Over the past six years, Baltimore has endured one of America’s deadliest drug epidemics. Fatal overdoses have fallen surprisingly hard on one group: Black men currently in their mid-50s to early 70s.

While just 7 percent of the city’s population, they account for nearly 30 percent of drug fatalities — a death rate 20 times that of the rest of the country.

An examination by The New York Times and The Baltimore Banner — drawing on previously undisclosed autopsy records, more than 100 interviews and a novel data analysis — revealed the impact on these men, who make up part of a little-recognized lost generation.

Black men born from 1951 to 1970 are dying of overdoses in Baltimore at an extremely high rate — and have been for decades.

More than 4,000 have been killed since 1993 amid waves of drugs: first heroin and crack cocaine, then prescription opioids and now fentanyl — the deadliest drug threat America has ever seen.

Though startling numbers of older white men and Black women died as well, this group’s fatal overdoses have elevated Baltimore’s rate far above other cities’.

Today, the introduction of fentanyl into the city’s drug supply has driven the death rate to new heights. Black people of this generation are more likely to die of overdoses than cancer or Covid at the height of the pandemic; drugs are essentially tied with heart disease for their top killer. “I can’t think of another situation like this,” said Robert Anderson, chief of statistical analysis and surveillance at the Centers for Disease Control and Prevention.

A generation devastated by drugs

People born between 1951 and

1970 have fatally overdosed at

the highest rates in Baltimore.

800 deaths per 100,000

600

BORN

BETWEEN:

1951-

1970

400

1971-

1990

200

All

1991-

2010

1931-

1950

1993

2022

Within that generation, Black men have

far exceeded other demographic groups.

800

Black

men

600

400

White

men

Black

women

200

White

women

1993

2022

800 deaths per 100,000

Black

men

People born between 1951 and

1970 have fatally overdosed at

the highest rates in Baltimore.

Within that generation,

Black men have far exceeded

other demographic groups.

600

BORN

BETWEEN:

1951-

1970

400

White

men

1971-

1990

Black

women

200

All

White

women

1991-

2010

1931-

1950

1993

2022

1993

2022

Source: Centers for Disease Control and Prevention • By Molly Cook Escobar/The New York Times

Drug deaths among Baltimore's Black men

This chart shows decades of fatal overdoes among

Black men in Baltimore, with those born between

1951 and 1970 highlighted in dark purple.

118 out of

155 total deaths

1993

23

42

Ages

1994

1995

1996

1997

1998

1999

2000

30

49

Ages

As they got older, the bulk of the city’s

overdose victims aged with them.

2001

2002

2003

2004

2005

2006

2007

Ages

56

37

In the mid-2000s, fatal drug overdoses

dropped to an all-time low. But men of

this age still died the most.

2008

2009

2010

2011

2012

2013

43

62

Ages

In 2013, as these men entered middle age,

fentanyl began making Baltimore’s drug

supply more addictive and extremely deadly.

2014

2015

2016

2017

2018

2019

2020

2021

277 out of

465 total deaths

2022

52

71

Ages

By 2022, as these men were in their

early 50s to early 70s, they were dying

in tremendous numbers.

This chart shows decades of fatal overdoses among Black men in Baltimore, with those born between 1951 and 1970 highlighted in dark purple.

118 out of

155 total deaths

1993

42

23

Ages

1994

1995

1996

1997

1998

1999

2000

30

49

Ages

As they got older, the bulk of the city's overdose victims aged with them.

2001

2002

2003

2004

2005

2006

2007

56

37

Ages

In the mid-2000s, fatal drug overdoses dropped to an

all-time low. But men of this age still died the most.

2008

2009

2010

2011

2012

2013

43

62

Ages

In 2013, as these men entered middle age, fentanyl began making

Baltimore’s drug supply more addictive and extremely deadly.

2014

2015

2016

2017

2018

2019

2020

2021

277 out of

465 total deaths

2022

52

71

Ages

By 2022, as these men were in their early 50s to early 70s,

they were dying in tremendous numbers.

Chart shows two-year rolling averages. Drug overdoses for those under 15 years of age and older than 90 are not shown.
Source: Centers for Disease Control and Prevention • Molly Cook Escobar, Scott Reinhard and Nick Thieme

Many of those men now live in subsidized apartments for seniors that residents say are awash in drugs.

Lonely grandparents and retirees who have been fighting their addiction for decades are suddenly surrounded by illicit temptations, in buildings where buying drugs can be as easy as walking down the hall. The number of deaths shot up during the pandemic.

At least 31 of the 50 addresses where people have fatally overdosed in Baltimore most often since 2018 are advertised as senior housing complexes. More than 340 people over 50 have died in those buildings.

This information comes from previously undisclosed autopsy records that became public only after The Banner won a lawsuit against the state’s Chief Medical Examiner’s Office.

“I feel like I work at the morgue sometimes,” said Larnell Robinson, tenant council president of Rosemont Tower, where 15 people over 50 have died from overdoses since 2018.

Their lives were shaped by forces that have animated the city’s drug crisis for decades.

Half a century ago, manufacturing jobs began disappearing in an industrial city where Black families had few other opportunities to build wealth. By 1980, nearly half of Baltimore’s Black men under the age of 30 were out of work — a level similar to Black unemployment during the Great Depression.

At the same time, an influx of highly addictive illegal drugs created a lucrative but corrosive shadow economy. Some young people turned to dealing drugs and then using them. Many were arrested and incarcerated, never finding jobs that let them move ahead.

Mayor Brandon Scott said in an interview that the causes of disparities in overdoses were apparent to him. When Black men are “denied jobs, denied good education, denied the opportunity to be trained in any of the places that other folks are working, this is what you get,” he said.

“As a Black man who lives in Baltimore, I know, because we’ve seen it our whole lives,” he added.

There have been few targeted efforts to help older Black men.

The city has concentrated its drug education efforts on the young, and the battle against overdoses in senior buildings has largely been left to people with little expertise — a nonprofit program coordinator here, an apartment manager there.

City health officials said they had taken steps to address the issue, including training residents at more than a dozen senior apartments to use naloxone, the generic name for Narcan. In an interview, Mr. Scott said the city’s efforts did not target any particular demographic group but served large numbers of older Black people because they were most affected by addiction.

The city also said it had been examining deaths in senior buildings and overdose data related to older adults for a year and a half. The state Health Department said that it had awarded a $30,000 grant to hire recovery specialists for one of the city’s hardest-hit senior buildings, and that it would support more related studies and programs in the future.

Managers at some buildings have sought out funding on their own and are trying to stem overdoses with new initiatives, such as converting a game room into an office where addiction specialists work full time.

This comes amid an overdose crisis of unprecedented proportions in Baltimore.

Last week, The Times and The Banner reported that Baltimore had become the epicenter of the worst drug crisis ever seen in a major American city. The city’s death rate from 2018 to 2022 was nearly double that of any other large city — a fact not known by several top leaders, including the mayor and the deputy mayor, who used to lead the city’s Health Department.

The city once had an aggressive overdose prevention strategy, but as officials became preoccupied with other crises, many of their efforts stalled.

Read those takeaways.

An earlier version of a chart in this article incorrectly indicated the overdose death rates in Baltimore for members of four generations. The rates were somewhat elevated. For instance, for those born from 1951 to 1970, the rate in 2022 was 373 deaths per 100,000 people, not 414 deaths per 100,000 people.