In Reply Harris’s observations extend our research letter and provide evidence that is concordant with prior findings from our group. Previously, we found rates of unintentional opioid overdose mortality increasing faster among Black residents of Ohio compared with their White counterparts. We also found that experiences of racist mistreatment by health care workers are common among Black patients seeking addiction treatment and that a history of such experiences is related to medical mistrust, delay in seeking treatment for addiction, anticipation of racial discrimination during addiction treatment, and fear of discrimination-precipitated relapse. Further, it has been observed that the US addiction treatment workforce is predominantly White, and an increase in addiction treatment professionals of other races and ethnicities is needed. Taken together with Harris’s observations, we see that while rates of unintentional overdose are increasing among Black youths, systemic and interpersonal racism may limit their access to lifesaving treatment. Another barrier in accessible treatment for Black youths is the criminal justice system. Black youths may be more likely to find themselves in the criminal justice system owing to disproportionate drug enforcement in Black communities. This disproportionate criminalization of Black youth can place them on a path that potentially excludes them from treatment. Therefore, we must not only seek “a better understanding of the race-specific drivers of overdose,” as Harris suggests, but strive for immediate, substantive progress toward addiction treatment and prevention services that are equitable, just, and culturally informed.
Clinical Practice Guidelines