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Opioids claiming more African-American lives as overdoses spread from Rust Belt to East Coast



For much of its horrific history, the faces of the deadly opioid epidemic that have ravaged the Rust Belt and killed more than 350,000 Americans since 1999 were largely white.

That is rapidly changing as the plague spreads to big cities on The East Coast, according to a new study by a quartet of researchers led by Stanford University's Mathew Kiang, was released Friday.

"Although opioid-related mortality has been stereotyped as a rural low-income phenomenon concentrated in the Appalachian or Midwestern states that it has spread rapidly, especially among the eastern states, "the researchers reported in the study that was published in JAMA.

The result is a broader range of populations being affected, with the spread of the epidemic from rural to urban areas and significant increases in opioid-related mortality observed in the black population. "

For example, the death rate from opioids in the District of Columbia, where nearly half of the population Dents are black, has tripled every year since 2013.

Why is it spreading?

"Heroin," Kiang told NBC News.

27 PHOTOS

Opioid and drug crisis in America [19659011] This Gallery

Discarded Needles are seen at the heroin campground in the Kensington neighborhood of Philadelphia, Pennsylvania, on April 7, 2017.
In North Philadelphia, the railroad gulch as it is known, is ground zero in Philadelphia's opioid epidemic. Known by locals as El Campanento, the open-air drug market and heroin camp is built with discarded materials from the gulch and populated by addicts seeking a hit of heroin to keep their dope sick or withdrawal symptoms at bay. In one area, near the 2nd Avenue overpass, empty syringe wrappers blanket the refuse like grass
The used needles they once contained were poking through like thistles.

 / AFP PHOTO / DOMINICK REUTER [Photo credit should read DOMINICK REUTER / AFP / Getty Images]

NEW YORK, NY – JUNE 07: Surfer shoots heroin in a park in the South Bronx on June 7, 2017 in New York City Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died of overdoses in 2016, the majority of those deaths involved in opioids. The Mott Haven-Hunts Point area of ​​the Bronx borough of New York is currently leading the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50. (Photo by Spencer Platt / Getty Images)

NEW YORK, NY – JUNE 07: A man leans against the wall appearing to be under the influence of drugs on a street in the South Bronx on June 7, 2017 in New York City. Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died of overdoses in 2016, the majority of those deaths involved in opioids. The Mott Haven-Hunts Point area of ​​the Bronx borough of New York is currently leading the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50. (Photo by Spencer Platt / Getty Images)

WASHINGTON, DC – SEPTEMBER 18: Family members of those who died of opioid overdoses attend 'Fed Up!' The rally to end the opioid epidemic is at the National Mall on September 18, 2016 in Washington, DC. Activists and family members gathered at the National Mall to march to the Capitol Building. Some 30,000 people die each year due to heroin and painkiller pill addiciton. Speakers called for Congress to provide $ 1.1 billion for the Comprehensive Addiction and Recovery Act, which the Congress passed in July without funding. (Photo by John Moore / Getty Images)

NEW YORK, NY – JUNE 07: A man rests against a wall appearing to be under the influence of drugs on a street in the South Bronx on June 7, 2017 in New York City . Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died of overdoses in 2016, the majority of those deaths involved in opioids. The Mott Haven-Hunts Point area of ​​the Bronx borough of New York is currently leading the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50. (Photo by Spencer Platt / Getty Images)

NEW YORK, NY – JUNE 07: Brian smokes a synthetic drug called K2 on the street in the South Bronx on June 7, 2017 in New York City. Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died of overdoses in 2016, the majority of those deaths involved in opioids. The Mott Haven-Hunts Point area of ​​the Bronx borough of New York is currently leading the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50. (Photo by Spencer Platt / Getty Images)

NEW YORK, NY – JUNE 07: "Surfer" shoots heroin in a park in the South Bronx on June 7, 2017 in New York City. Like Staten Island, parts of the Bronx are experiencing an epidemic in drug use, especially heroin and other opioid based drugs. More than 1,370 New Yorkers died of overdoses in 2016, the majority of those deaths involved in opioids. The Mott Haven-Hunts Point area of ​​the Bronx borough of New York is currently leading the city in heroin overdose deaths. According to the Deputy Attorney General, drug overdose are now the leading cause of death for Americans under the age of 50. (Photo by Spencer Platt / Getty Images)

WASHINGTON, DC – SEPTEMBER 18: Activists and family members of loved ones Who died in the opioid / heroin epidemic to take part in 'Fed Up!' rally at Capitol Hill on September 18, 2016 in Washington, DC. Protesters have called for a legist to provide funding for the Comprehensive Addiction and Recovery Act, which the Congress passed in July without funding. Some 30,000 Americans die each year due to heroin and painkiller pill addiciton in the United States. (Photo by John Moore / Getty Images)

Quincy Massachusetts Police Detective Lt. Patrick Glynn holds a nasal injection containing the overdose-reversing drug naloxone at the police headquarters in Quincy, Mass., On June 13, 2014. Quincy, Mass., In 2010, became the first U.S. City to make the drug standard equipment for its police officers who have used it to reverse some 275 overdoses, a significant number in a city of 93,000 people. Police forces nationwide are starting to follow suit. The state program has now moved far beyond the police, training some 25,747 people in Massachusetts how to recognize signs of opioid drug overdose and administer naloxone. June 13, 2014 REUTERS / Gretchen Ertl (UNITED STATES – Tags: DRUGS SOCIETY HEALTH CRIME LAW)

A woman suspected of acting under the influence of heroine shows arms to police on April 19, 2017 in Huntington, West Virginia.
Huntington, the city in the northwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicenter of the opioid crisis. On August 15, 2016, from 3:00 pm to 9:00 pm, 28 people in the city overdosed heroin laced with fentanyl, a synthetic opioid far more powerful and dangerous than heroin. The economic incentives are powerful: one kilogram of fentanyl costs $ 5,000, which can make a million tablets sold at $ 20 each for a gain of $ 20 million. "This epidemic does not discriminate," Huntington Mayor Steve Williams said. 'Our youngest overdose was 12 years old. The oldest was 77. '
 / AFP PHOTO / Brendan Smialowski / TO GO WITH AFP STORY by Heather SCOTT, US-health-drugs-West Virginia (Photo credit should read BRENDAN SMIALOWSKI / AFP / Getty Images)

Paraphernalia for smoking and injecting drugs is seen after being found during a police search on April 19, 2017 in Huntington, West Virginia.
Huntington, the city in the northwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicenter of the opioid crisis. On August 15, 2016, from 3:00 pm to 9:00 pm, 28 people in the city overdosed heroin laced with fentanyl, a synthetic opioid far more powerful and dangerous than heroin. The economic incentives are powerful: one kilogram of fentanyl costs $ 5,000, which can make a million tablets sold at $ 20 each for a gain of $ 20 million. "This epidemic does not discriminate," Huntington Mayor Steve Williams said. 'Our youngest overdose was 12 years old. The oldest was 77. '
 / AFP PHOTO / Brendan Smialowski / TO GO WITH AFP STORY by Heather SCOTT, US-health-drugs-West Virginia (Photo credit should read BRENDAN SMIALOWSKI / AFP / Getty Images)

Paraphernalia for smoking and injecting drugs is seen after it was Found during a police search on April 19, 2017, in Huntington, West Virginia.
Huntington, the city in the northwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicenter of the opioid crisis. On August 15, 2016, from 3:00 pm to 9:00 pm, 28 people in the city overdosed heroin laced with fentanyl, a synthetic opioid far more powerful and dangerous than heroin. The economic incentives are powerful: one kilogram of fentanyl costs $ 5,000, which can make a million tablets sold at $ 20 each for a gain of $ 20 million. "This epidemic does not discriminate," Huntington Mayor Steve Williams said. 'Our youngest overdose was 12 years old. The oldest was 77. '
 / AFP PHOTO / Brendan Smialowski / TO GO WITH AFP STORY by Heather SCOTT, US-health-drugs-WestVirginia (Photo credit should be read BRENDAN SMIALOWSKI / AFP / Getty Images)

A parenteral for injecting drugs is seen after being found during a police search on April 19, 2017 in Huntington, West Virginia.
Huntington, the city in the northwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicenter of the opioid crisis. On August 15, 2016, from 3:00 pm to 9:00 pm, 28 people in the city overdosed heroin laced with fentanyl, a synthetic opioid far more powerful and dangerous than heroin. The economic incentives are powerful: one kilogram of fentanyl costs $ 5,000, which can make a million tablets sold at $ 20 each for a gain of $ 20 million. "This epidemic does not discriminate," Huntington Mayor Steve Williams said. 'Our youngest overdose was 12 years old. The oldest was 77. '
 / AFP PHOTO / Brendan Smialowski / TO GO WITH AFP STORY by Heather SCOTT, US-health-drugs-West Virginia (Photo credit should read BRENDAN SMIALOWSKI / AFP / Getty Images)

Jessica, a homeless heroine addict, shows her kit of clean needles, mixing cap and tourniquet in the Kensington area of ​​Philadelphia, Pennsylvania, on April 14, 2017.

In North Philadelphia, the railroad gulch as it is known is ground zero in Philadelphia's opioid epidemic. 80 percent of us want to get out, "said Jessica, before she outlining the numerous ways she has tried to get treatment for her addiction. In one case, she said, there were no available beds. In another, the treatment provider needed a positive drug test before delivering help, meaning if she had not used recently she'd be denied. Instead of getting treatment, she spends her nights trying to keep warm on a mattress under the bridge, the very spot where she was raped and infected with HIV. People come from all over the city, and some as far away as the Midwest, for the heroin that is remarkably cheap and pure at the largest heroin market on the East Coast. / AFP PHOTO / DOMINICK REUTER (Photo credit should read DOMINICK REUTER / AFP / Getty Images)

Drug paraphernalia and other garbage litter a vacant house on April 19, 2017 in Huntington, West Virginia.
Huntington, the city in the northwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicenter of the opioid crisis. On August 15, 2016, from 3:00 pm to 9:00 pm, 28 people in the city overdosed heroin laced with fentanyl, a synthetic opioid far more powerful and dangerous than heroin. The economic incentives are powerful: one kilogram of fentanyl costs $ 5,000, which can make a million tablets sold at $ 20 each for a gain of $ 20 million. "This epidemic does not discriminate," Huntington Mayor Steve Williams said. 'Our youngest overdose was 12 years old. The oldest was 77. '
 / AFP PHOTO / Brendan Smialowski / TO GO WITH AFP STORY by Heather SCOTT, US-health-drugs-West Virginia (Photo credit should read BRENDAN SMIALOWSKI / AFP / Getty Images)

A man injects himself in the foot with heroin near a The heroin encampmentin the Kensington area of ​​Philadelphia, Pennsylvania, on April 14, 2017.

In North Philadelphia, the railroad gulch as it is known is ground zero in Philadelphia's opioid epidemic. At the camp, and across the nearby area, a user can buy a bag
of high-grade heroin at a low price and even pay someone else to inject
they if for any reason they are unable to inject themselves. For some individuals, the addiction process was a slow one that started with a doctor's prescription for pain pills after an accident or surgery, and by the time the medication was completed, there was a dependency on it. After a search of black-market pills to feed their addiction, the simple economics of heroin won out: the price of a single pill could be anywhere between 2 and 10 bags of heroin, savings that's hard to ignore when a insurance company no longer underwrites the cost

 / AFP PHOTO / DOMINICK REUTER (Photo credit should read DOMINICK REUTER / AFP / Getty Images)

WASHINGTON, DC – SEPTEMBER 18: Michael Botticelli, U.S. National Drug Control Policy Director speaks at the 'Fed Up!' rally to end the opioid epidemic on September 18, 2016 in Washington, DC. Activists and family members of the people who died in opioid and heroin epidemic gathered at the National Mall to march to the Capitol Building. Some 30,000 people die each year due to heroin and painkiller pill addiciton. Speakers called for Congress to provide $ 1.1 billion for the Comprehensive Addiction and Recovery Act, which the Congress passed in July without funding. (Photo by John Moore / Getty Images)

A man uses a syringe to collect the last drop from a scavenged water bottle to mix up a shot of heroin near heroin camp in the Kensington area of ​​Philadelphia, Pennsylvania, on April 14 , 2017

In North Philadelphia, the railroad gulch as it is known is ground zero in Philadelphia's opioid epidemic. The tracks and the surrounding property are owned and operated by Consolidated Rail Corporation, a joint subsidiary of Norfolk Southern and CSX. People come from all over the city, and some as far away as the Midwest, for the heroin that is remarkably cheap and pure at the largest heroin market on the East Coast. According to the Health Commission, Philadelphia is on track to see 33 percent more drug overdose deaths in 2017 over the past year.

 / AFP PHOTO / DOMINICK REUTER [Photo credit should read DOMINICK REUTER / AFP / Getty Images]

A Philadelphia Police officer patrols under a bridge near heroin camp in the Kensington neighborhood of Philadelphia, Pennsylvania, on April 14, 2017.

In North Philadelphia, the railroad gulch as it is known is ground zero in Philadelphia's opioid epidemic. The tracks and the surrounding property are owned and operated by Consolidated Rail Corporation, a joint subsidiary of Norfolk Southern and CSX. Last month, Philadelphia Mayor Jim Kenney announced citations against the Consolidated Rail Corporation for what the mayor, in a release, said was Conrail's failure to clean and secure their own property. ' Visitors and homeless residents of the gulch say the trash is not their fault, and that they are only there because they have nowhere else to go. According to the Health Commission, Philadelphia is on track to see 33 percent more drug overdose deaths in 2017 over the past year.
 / AFP PHOTO / DOMINICK REUTER [Photo credit should read DOMINICK REUTER / AFP / Getty Images]

SANFORD, ME – FEBRUARY 16: Milo Chernin, who lost her son Sam to her heroin overdose Jan. 16, 2017, looks at photos at her home in Sanford. She says that Sam, who died at age 25, struggled with his addiction and could not stay away from heroin despite getting treatment. (Photo by Derek Davis / The Portland Press Herald via Getty Images)

WASHINGTON, DC – SEPTEMBER 18: Activists and family members of the "Eaters of the Opioid / Heroin Epidemic" take part in 'Fed Up!' rally at Capitol Hill on September 18, 2016 in Washington, DC. Protesters have called for a legist to provide funding for the Comprehensive Addiction and Recovery Act, which the Congress passed in July without funding. Some 30,000 Americans die each year due to heroin and painkiller pill addiciton in the United States. (Photo by John Moore / Getty Images)

GROTON, CT – MARCH 23: A box of the opioid antidote Naloxone, also known as Narcan, is on display during a family addiction support group on March 23, 2016 in Groton, CT . The drug is used to revive people who suffer from heroin overdose. The group communities Speak Out organizes monthly meetings for members of the family to talk about how their loved ones' addiction affects them and gives each other emotional support. Communities nationwide are struggling with the unprecidented heroin and opioid pain pill epidemic. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid analgesics prescribed nationwide, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is more and more expensive. (Photo by John Moore / Getty Images)

NEW LONDON, CT – MARCH 23: A heroin user injects himself on March 23, 2016 in New London, CT. Communities throughout New England and nationwide are struggling with the unprecidented heroin and opioid pain pill epidemic. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid analgesics prescribed nationwide, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is more and more expensive. (Photo by John Moore / Getty Images)

GROTON, CT – MARCH 23: Family members of addicted heroin and opioid pain pills share stories during a support group on March 23, 2016 in Groton, CT. The group communities Speak Out organizes monthly meetings for members of the family to talk about how their loved ones' addiction affects them and gives each other emotional support. Communities nationwide are struggling with the unprecidented heroin and opioid pain pill epidemic. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid analgesics prescribed nationwide, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is more and more expensive. (Photo by John Moore / Getty Images)

NEW LONDON, CT – MARCH 14: Jackson, 27, who said he was addicted to prescription drugs, was released in public library on March 14, 2016 in New London, CT . Police say an increasing number of suburban addicts are coming to the city to buy heroin, which is much cheaper than opioid analgesics. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid analgesics prescribed nationwide. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is more and more expensive. (Photo by John Moore / Getty Images)

ST. JOHNSBURY, VT – FEBRUARY 06: 'Buck' who is 23 and addicted to heroin, shoots up Suboxone, a maintenance drug for opioid dependence, which is also very addictive on February 6, 2014 in St. Johnsbury, Vermont. Vermont Governor Peter Shumlin has recently devoted his entire State of the State speech to the scourge of heroin. Heroin and other opiates have begun to devastate many communities in the Northeast and Midwest leading to a surge in fatal overdoses in a number of states. As prescription painkillers, such as the synthetic opiate OxyContin, become increasingly expensive and regulated, more and more Americans are turning to heroin to fight pain or to get high. Heroin, which has experienced a surge in production in places like Afghanistan and parts of Central America, has a relatively inexpensive street price and provides a more powerful impact on the user. (Photo by Spencer Platt / Getty Images)




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Specifically, fentanyl-laced heroin which is 25 to 50 times more powerful than straight heroin and fast becoming the fix for choice for big city addicts

"The heroin on the East Coast is much more lethal than heroin on the West Coast," Kiang said.

Because heroin is so cheap, drug smugglers have taken to lacing it with fentanyl to boost profits and boost. The high and often the street-level dealers do not even know they sell fentanyl-spiked heroin, NBC News reported earlier.

Out west, junkies use black tar heroin, which looks more like a melas, than white or brownish powder that predominates on the east coast. As a result, heroin addicts in Los Angeles or Seattle are less likely to be laced – or even replaced – with fentanyl, which is also a white powder.

"The worry is fentanyl making its way into other drugs that are unthinking people use like cocaine, "said Kiang. "This is probably the one people are most concerned about and it has real implications for places like California."

In a previous study published last year, Kiang and two other researchers took note of what was already widely accepted – that the epidemic was driven in the 1990s and 2000s by prescription opioids as part of aggressive marketing techniques by the pharmaceutical industry and changing medical standards in the diagnosis and treatment of chronic pain. "

People would get hooked on prescription painkillers and then gravitate to heroin, they said.

But African-Americans were less affected because there were "much lower opioid prescription rates in the black population than in the white population," the study said.

However, in recent years "heroin rates use and prescription opioid abuse in blacks and whites have begun to converge, "that study said.

From 1999 to 2016, according to a study by Kiang and his collaborators who was Released Friday, 231,264 men and 120,366 women died from opioid-related causes across the United States.

The median death rate for men was 39.8 and for women it was 43.5, researchers found.

"Opioid- related mortality, in particular the mortality associated with synthetic opioids, has increased in the east of the United States. "They concluded.


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