Opioids and the Black Community
The opioid epidemic has been a significant point of discussion for political representatives on both sides of the aisle. Also, many others have highlighted the differences in policy approaches between the crack-cocaine epidemic in the 80s and the present-day opioid epidemic. The crack-cocaine epidemic was accompanied by a ‘get tough’ law-and-order approach. Here, the criminal justice system was used as the main instrument to combat drug abuse in black and brown communities. Today, however, there is a rallying cry among many voters for us to be less reliant on the criminal justice system and provide more public health opportunities to address opioid addiction. In fact, many law enforcement agencies today encourage or mandate their officers to attend NARCAN training to be better prepared when confronting opioid addiction.
We know that the different political and social approaches of crack-cocaine and opioid use has to do with race. Opioid addiction and overdose are heavily prevalent within white communities. In the United States, roughly 80% of overdose ‘victims’ are white Americans. Ironically, most of the opioid addictions are a result of whites having more access to health care. Doctors began to over-prescribe opioid medication, which led to higher rates of addiction in white communities. This prescription privilege led to an opioid epidemic. Doctors have a racial bias in pain assessment and are less likely to prescribe medication to people of color due to the perceived risk of abuse and pain tolerance.
More importantly, what has been missing from this conversation on opioids is the 20% of non-whites who suffer from opioid overdosing. Experts are concerned at the increasing rates of black and brown bodies who are dying from opioid use. Although white people are more likely to use opioids, black people are more likely to die from it. In one study examining these differences, the researchers found that in places like Chicago, “…Blacks make approximately 32% of the population, but they account for about half of all opioid deaths…In 2016, the rate of African American deaths was 56%, which was higher than Caucasians’ death rate from opioids.”
The very inequalities that can explain the disparity in usage are also the reason for the discrepancy in deaths. Black people are more likely to die from an overdose because of the systemic exclusion of healthcare resources. One study highlighted that even the type of treatments offered, such as methadone therapy, are burdensome for Medicaid patients and low-income communities. The article from Taylor and Jonathan Santoro states, “Additionally, even when access is available, non-white minorities utilize the services at half the rate of Caucasians due to the financial burden associated with overcoming multiple barriers. Further, methadone clinics must be visited on a daily basis to receive proper dosing, which can burden the patient (from both a logistical and economic perspective) and hinder adherence. Non-government funded opioid agonist clinics are more frequently located in areas of high income, further compounding the access to care for minorities who have lower socioeconomic status to Caucasians throughout the country.”
Most of the researchers discussing racial differences in opioid-related deaths claim that if black people have been left out of the discussion for opioid treatments, they will continue to die at high rates. Researchers, Keturah James and Ayana Jordan, argue that “federal and state governments should develop more culturally targeted programs to benefit Black communities in the opioid crisis. Such programs include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and the formal consideration of Black people’s interaction with the criminal justice system in designing treatment options.”
Politicians from Trump to Bernie Sanders have loudly stated the need to address the opioid epidemic. However, in that same vein, politicians from Trump to Bernie Sanders have not discussed the racial inequalities in opioid treatment. If political leaders continue to neglect the needs of substance abuse within black communities then those very communities will be left in the margins when policy changes are implemented. The opioid epidemic is very much a black issue, too. However, similar to how this epidemic began, I’m afraid that white pain gets healed, and black pain gets ignored.
Check out a recent episode where BhD discussed this topic!