The current opioid crisis in the U.S. has been called a national public health emergency and the deadliest drug crisis in the nation’s history. Thousands of opioid-related overdose deaths have made law and health authorities stand up and take notice, and the death toll continues to rise.
“More than 64,000 Americans died from drug overdoses in 2016, according to the U.S. Centers for Disease Control and Prevention, and nearly two-thirds of these deaths (66 percent) involved a prescription or illicit opioid. In 2017, the numbers were even worse. An estimated 72,000 people in the U.S. died by drug overdose, which reflects a record rise of 10 percent,” The New York Times reports.
While this is hardly America’s first drug epidemic, it is one that’s gotten attention for reasons that have little to do with the unprecedented numbers of people dying. Those reasons involve race and social status.
Recent research published in the Annals of Internal Medicine reports that the rate of opioid-related overdose deaths among non-Hispanic white Americans is comparable to the rate of cocaine-related overdose deaths among African Americans. A news release about the research says, “While strategies to address prescription opioid and heroin overdoses remain critical for all racial/ethnic groups, prevention efforts focused on reducing cocaine-related deaths among the non-Hispanic black population are also needed.”
Though all racial and ethnic groups struggle with overdose, as this news release says, the responses they receive from public health and law enforcement officials are not the same, some say, particularly when it comes to white people and black people.
This criticism is not new. This view comes up again and again when the conversation turns to how the crack cocaine epidemic of the 1980s was handled versus today’s opioid crisis, which largely affects a significant number of non-African-Americans.
The disparities in response remain a sore spot. A headline on a recent PBS NewsHourreport perhaps sums up many people’s thoughts on the issue: “There was no wave of compassion when addicts were hooked on crack.”
The crack cocaine epidemic of the 1980s and 1990s ravished communities, destroyed lives, and put many on the path to an uncertain future. The absence of a strong public health response to crack use and addiction of that era has left many people in those communities numb and unsympathetic to the fact that today’s drug overdoses have now killed more people than car crashes, guns, and the peak period of the HIV/AIDS epidemic.
THE INTRODUCTION OF CRACK COCAINE AND THE AFTERMATH
The heroin epidemic that emerged in the 1960s started to fade in the late 1970s, but the use of cocaine became popular soon after. However, a surplus of cocaine in the U.S. meant falling prices for drug dealers, so they started to make a solid rock form of the drug that was mixed with ingredients such as baking soda or ammonia.
The new product could be broken into small chunks and smoked with a glass hand pipe or water pipe. The drug was called crack cocaine, a cheaper, highly addictive version of cocaine that is easy to make and easy for anyone to obtain, especially people who couldn’t afford the more expensive option.
By the time the 1980s and 1990s arrived, crack cocaine use had reached epidemic levels in largely black American communities in major U.S. cities and urban areas where crime and violence were widespread. As a Vox article notes, there were thousands of overdoses every year as a result. There also were “thousands more murders associated with the drug trade at the time,” the site writes. Instead of treating it as the public health emergency that it was, more laws were passed to fight the “war on drugs.”
Having an addiction was criminalized, observers say, and drug users and drug dealers were met with arrests and harsh prison sentences instead of compassion and understanding. This is also the era that introduced the terms “crackhead” and “crack baby,” furthering a negative view of people who struggled with drug dependence and addiction.
The crack cocaine epidemic started to dissipate by the late 1990s, but that’s about the time doctors started to prescribe prescription opioid medications to treat people with pain conditions. Many point to that time as the beginning of the opioid crisis we have today.
WHAT CAN BE LEARNED FROM BOTH EPIDEMICS?
While the disparity in responses to both health issues is widely recognized, there are similarities between the two events. Some even say today’s opioid crisis has its roots in the crack cocaine epidemic.
As we turn our attention to the future, what can be learned from the crack cocaine epidemic of the 1980s and 1990s and today’s opioid emergency?
LESSON 1 – PERCEPTION OF ADDICTION NEEDS TO CHANGE.
As the crack cocaine epidemic showed us, ostracizing people with addiction to get them to stop using does not work. Stigmatizing people with addiction does little to help them, and it may even discourage them from seeking treatment. Addiction has slowly gained acceptance as a medical condition overall, regardless of race and economic status. The stigma attached to addiction is slowly changing, too, in the public eye as well as in today’s criminal justice system.
LESSON 2 – CRIMINALIZING ADDICTION DOESN’T WORK.
Linking addiction to crime and arresting people with substance abuse issues haven’t worked in the past. Acknowledging it as a public health issue and treating it as such can help change how addiction is viewed. It also may get more people to consider getting help.
“We cannot arrest our way out of the heroin and opioid addiction crisis,” said Brian Moran, Virginia’s secretary of public safety and homeland security, said at a recent federal hearing, CBS News reports.
LESSON 3 – EFFECTIVE POLICIES ARE NEEDED TO COMBAT DRUG ABUSE AND ADDICTION.
Drug epidemics of yesterday and today also are similar in that they implore the nation’s leaders to create improved policies that address the use of controlled substances and the effects of drug abuse.
“With overdose rates for opioid-addicted whites and cocaine-addicted African Americans now at comparable rates, policymakers are faced with a chance to re-examine the social and cultural contours of U.S. drug policy,” Jared Keller of Pacific Magazinewrites. “Whether an administration built on law and order chooses to actually do something about it is another matter entirely.”
Keller highlights that 40 states and the District of Columbia have adopted “Good Samaritan” measures that offer immunity from arrest “when a person who is either experiencing an opiate-related overdose or observing one calls 911 for assistance or seeks medical attention,” so that’s a start.
STILL A LONG WAY TO GO
Reining in the nation’s current drug overdose problem will not be easy. According to a CBS Newsarticle, U.S. “health officials are fighting the current epidemic on three fronts: preventing overdose deaths, helping people recover from addiction, and preventing new addictions.”
With data indicating a downward trend in opioid misuse in adults younger than age 50, perhaps there’s some encouraging news on the first front, the article says. But on the other two fronts, the nation is still struggling to get a handle on matters despite an increase in awareness and funding for programs.
According to the article, “Deaths are still rising, and University of Pittsburgh researchers estimate as many as 300,000 will die from overdoses over the next five years.”
The lingering lesson from the crack cocaine crisis of the 1980s and ‘90s may be that immediate action and adequate response should be the goal.
“If the U.S. had responded to this crisis by investing in drug addiction treatment, there would be an infrastructure for dealing with such a crisis that could have endured to this day,” Vox reporter German Lopez, notes in the article titled, “The deadliness of the opioid epidemic has roots in America’s failed response to crack.”
“This may have prevented one of the biggest challenges in the current opioid crisis — that only about 10 percent of people with a drug use disorder get specialty treatment, according to a 2016 report from the surgeon general.”