In the 1970s and ’80s, doctors were wary of prescribing opioids. Physicians had long been taught that opioids were addictive by nature and should largely be avoided. However, a letter to the editor published in the New England Journal of Medicine Jan. 10, 1980 changed all of that. Titled “Addiction Rare In Patients Treated With Narcotics” and only eleven lines long, this letter ended up having a snowball effect that helped set off the opioid epidemic. Despite being filled with flaws, the letter was cited over 55 times more frequently than other letters to the editor in that same issue; over time, the prevailing school of thought became that opioids were not addictive, and by the early ’90s opioids were being prescribed by the millions.
Fast forward to today. Widespread abuse of opioids, including OxyContin, Percocet, Vicodin, and heroin, has skyrocketed in the U.S.. The epidemic has caused the deaths of around 64,000 Americans per year, surpassing the number killed by the Vietnam War.
The response to the recent opioid crisis has likely been the best the U.S. has seen, with President Donald Trump declaring a “health emergency” and calling for increased training for prescribers, enacting a federal initiative to pioneer non-addictive drugs, and suspending a rule that prevents Medicaid from funding many drug rehabilitation facilities. He did suggest an idea that was essentially the same concept as the “Just Say No” campaign by Nancy Reagan in response to the 1980s crack epidemic, which literally suggested just saying “no” to drugs and failed spectacularly; nonetheless, it was a step in the right direction.
Unfortunately, this step in the right direction is for all the wrong reasons. The opioid epidemic primarily affects white Americans, who account for around 82 percent of the epidemics deaths, according to the Center for Disease Control and Prevention. However, it has been treated differently than other drug epidemics. To quote Dr. Andrew Kolodny, an expert specializing in opioid policy research. “It’s good that we’re hearing it now. It’s too bad we didn’t hear it then.”
“Too bad” is a bit of an understatement, though.
When faced with a similar crisis during the crack cocaine epidemic in the 1980s, the response was nearly the opposite. Rather than being viewed as a health issue, it was labeled only as a criminal issue, with President Ronald Reagan declaring a “war on drugs” via a televised address. Weeks later, he enacted the first Anti-Drug Abuse Act with $1.7 billion in funding. Of the $1.7 billion allocated, approximately 86 percent went to law enforcement, prisons and interdiction, while 14 percent went to treatment, education and prevention. As a result of this, during the next two years drug use and sales increased, and social, legal and medical problems proliferated.
In this case, mandatory minimum sentencing laws meant that the government could effectively target specific groups via legislature. This was done during the earlier war on drugs in the 1960s, with President Richard Nixon’s domestic policy chief John Ehrlichman saying, “We knew we couldn’t make it illegal to be either against the war or black, 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.” Reagan’s war on drugs also targeted black people in devious ways, such as through his Anti-Drug Abuse Act of 1986. Because of the growing price of cocaine, crack became especially popular in low-income, primarily African-American communities, such as Harlem. The popularity of crack was largely due to that fact that it was cheap, so while it grew among primarily poor, black communities, powder cocaine was still popular in upper-class white areas. So in order to capitalize on this, the act mandated a minimum sentence of five years without parole for possession of five grams of crack cocaine, while only giving that same sentence for having 100 times the amount of that in powder cocaine. This sentencing was only changed in 2010 with the Fair Sentencing Act, but drug arrest rates have perfectly illustrated the effect of the act since its inception; from 1980 to 2010, the drug-arrest rate among black people rose from 6.5 to 29.1 per 1,000 people, while the white drug-arrest rate rose only from 3.5 to 4.6 per 1,000 people, per The Sentencing Project.
The solution to many of these issues are as straightforward as they seem: make drugs a health issue, not a criminal issue. Although I’m not suggesting to make all drugs legal, addiction needs to stop being treated as an issue that is purely the user’s fault. Fifty to 70 percent of people with substance abuse problems also suffer from depression, post-traumatic stress disorder or other mental health disorders, according to John Renner, president of the American Academy of Addiction Psychiatry. For this reason, it’s incredibly unfair to place the blame on drug users themselves. The only reasonable solution is to help build the resources that these individuals need instead of further devastating those in a situation that is already horrific. One would think the opioid epidemic would make legislators realize that the cause of this problem isn’t necessarily rooted in the users’ poor morals or lack of morals, but rather the situation they were put in.
Unfortunately, on issues other than the opioid epidemic, legislators have gone in the opposite direction. Despite every war on drugs in the U.S.’s history only increasing drug use and arrests, U.S. Attorney General Jeff Sessions has decided to bring back the mandatory minimum sentences for low-level drug charges, thus undoing years of progress made during the Obama Administration, such as reducing sentences for crack cocaine relative to powder cocaine. The war on drugs was a dark time in the U.S.’s history, and its devastation of the black community should be a lesson in how not to address the problem, rather than a blueprint of what to do.
While the opioid epidemic will hopefully have its proposed solutions implemented soon, and politicians of all different backgrounds give respect to those affected by it, we shouldn’t only advocate for the victims of the opioid epidemic. A simple racial divide has completely alienated one group of victims while giving the other the limelight, and rather than falling back on policies that have failed miserably in the past, our country should be concerned with finding quality solutions to an epidemic that has killed more Americans last year than the Vietnam War.
