By the year 2000, pharmaceutical companies had convinced medical professionals across the United States that opioid analgesics - a highly potent painkiller that successfully marketed itself as a therapeutic drug in the late 1990s - would not deleteriously affect the mental stability of patients, nor make them overly dependent on the relief it provided (Meier). After years of tense debate on whether the spreading of this misinformation was deliberate, all controversy would be put to rest when thorough investigations into Purdue Pharma, the leading pharmaceutical company and birthplace of this myth, was confirmed to “know of the significant abuse of OxyContin - [their opioid product] - soon after it came on the market” and continued misadvertising their product for profit (Meier).
Subsequent to the normalization of opioid prescription in healthcare, America would experience a wave of drug-related deaths that can be attributed to the overprescription and consumption of what the public believed to be a revolutionary substitute for anesthetics. While much is needed to be said here on the fundamental cracks in America’s contemporary healthcare system that facilitated such susceptibility to the shortcomings of capitalism, the primary objective of this review is to assess the effects that this ‘opioid epidemic’ has had - not on American residents as a whole, but specifically on one of the many racial demographics most disproportionately affected by this health crisis: Black Americans. While this assertion may, understandably, sound counterintuitive - given that Black Americans exhibit a lower opioid death rate than our white counterparts, the assertion is only counterintuitive if you are solely investigating the direct effects of opioid overprescription rather than assessing how the consequences of opioid consumption in marginalized communities can interact with other societal obstacles these communities already face.
One of the biggest burdens in the Black community that the opioid epidemic has further exhausted is the issue of mass incarceration: the staggering increase in federal and local prison populations that many young Americans now understand to be a reinvention of racial segregation, given the disproportionate arrests that Black Americans experience in the 21st century. The inception of such draconian sentencing started with Richard Nixon’s “War on Drugs,” which - although once advertised as a mission to protect America against the dangers of drug abuse - is now ubiquitously known by Black Americans to be a direct attack on their assimilation into the U.S. (Drug Policy Alliance). This conclusion was confirmed in a 1994 interview with Nixon’s head of domestic policy, John Ehrlichman, where Ehrlichman confessed: “We knew we couldn’t make it illegal to be either against the war or Blacks, but by getting the public to associate the hippies with marijuana and Blacks with heroin, and then criminalizing both heavily, we could disrupt those communities” (Lopez).
Even without the effects of Nixon’s drug war, Black Americans in the United States already have a harsh relationship with our criminal justice system. For general crime, Black Americans are up to “five times more likely to be stopped without just cause” than a caucasian American, with one in three Black males being incarcerated at least once in their lifetime, contrary to one in seventeen for white males (NAACP). Although contemporary conservative ideologies contributes this to the ‘behavior’ of Black Americans in contrast to white Americans, statistical evaluation of federal data indicates that Black Americans who have commited the exact same crime as a white American will not only be sent to prison at higher rates, but will, on average, be charged with a 20% longer sentence (United States Sentencing Commision).
This issue was disastrous enough for Black Americans without the input of our association with narcotics, but now given the criminal justice system’s implicit association of Black Americans with drug abuse, it becomes easier to understand how the recent increase of opioid prescription in Black communities has led to nonsensical rises in Black people’s incarceration for drug possession. Although Black Americans and white Americans consume these illicit drugs at similar rates, 10.5% and 9.5% respectively, Black Americans “comprise 62.5% of all drug offenders admitted to state prison” - with the addition of the aforementioned 20% longer sentencing (HRW).
This steady increase in opioid prescription and consequent incarceration of Black Americans has created irreversible damage to the Black community. As of 2016, one in nine Black children have at least one incarcerated parent, the vast majority of whom being ‘drug offenders,’ resulting in the further intentional dismantling of the already-broken Black household (Rutgers). By virtue of the economic and psychological strains of having a missing parent, Black children in a single-parent household are “more likely to drop out of school, exhibit behavioral problems, end up in the criminal justice system, and suffer unemployment” (Joiner). Although these effects of parental absence are most commonly employed in contemporary politics to falsely attribute all the hardships that Black children experience in America to ‘father absence,’ it’s no mistake that the dismantling of the Black household has been a recurring theme in American public policies since the Civil Rights Movement and is rarely discussed in good faith in contemporary public policy debates.
Mental Health Support
In addition to the Pandora’s Box that is mass incarceration, and its consequent effects on African American children, another lumbering issue that this opioid epidemic has exacerbated in the Black community is its lack of access to substance-use treatment, which is reflected in Black Americans experiencing a “38% increase in opioid deaths from 2018 to 2019, while the rates for other race and ethnic groups held steady or decreased” according to novel studies conducted by the American Journal of Public Health (NIH). This is largely due to implicit biases within the healthcare system, as well as socioeconomic factors that act as barriers to psychological therapy.
Since the 20th century, Black Americans have repeatedly experienced obstacles to equal mental health treatment from the psychiatric and therapeutic disciplines by virtue of previous and modern societal stigmas around Black Americans who exhibit even the slightest emotion. America’s first instance of this stems from the Civil Rights Era, in which Black Americans who exhibited symptoms of depression and anxiety were disproportionately diagnosed with schizophrenia, despite the fact that the majority of the depressive symptoms exhibited by these patients stemmed from poverty, social ostracism, and active persecution by political and social structures. Naturally, this resulted in differential access to mental health treatment between white Americans - whose mental illnesses were treated as mental illnesses - and Black Americans - whose mental illnesses were dismissed as psychosis (Metzl). Similar patterns can be seen in mental health facilities treating opioid addiction, with white Americans completing drug treatment at a rate of 52.1%, and Black Americans completing drug treatment at a rate of 46.3% - though the cause of this is estimated to be a mixture of implicit racial biases in the healthcare system, economic disparities preventing Black patients from affording care, & even being able to access these programs through America’s prejudiced criminal justice system (Brendan, Lê Cook). Consequently, not only has this opioid epidemic physically damaged the Black community, through the disproportionate imprisonment of Black Americans suffering from their newfound opioid addiction, but it has also managed to further suffocate the mental health of our community through further reinforcing Black Americans’ restrictive access to equal mental health treatment.
When tying the pieces together, much of this issue leads back to Purdue Pharma and its initial false advertisement of their heroin product - OxyContin - in the early 1990s. The public health crises they’ve caused have resulted in the deaths of nearly 400,000 Americans - and counting - since the start of the 21st century (Hoffmen and Benner). However, in August 2021, Purdue Pharma, led by the wealthy Sackler family, confessed to their false advertisement and agreed to pay 225 million for the damage they’ve done to America (Hoffmen and Benner). Moreover, current legislative discussions concenter on the amount of money that should be paid in addition to this, with current estimates being in the billions. After years of attempting to hold these individuals accountable for the damage they’ve done to various American communities, this payment marks a major event for underprivileged Americans - Black and otherwise - who’ve had their freedom, mental health, family members, and financial stability taken away from them as a consequence of this drug epidemic.
Mohamed Diagne is a 3rd Year student at the University of Virginia.
Meier, Barry. “Origins of an Epidemic: Purdue Pharma Knew Its Opioids Were Widely Abused.” The New York Times, The New York Times, 29 May 2018, https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxycontin.html.
“A Brief History of the Drug War.” Drug Policy Alliance, https://drugpolicy.org/issues/brief-history-drug-war.
Lopez, German. “Was Nixon's War on Drugs a Racially Motivated Crusade? It's a Bit More Complicated.” Vox, Vox, 29 Mar. 2016, https://www.vox.com/2016/3/29/11325750/nixon-war-on-drugs.
“Demographic Differences in Sentencing.” United States Sentencing Commission, 13 Jan. 2021, https://www.ussc.gov/research/research-reports/demographic-differences-sentencing.
HRW. “Vi. Racially Disproportionate Incarceration of Drug Offenders.” United States - Punishment and Prejudice: Racial Disparities in the War on Drugs, https://www.hrw.org/reports/2000/usa/Rcedrg00-04.htm.
Rutgers. Children and Families of the Incarcerated Fact Sheet. https://nrccfi.camden.rutgers.edu/files/nrccfi-fact-sheet-2014.pdf.
Joiner, Lottie. “How Absent Fathers Are Hurting African American Boys.” Center for Health Journalism, https://centerforhealthjournalism.org/resources/lessons/lessons-reporting-how-absent-fathers-are-hurting-african-american-boys.
Metzl, J.M. (2009). The protest psychosis: How Schizophrenia became a Black disease. Boston, MA: Beacon Press.
Saloner, Brendan, and Benjamin Lê Cook. “Blacks and Hispanics Are Less Likely than Whites to Complete Addiction Treatment, Largely Due to Socioeconomic Factors.” Health Affairs (Project Hope), U.S. National Library of Medicine, Jan. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570982/.