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It’s notable how this kind of coverage emphasizes the humanity of opioid users. Phrases like “introduced to,” “caused by” and “fell into” are increasingly used to describe pathways to addiction, and we often hear the perspectives of loved ones who vouch for the lives of victims were before they became addicted. Something else stands out, too: It seems the majority of the victims whose stories have been told in recent years are white. This has led to journalists and others pointing out the stark contrast between the kind of compassionate treatment opioid users receive now and the contempt that dominated reports about the largely black victims of the crack epidemic of the 1980s and 1990s.
“The Gentrification of Addiction” read one headline in The Philadelphia Inquirer, “Why Is the Opioid Epidemic Overwhelmingly White?” asked NPR. Teen Vogue pointed out that “The Opioid Crisis Only Became a Crisis When It Affected White People.”
But the opioid epidemic is not entirely white — and it’s a mistake to characterize it that way, given how opioids are harming nonwhite communities.
According to statistics collected by the Kaiser Family Foundation, black people made up 12 percent of all opioid-related fatal overdose victims in 2017, with 5,513 deaths, more than double the number in 2015. (Non-Hispanic whites accounted for 78 percent of all victims — 37,113 deaths in total, a 37 percent increase from 2015 — and Hispanics 8 percent.)
Twelve percent may not seem like a lot, but it is roughly proportional to the number of African-Americans in the United States population as a whole. In some areas, most victims of fatal overdoses are black, as in the District of Columbia, where black people make up more than 80percent of opioid-related deaths. In Massachusetts, meanwhile, opioid death rates are going down for all other groups, but continue to rise for black people.
Dr. Tom Gilson, a medical examiner in Cuyahoga County, Ohio, told the Boston NPR affiliate WBUR that there was a “Fourteen-fold increase in fentanyl deaths among African-Americans” in three years; most of those deaths involved fentanyl mixed with cocaine. A recent studyfound that between 2012 and 2015, black men died from cocaine overdose at rates as high as white men who died from opioids during that period. If fentanyl-laced cocaine becomes more common, overdoses among black Americans could get much worse.
Native Americans have also been hit hard by the opioid crisis. According to the Centers for Disease Control and Prevention, between 1999 and 2015 Native Americans had the largest increase in overdose deaths compared to other groups. The C.D.C. also reported that in 2016, rates of prescription-opioid-related overdose were higher among both non-Hispanic whites and Native Americans than other groups. In response to this, several Native American tribes have filed lawsuitsagainst the manufacturers and distributors of prescription opioids.
Where the opioid crisis has affected nonwhite communities, the response has often been slow and inadequate. In Puerto Rico, before Hurricane Maria, there were 600 fentanyl-related overdoses and 60 deaths in 2017. There are no official statistics for the time after that, but those who work with drug users say they have seen an increase in overdoses since the hurricane. Puerto Rico has not applied for federal funding to tackle the opioid crisis, nor has it passed a law to allow the administration of the lifesaving overdose drug naloxone by nonmedical personnel.
Similarly, the District of Columbia has faced criticism for its slow response to overdose deaths, distributing naloxone at a lower rate than other cities and failing to establish addiction treatment programs.
In cities like New York, access to addiction treatment can be segregated by income and race: low-income Latino and black users often have to travel far from home to get methadone from clinics, while more affluent white patients can afford to get prescriptions of newer drugs used to treat addiction, like buprenorphine, from private doctors. A 2016 study found that rates of buprenorphine use increased the most in areas with higher incomes and low percentages of black and Latino people.
Labeling the opioid crisis as “white” risks overlooking the very real damage experienced by black, Latino and Native American communities. This is not a call to ignore the wrongs of the past. We should continue to scrutinize how attitudes toward drug users seem to change depending on the racial identity of the people whose stories the media tells.
But this crisis is a reminder that anyone can become addicted to drugs. Our empathy should not be conditional
The gentrification of addiction: Now that whites are addicted, the language of shame has changed | Solomon Jones