina. For example, in 2019, it accounted for 88% of opioid use prevention and treatment services funded by a $54 million grant from the Federal Agency for Substance Abuse and Mental Health Services, North Carolina Health News reported. Meanwhile, blacks made up about 24% of North Carolina’s population, but only 7.5% of those served with state aid.
Nationally, black people may be referred or treated for white people — even after a non-fatal overdose, according to the Centers for Disease Control and Prevention.
“If you’re black and have an opioid use disorder, you could be treated five years later than you would if you were a white person,” said Nora Volkow, director of the National Institutes of Health’s Institute of Substance Abuse. “Five years can make a difference whether you’re alive or not.”
According to the CDC, only one in 12 non-Hispanic blacks who died from opioid overdose were engaged in substance use treatment, while non-Hispanic whites were treated almost twice as much. Even those seeking care are less likely to complete the program and have less outcomes. This study is linked to implicit bias and lack of diversity and empathy among treatment providers in black patients.
Daliah Heller, vice president of drug use initiatives at global health nonprofit Vital Strategies, said he is suffering from an equal access to drugs across the entire range of opioid use disorders, which are considered the gold standard for care.
These drugs can reduce the risk of overdose by half and double the chances of patients entering a long-term recovery. The FDA has approved three drugs: buprenorphine and methadone, synthetic opioids that reduce craving and withdrawal symptoms.
Black people are treated overwhelmingly with methadone. Methadone patients continue to receive treatment at a higher rate compared to prescribed buprenorphine, but face serious drawbacks, such as the requirement to visit the clinic daily, waitlist, and daily clinic daily to receive medication under the supervision of the clinic.
Buprenorphine, meanwhile, is prescribed in an office environment and filled with pharmacies. A University of Michigan study found that white patients received buprenorphine three to four times more frequently than black patients due to geographic availability and ability to pay.
“When buprenorphine came online in the early 2000s, we thought that it could be integrated with health care. You don’t need to go to any special programs anymore,” Heller said. “That didn’t happen.”
Edwin Chapman, who runs an addiction clinic in Washington, DC, said many prescribing challenges must be overcome to effectively treat his mostly black patient population.
“Many state insurance companies have imposed more restrictions on patients in urban areas, including requesting advance approval for addiction treatment,” Chapman said he spoke from his own experience working with patients. “The dosage criteria were based on the white population and those obsessed with pills. Our surviving black population needs a higher dose of buprenorphine.”
Heller said the lack of access to treatment is also driven by wider and systematic issues. She said many black people fear that seeking social services could lead to them getting caught up in the criminal justice system and ultimately lose their children’s employment, housing and even custody.
“Drug use occurs at the same level in racial and ethnic groups, but Black Americans are more likely to be arrested and jailed on drug charges,” Heller said. “The more highly intimate knowledge experience imposed on the Black community will hinder access to care.”
This is all about the increasing reasons why nonprofits like Hajee House can provide information and provide low barrier access to services in the black community, Carter said.
She celebrates the success of Hajee House for her personal connections and her keen understanding of the needs and cultural preferences of the Black community. For example, hosting an overdose awareness event will feature cookouts, bouncy homes and DJs to make them look like a block party.
“We focus on creating events and outreach is a comfortable and familiar environment for the Black community,” Carter said. “We’re black, so we’ll keep it black.”
