Who Speaks for Us? Addressing the Black Overdose Crisis in Appalachia

By BBG 

On Friday, December 6, 2024, state and local leaders gathered in South Charleston at Café Appalachia, a nonprofit that supports people with substance use disorders, for a town hall meeting on West Virginia’s drug and overdose epidemic. The event, hosted by the Community Education Group (CEG) and moderated by its founder, A. Toni Young, brought together a panel of prominent voices: Senator Tom Takubo, Bishop Robert L. Haley, III, Dr. Stephen Loyd, and Megan Simpson of the Greater Kanawha Valley Foundation.

The discussion centered on the ongoing challenges of West Virginia’s syndemic—a collision of the opioid crisis with increasing rates of HIV and hepatitis among people who use drugs. Panelists highlighted critical gaps in identifying and preventing these health crises and the barriers posed by legislative and systemic limitations.

CEG Founder Toni Young described the overlap of the opioid crisis, HIV, and hepatitis as a “train” driving through Appalachia, with the opioid epidemic leading the charge. Without addressing the root causes of the syndemic—poverty, systemic racism, and inadequate healthcare—Young warned that Black communities would continue to experience disproportionate harm.

During the event, Black By God Publisher Crystal Good and Folk Reporter Traci Phillips raised a pivotal question:

“Who is telling the story of how the opioid crisis has impacted the Black community in Central Appalachia?”

Rising Overdose Rates in Black Communities

Dr. Stephen Loyd, head of the state’s Office of Drug Control Policy, emphasized that while overdose deaths in West Virginia have decreased overall, Black communities have not benefited from the same progress.

“Overdose numbers have gone down 30% month over month from January to June, except for one group—and that’s Blacks. And they’re going up,” Loyd said.

He also highlighted systemic inequities in addiction treatment, noting that access for people of color is significantly lower than for White populations.

“There’s one in ten people [in the U.S.] who get help for addiction. If you compare that to diabetes and hypertension, the number is eight out of nine. But for people of color, I don’t think we really know it, but it’s got to be close to one in 30, one in 40,” he explained.

Reflecting on historical responses to addiction, Loyd drew attention to the stark disparities in how addiction crises have been addressed in the U.S.:
“During the crack epidemic in the 1980s, we took tanks and knocked down walls and arrested Black people because it was an inner-city problem. Now it’s opiates, and it started as a White issue, and we’re treated differently. We have to own that because I think it’s true.”

Systemic Neglect and Community Solutions

Bishop Robert L. Haley, III, founder of A More Excellent Life Center Church, addressed how systemic neglect and stigma contribute to barriers in addiction recovery for Black communities.

“We have young people… girls come to our church daily. And the majority are Whites,” Haley noted, highlighting the lack of representation and trust in recovery programs.

He pointed to deeply ingrained mistrust of healthcare systems as another hurdle: “The stigma of us asking for help—I think that’s not just a Black situation. I think that’s a West Virginia situation. Because people here grew up tough, just dealing with things, and not asking anybody for help.”

Haley emphasized the need for community-centered solutions, calling for direct engagement with those impacted: “You can’t sit in your office, and you can’t sit in a hospital, and think you can cure the problem. You gotta cure that in the community. You know, come on out, walk with us, talk to us.”

The Role of Data—and Its Gaps

Panelists agreed that accurate data is critical for addressing the syndemic. However, as highlighted in Caity Coyne’s article for West Virginia Watch, State, local leaders call for more education, data related to drug epidemic to bolster response, policies in the state hinder or harm reduction programs, reducing opportunities to build trust and offer care.

“If lawmakers aren’t educated on the realities of substance use disorder, they won’t fund the programs we need,” said Senator Takubo. “The only way to change that is through education and data.”

However, much of the existing data fails to reflect the lived experiences of Black Appalachians, leaving critical gaps in understanding and addressing the crisis effectively.

A Missing Narrative

While overdose deaths in West Virginia have decreased overall, data from the WV DHHR reveals a contrasting trend for Black communities. Overdose death rates among Black Appalachians are rising at a concerning rate, even as rates among White populations decline.

This disparity is rarely reflected in public conversations or media coverage. Headlines such as “West Virginia Sees Major Decline in Opioid Overdose Deaths” often fail to account for the nuanced realities of Black communities, where the crisis continues to deepen.

The town hall underscored the urgency of systemic change to address the opioid crisis and its intersecting impacts on Black communities. Panelists emphasized that targeted interventions, better data, and community-centered approaches are essential to combating these crises effectively.

References

• Caity Coyne, West Virginia Watch: State, local leaders call for more education, data related to drug epidemic to bolster response
• WV DHHR, Fatal Overdoses Key Drugs and Demographics Report, 2024