“Opioid Crisis” vs “War on Drugs”

According to the Kaiser Family Foundation around 33,000 died from overdosing on opioids in 2015; the New York Times estimated it at 60,000. New Hampshire and West Virginia are among the states with the highest per capita opioid death rates. In July 2017, FDA Director Scott Gottlieb wrote that opioid addiction had become “FDA’s biggest crisis”. CDC Director Thomas Frieden said that “America is awash in opioids; urgent action is critical”. The opioid crisis is mostly prevalent among the lower middle class, working class and rural poor whites. The great recession seems to have had a significant impact on the psyche and drug dependency of a very vital part of our nation creating a massive public health crisis.

The U.S. government has been working on several counter measures to present, manage and treat the opioid abuse. In 2010, the U.S. government began cracking down on pharmacists and doctors who over prescribed opioid pain killers. In June 2017, Ohio’s Attorney General Mike DeWine filed a lawsuit against a handful of pharmaceutical companies including Purdue Pharma, Teva and Johnson & Johnson accusing them of spending millions of a marketing campaign to “trivialize the risks of opioids while over stating the benefits of using them for chronic pain.”

In July 2016, President Obama signed into law the Comprehensive Addiction and Recovery Act for opioid addiction treatment, and authorized millions of dollars in new funding for opioid research and treatment. In December 2016, the 21st Century Cures Act passed with wide bi-partisan support (94-5 in the Senate and 392-26 in the House) and included $1 billion in state funds to fight the opioid epidemic. There have been significant actions at the state and local levels to deal with the opioid crisis. It will be quite surprising if the new healthcare bill and the budget does not include significant funding to combat the opioid epidemic.

How does one answer the African American population that is cynical that all of these activities were motivated by the fact that the opioid crisis is a white problem? The opioid epidemic is indeed disproportionately a white phenomenon. In 2015 according to the data from the Kaiser Family Foundation, 83.8% of those who died of an opioid were white. Some claim that over the past decade, those affected by opioid addiction was 90% white.  African Americans are significantly less likely to be prescribed opioids to treat pain than whites, and this disparity persists even when the numbers are adjusted for socio-economic variables such as income, and even in emergency rooms.

While 33,000 people died from overdosing on opioids in 2015, the crack epidemic in the late 1980s, killed around 94,000 per year. Drug, especially crack cocaine, abuse in the 1980s and 90s was predominantly an African American problem. The reasons for this abuse may have been very similar to the opioid abuse of the recent decade: joblessness, loss of self esteem due to job loss, societal and economic marginalization. The easy reaction to their depressed condition was for many to get into cheap heroin and crack cocaine. Of course then the country reacted by declaring “war” on drugs.

The crack cocaine epidemic resulted in militarized policing of mostly minority communities. Police and para-military forces armed with assault weapons and tactical training from special forces were used to “pacify” neighborhoods suspected of being either buyers or sellers in the crack cocaine “trade”. The federal government responded even more harshly, issuing a discriminatory “100 to 1” decree for the possession or trafficking of crack versus the penalties for trafficking of powder cocaine; this stood for nearly 3 decades, until 2010, when the Fair Sentencing Act cut the sentencing disparity to 18:1. Someone convicted in federal court of possession of 5 grams of crack cocaine received a minimum mandatory sentence of 5 years in prison, compared to less than a year for powder cocaine.

In 1980, about 41,000 people were incarcerated for drug crimes, according to the Sentencing Project. In 2014, that number was about 488,400 — a 1,000 percent increase. As Fareed Zakaria wrote in Time “Drug convictions went from 15 inmates per 100,000 adults in 1980 to 148 in 1996, an almost tenfold increase.” In 1996, approximately 60% of inmates incarcerated in the US were sentenced on drug charges; around 80% of those convicted on crack cocaine were black, 10% were Hispanic, and only 10% were white. In 2009 alone, 1.66 million Americans were arrested on drug charges, more than were arrested on assault or larceny charges. And 4 of 5 of those arrests were simply for possession.

Throughout the crack cocaine epidemic, there was was little or no discussion of the crisis being brought on by economic despair, or that it was a public health issue, or that the users needed rehabilitation. The social upheaval caused by the drug war against the minorities and their families has had deep and significant effects. One would even suspect that the slow down of social and economic progress of the African American community since the early 1990s could be attributed to the violent reaction of the U.S. government to the drug crisis which sent away many young women and mostly men to languish in prison. These very people could have been productive members of society and helped the economic and social well being of their families. What a waste!

As Michael Eric Dyson said in a February 2017 appearance at the University of Memphis, “White brothers and sisters have been medicalized in terms of trauma and addiction. Black and brown people have been criminalized for their trauma and addiction.” It would be inhumane in the extreme and certainly hypocritical if the United States was to treat the white opioid crisis as though it was a public health issue, and not have an active plan to rehabilitate all those African American and minority lost souls who were equally addicted to cheap drugs by letting them waste away in prison.

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