It seems like everywhere we turn these days, screaming headlines declare our nation to be under siege by what has been deemed the “opioid epidemic.” If you tune in and listen to the chatter, the popular narrative is almost always certain to include blurbs such as the following:
Hannah was a good kid...not the type of kid who would ever use drugs. Straight A student. Star of the soccer team. Babysat the neighbor’s kids. Bright future. If it weren’t for her doctor irresponsibly prescribing painkillers for a soccer injury and those damn pharmaceutical companies getting rich off of it, she never would have wound up using heroin.”
While this popular narrative would have you believing that the sole cause of increased opioid use disorders and subsequent opioid-related overdose deaths among white Americans is that lots of us white folks were innocent victims of bad pharmaceutical companies and irresponsible doctors overprescribing to us for pain, it is simply not true. Is it convenient to tell the tale from this lens? Yes, absolutely. But is it our truth? No, it is not the truth for the overwhelming majority of us.
The overwhelming majority of us, myself included, developed an opioid use disorder not as the result of being prescribed opioids for treating physical pain but instead through our nonmedical use of opioids, often obtained illegally, for the purpose of feeling good and/or relieving psychological and emotional pain. In other words, we used opioids to “get high.” We got them from our family members and friends, and if they didn’t give them to us willingly, some of us stole them from our family members and friends. We bought them on the street in the illicit market. The fact is that most people who are prescribed opioid medications for physical pain do not develop an opioid use disorder - they are taking these medications to treat pain and they are not the bulk of us who go on to transition to heroin use. A number of articles been have written on this reality and links to a few of those articles will be posted below. For the purpose of this article however, I want to instead focus on the why behind the lie — why are white Americans lying to ourselves and each other about what is behind our increased opioid use? Why, if we know that it was our illicit use of opioids that was the root of the problem for most of us, why do we fail to talk about that? I also want to focus on the harm being caused by this lie — what are the collateral consequences of our collective inability to face and tell our opioid use truth? Who is being harmed by this utterly false narrative surrounding the opioid epidemic? Who are we killing by our failure to be honest here?
Understandably, there is far less shame in the white lie, hereafter referred to as the white-washed tale of the opioid epidemic. There is far less shame in narrating Little Hannah as an innocent victim of bad pharmaceutical companies and irresponsible doctors than there is in owning the reality that Little Hannah used drugs to get high. To admit that Little Hannah is just like “those people” who use drugs is a pretty hefty admission for many of us white folks to make. For one, we then have to look at how we dehumanized and criminalized “those people” for nearly 50 years with the devastatingly harmful, misguided and racist War on Drugs. We have to reckon with how we locked “those people” up, stripped them of full citizenship, denied them equal rights in society, and in nearly every possible way, othered them as different than us. Drug users have long been a highly marginalized and stigmatized group in society, but when race became a part of the equation in terms of who was targeted by the War on Drugs, drug users came to be synonymous in the white America consciousness with black and brown people. White America has long been unable to see black and brown people as the same as them. Little Hannah can’t possibly be the same as “those people,” and gasp!, Little Hannah surely doesn’t deserve to be thrown in jail! So instead of telling our truth that Little Hannah is in fact just like “those people” who use drugs to get high, and that if Little Hannah doesn’t deserve to be treated like “those people” have been treated, then maybe we were terribly wrong for having treated “those people” that way - instead of telling our truth and reckoning with our guilt, shame and discomfort, we white-wash the whole thing. We come up with a convenient tale that washes our hands of all of it - we are both not drug users like “those people” and we don’t have to face up to what we have been doing to “those people.”
Unfortunately, our white-washing of white America’s binge on opioids has implications that extend far beyond our being dishonest with ourselves and each other. For one, by white-washing the opioid epidemic narrative, we are robbing ourselves of the opportunity to identify real solutions. We instead are chasing policy and practice changes that are only solutions for the lie and thus will inevitably be ineffective. People living with an opioid use disorder are continuing to die preventable opioid-related overdose deaths at an increasing rate. Our fake solutions tied to a fake narrative aren’t helping anybody. Second, we are continuing to cause harm by allowing the War on Drugs to continue being waged on black and brown people while also failing to atone for the harm it has already caused. By white-washing the opioid epidemic in a way that paints us white folks as innocent victims, we have created a parallel group of drug users in this country that acts as the “deserving” group. This deserving group is privy to a more compassionate response to drug use, is given greater access to treatment and recovery support services, is privileged to be open about their recovery status and not face societal consequences - all while our black and brown brothers and sisters remain in the undeserving drug user group, denied access to these very same things. By separating ourselves as “different” drug users than “those people,” we are continuing to cause tremendous harm to people of color. And lastly, people living with chronic pain are being harmed. People who have been taking opioid medications for chronic pain conditions are now being stigmatized as “addicts,” being too quickly titrated off of opioid medications or abruptly kicked off of them without connections to other effective pain management strategies, and are often struggling to find physicians who are willing to treat them in today’s opioid climate. People living with chronic pain are suffering as a result of some of the policies and practices that are being built off of the lie and sadly, many are turning to suicide as the only option for relief. It is not overly-dramatic to say this: our white lie, our white-washing of white America’s opioid binge, is leaving behind, harming and killing people. It is time we get honest with ourselves. It is time we stop causing harm with our lie and start facing up to our truth, white America.
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