What About People Of Color Who Use Opioids?

As a young man, Joe L. of Wilmington, North Carolina, worked in construction and concrete in rural Brunswick County. At 22 years old he was injured in a work-related accident. Having no medical insurance, he sought opioid prescription pills in the street to manage his pain. His tolerance built and soon he switched to heroin. Today he is 37 years old and still struggles with heroin addiction.

Natalie C. of Knightdale, North Carolina, began using prescription pills in her early 20s. She used them recreationally for years, mostly on weekends to unwind and have fun. After a bad breakup with a boyfriend, her pill use escalated to daily. When she couldn’t afford her increasing reliance on pills, she switched to heroin at 24 years old – initially snorting it, then injecting. After six months she sought treatment from Southlight methadone clinic in Raleigh. She is now 27 years old, still on methadone, and has not used illicit drugs in over a year.

Joe and Natalie echo the stories of millions of other Americans whose lives are impacted by opioid addiction. But there is one thing that sets them apart from most of the stories depicted in the media: Joe is a black man and Natalie is Hispanic.

We keep hearing about how the opioid epidemic is devastating white communities. Most of the media stories revolve around white high school honor students and athletes who were prescribed pills after an injury, or rural white blue-collar workers addicted to heroin, or white veterans returning home from the war to self-medicate. It is rare to see a story that focuses on people of color.

It is true that white people use opioids at higher rates than people of color. Eighty-two percent of the people who died of opioid overdose in 2015 were white. That might seem to make a solid case for why the media, policy makers and treatment providers focus so much on white communities. But that 82% is misleading. The number is high because the percentage of white people in the population is high. If you look at the rate of deaths per 100,000 broken down by race, the numbers are quite different. According to the Centers for Disease Control, from 2010-2014 the percentage increase in rate of death from opioids per 100,000 was 267% among whites, while it was 213% among blacks and 137% among Hispanics. Each of these communities has seen significant rises in opioid overdose death during the past few years, though you wouldn’t know it from watching the news.

Additionally, the age-adjusted rate of opioid overdose deaths per 100,000 in 2015 was 13.9 for whites, 6.6 for blacks and 4.6 for Hispanics. So yes, white people are dying more, but only at about twice the rate of black people and three times the rate of Hispanics, which again does not reflect the overwhelmingly white stories portrayed by the media.

The disparities in media portrayal of the faces of drug addiction can have a negative effect on communities of color who are using.

“When the media talks about white people using drugs they say [addiction] is a disease and we need naloxone to save people, but when they show a black or Hispanic person they will often call them a criminal or a thug,” says Natalie.

Tyra F., a 46-year-old black woman from Durham who uses heroin, says, “When law enforcement see a black person doing heroin they want to search that person or arrest them, but if they see white person sometimes they let them off easier or try to get them treatment.”

There is real anger in communities of color over the drastic differences in how policymakers, law enforcement, the medical community and others are handling opioid addiction as opposed to the crack cocaine crisis a few decades ago. Still, they feel some hope that harm reduction techniques and a more health-centered approach to drug policy are starting to permeate the culture.

“I think people are starting to realize that addiction is a disease,” says Natalie. “If someone gets cancer because they were smoking cigarettes, we don’t judge them the same way we judge drug users who overdose or get hepatitis.”

Tyra says that communities need to have more opportunities to sit down and discuss disparities in how opioid users of different races are portrayed and also to talk about solutions.

“We should make methadone clinics free to whoever needs them,” she says. “I want to stop using heroin. I want to go to a methadone clinic, but I can’t afford it.”

The opioid epidemic and the new emphasis on treatment, prevention, and compassion has bred some optimism that drug policy can turn towards a more health-centered approach. But if we continue to classify drugs along race lines and treat users differently, then we have made no progress at all. It is imperative that the public health gains in recent years remain permanent and that we do not allow ourselves to be scared back into the lock’em up tactics of years past. The opioid problem will eventually go away and another drug crisis will take its place. We should be prepared to treat that new group of users, regardless of their race, with the same evidence-based, all-hands-on-deck approach that we have brought to opioid users.

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