Since the early 20th century, the topic of race and addiction has been a part of the public health conversation and, as the 20th century gave way to the 21st, how people bought and sold drugs changed, and how people understood race and demographics also changed.
What has not changed, according to americanaddictioncenters.org, is the danger of drugs.
Even as more information surfaces about the deadly influence of drugs across different sections of society, there’s a constant reminder that drugs, and the market behind them, do not discriminate.
Yet, the opioid crisis engulfing the nation has focused predominately on white users from suburbia and middle-class America.
Painkillers like oxycontin and Percocet have been the primary culprits along with the very deadly fentanyl.
But, the precursor to those has been heroin, which has made a terrifying comeback.
“While heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the last decade were white,” said Glenn Ellis, a health advocacy communications specialist.
“But the epidemic has also been seeping into communities of color, where heroin overdose death rates have more than doubled among African-Americans, but gone largely overlooked by the media,” Ellis noted in an editorial.
The heroin epidemic in the African-American community is distinct for another reason in that they’re less likely to come to the drug through opioids.
Many studies have shown that doctors are less likely to prescribe opioid painkillers to Blacks than whites, even young children, for the same ailments.
However, heroin has claimed the lives of African-Americans long before pain pills.
Prominent African-Americans like the legendary Billie Holiday and Charlie Parker, whose death led to headlines like, “Charlie Parker’s Heroin Addiction Made him a Genius,” have succumbed to heroin and drug abuse.
Also, the deaths of Jimi Hendrix, Whitney Houston, Michael Jackson and Prince all included elements of abusing prescription pain medication.
“I don’t hear it get talked about and many people are suspicious about that explanation for Prince’s death. Furthermore, there remains so much stigma and ignorance around the disease of addiction,” said Dr. Nina T. Harawa, associate professor of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA.
The recent crisis has most dramatically affected white communities and stemmed from interactions with medical systems. For economic and policy reasons, it has often been centered in white working-class communities, Harawa said.
The face of this crisis in the news, promoted by government institutions and promoted through media outlets has often been white, she said.
“The infamous articles discussing unprecedented increases in death and declines in life expectancy associated with the opioid epidemic focused on whites not Blacks,” Harawa said.
Fortunately, the opioid epidemic hasn’t hit African-American communities at the same alarming rates at whites, but that does not mean it can’t or isn’t harming Blacks, she said.
In the last 16 years, more than 183,000 Americans have died from overdoses related to prescription opioids, according to the Centers for Disease Control and Prevention.
Fatal overdoses involving so-called “natural,” “semi-synthetic,” and “synthetic” opioids (morphine, oxycodone, methadone) all fell between 2010 and 2015, but the percentage of fatal overdoses involving heroin tripled.
More specifically, in 2010, 29 percent of fatal overdoses involved so-called “natural” and “semisynthetic” opioids, while only about 12 percent involved methadone, a “synthetic” opioid.
Five years later, the percentage of fatal overdoses involving these drugs fell to 24 percent and 6 percent, respectively.
In contrast, fatal overdoses involving heroin reportedly skyrocketed from 8 percent in 2010 to 25 percent in 2015 – essentially tripling.
In 2015, 27,056 white people died of overdose, compared to a combined 5,248 deaths for Blacks and Hispanics. There were more than five times as many opioid deaths for whites in 2015 than for all other races combined.
Various states have and continue to map out plans to attack the crisis.
For instance, in Maryland, the state announced a plan to spend more than $22 million to fight the epidemic, with 80 percent going to 24 local jurisdictions and service providers to fund prevention, enforcement, and treatment efforts.
In Ohio, overdose deaths reportedly have been on the rise particularly in Cuyahoga County, which includes predominately Black Cleveland. Fentanyl-related deaths among African-Americans there rose almost 900 percent between 2014 and 2016.
“We have to find a way to get some control over the sales of fentanyl and find out where it’s coming from,” said U.S. Rep. Marcia Fudge, D-Ohio.
The number of individuals who admit having used an illicit drug rose from 31.3 percent in 1979 to 48.8 percent in 2015 and the 469,545 incarcerated for drug offenses in 2015 proved 11 times more than in 1980.
Moreover, U.S. taxpayers spent about $327 billion on drug control efforts from 2013 to 2016, according to WalletHub, the District-based personal finance website.
Complicating matters, the current Trump administration has sent mixed messages about how seriously it takes the problem, WalletHub analysis said.
On the one hand, President Trump established a commission to study the opioid epidemic. On the other, the administration has proposed cutting the Office of National Drug Control Policy’s budget by 95 percent and classifying addiction as a preexisting condition.
“The opioid addiction among whites is given a legitimacy that heroin addiction among Blacks never had,” said Naomi Zack, a professor in the Philosophy Department at the University of Oregon.
“I think that African-Americans already know a lot about street drugs and what to avoid. They use doctors less frequently than whites and studies show they are, for discriminatory reasons, under-medicated for pain. This could be a blessing in disguise,” Zack said.
In the present political climate, the best approach would be to combine efforts among different racial communities as much as possible, to lessen opioid addiction, she said.
“This is difficult to do in primarily white rural areas, but it may be more possible in cities. Indeed, in some urban areas, opioid issues as medically addressed and as subjects for public health practitioners are already well-integrated,” Zack said.