By Kyli Rodriguez-Cayro, Content Manager, Overdose Prevention Program
In 2024, the United States witnessed a decline in overdose deaths for the first time in five years—an estimated 25% decrease through October 2024, based on the most recent data available. While this overall trend is positive news, it is not experienced equally: Black and Indigenous communities across the country remain disproportionately affected by fatal overdose.
This pattern is reflected in the seven states where Vital Strategies’ Overdose Prevention team is currently working. For example, in North Carolina, overdose deaths declined by 27% overall from September 2023 to September 2024, but increased in Black communities. Similarly, fatal overdose in Kentucky fell by 10% in 2023, but increased by 5% among Black Kentuckians.
Vital Strategies interviewed Tracie M. Gardner, Executive Director of the National Black Harm Reduction Network, to learn more about the crucial role Black thought leaders play in overdose prevention and her plans for the organization.
Interview has been edited for clarity.
What are your thoughts on current and past approaches to drug use, especially criminalization approaches and efforts to increase those tactics? What would you like to see change?
Why would we regenerate a bunch of strategies that we know won’t work, and are almost always more expensive than the more community-based, non-coercive, voluntary and engaging work that we know works? Overall, our whole thinking is going to have to change about what we mean by substance use, what we even mean by safe supply, and this idea that people will use drugs, and they shouldn’t die because of that. All lives are of value; all lives are of critical value.
What is your vision for the Black Harm Reduction Network in this space? What work are you doing today, and what work do you see being necessary in Black communities, to have the impact that you hope for?
A lot of the work that we’re doing is just creating visibility for ourselves and answering the question, “Why do we need a National Black Harm Reduction Network?”
That has meant bringing the perspectives and experiences of Black communities in the overdose epidemic into conversations that are happening and that don’t include that perspective.
Whether it’s an opportunity to testify before the Congressional Black Caucus, or to work on increasing naloxone availability in Black communities with Vital Strategies, definitely a big element that’s been going on is people reaching out to us looking for technical assistance, training, and how to work in Black communities in a way that’s respectful and sensitive. We get a lot of outreach from Black professionals who want to work in these communities but don’t know how to get plugged in.
Then we especially have people reaching out to us trying to find other places of support. That’s something, I think, that comes really close to my heart as the parent of two sons who are growing up in this time where we have to make sure they have Narcan and test strips, and understand all of these things, that this is the world that we’re in. This is part of their landscape. We want to be able to be a resource for families, and a conduit to the kinds of services and supports that Black families need.
Can you tell us a little bit about the history of harm reduction in Black communities in the United States, and what you see as the future of this movement?
Black Harm Reduction was distinctly started by Black people who were doing harm reduction work, and looked around and saw there weren’t that many other Black people doing it. They were in predominantly white settings, and the communities that needed the strategies were very suspicious and hostile to the interventions.
We know that this has a lot to do with how the message is delivered. It has to do with addressing the history of criminalization, and with the hypocrisy of white people using more drugs but Black people are more criminalized for their drug use.
We really see bridging the generational gap between the “OG’s” who’ve done such amazing work to establish Black harm reduction, because it’s not a new concept, and the young people who are coming into the work, who are questioning everything about drug policy, about health policy, about equity. They want to do this work because harm reduction is a natural approach to wanting people to be healthy, to be well, and to be respected in their dignity.
In late March, Vital Strategies and the National Black Harm Reduction Network teamed up to launch “You Have the Power to Save Lives,” a media campaign to promote knowledge, availability and utilization of the lifesaving overdose reversal medication naloxone in Black communities in the United States. The campaign, running in seven U.S. cities, features personal stories of community leaders themselves directly affected by overdose deaths and their powerful pleas to keep naloxone readily available.
Community and government partners in each city are expanding the availability of free naloxone, and the campaign website links to specific information for obtaining free naloxone in each city. Vital Strategies issued a data brief that looked at overdose disparities in the seven cities highlighted in the campaign.
To learn more about the National Black Harm Reduction Network, click here. Check out Vital Strategies’ past blogs about Black leaders in overdose prevention here and here.