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Abstract

Black and homeless people who struggle with substance use disorder (SUD), especially opioid use disorder (OUD), have experienced unique obstacles due to inequalities relating to their social determinants of health (SDOH). Historical context and peer-reviewed research were used to evaluate racial bias and expand upon the factors that contributed to the opioid crisis, the effects of COVID-19 on drug overdoses, and the presence of fentanyl in illicit drug supplies. Various studies combat the stigma surrounding substance use disorder (SUD) by acknowledging the disease as a chronic health condition. Research showed that the most effective way to combat these inequalities and reduce the number of overdoses in the United States involved a mixture of decriminalization of possession and use of drugs, legalization and regulation of safe supply, and various harm reduction techniques such as naloxone, naltrexone, and safe consumption sites (SCS). The effects of reforming drug classification as it relates to the justice system, education surrounding racial bias in the medical field, and the implementation of education programs to combat stigma and misinformation surrounding drug usage are suggested areas for further research.

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