To Address Addiction, Confront Racism in Our Health and Justice Systems

It’s widely documented that decades of punitive criminal justice and drug policies have led to the US becoming the world’s leading incarcerator. We are slowly beginning to come to our senses, realizing mass incarceration does not make us safer—nor is the cost tenable—and nationwide, the push for comprehensive criminal justice reform is strong.

Likewise, as our country faces co-occurring crises of overdose and suicide, there is broad consensus on both sides of the proverbial aisle that we must urgently address how we respond to both addiction and mental health. However, entrenched stigma and discrimination around people with substance use and mental disorders has been baked into our health and social service systems. So, too, has racism.

Racial Bias and the Overdose Crisis 

Today’s opioid-involved overdose crisis has garnered a national spotlight not only because of the havoc it is wreaking on individuals and families (in 2017, there were more than 47,000 overdose deaths involving opioids, and over 70,000 total overdose deaths), but because of the impact it has had on the white, middle-class population that society sees as victims of opioid addiction.

The juxtaposition of the white victim against the black criminal is insidious and reinforces national drug policy.

A recent study by JAMA Internal Medicine assessing racial and income disparities in the prescription of opioids in California suggests that the initial higher concentration of white Americans with opioid use disorder (OUD) was itself the result of systemic racism. A lack of healthcare access, as well as discriminatory treatment based on race and class largely shaped who was prescribed opioids in the first place.

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