White opioid epidemic fuels black frustration

It has always been a crisis in the inner city, critics of the drug war say. So why is it just getting attention now?

The circle of patients gathered for group therapy at a doctor’s family practice in McKenzie, Tenn., could represent the face of the state’s opioid epidemic.

They were in a small city in a rural county, fertile ground for prescription drug addiction, though they traveled from as far as Nashville and Missouri. They were young or middle-aged and ranged from blue-collar workers to businesspeople. They said painkillers prescribed after accidents or injuries paved the way to their dependence on opioids. They also were all white. Among African Americans critical of the modern drug war launched four decades ago by President Nixon, the fact that the opioid epidemic is primarily striking the majority race helps explain why it is largely being called an epidemic and treated as a public health crisis rather than a war.

“Look at the inner city: It’s always been what we consider an epidemic,” says the Rev. Ralph White, pastor of Bloomfield Full Gospel Baptist Church in Memphis.

“If this had been the case in other areas, the community would have been crying out long ago,” White says. “But now that it’s taking the lives of Euro-

pean Americans, we find that it’s at a time of crisis.”

Of all deaths in 2015 from opioid and heroin overdoses in Tennessee and nationwide, about 90% of the people were white. Black people accounted for little more than 6% in Tennessee and 8% across the country, according to U.S. Centers for Disease Control and Prevention data.

“White brothers and sisters have been medicalized in terms of their trauma and addiction. Black and brown people have been criminalized for their trauma and addiction,” says Michael Eric Dyson, a Georgetown University sociology professor as well as a minister and the author of Tears We Cannot Stop: A Sermon to White America.

Doctors and other health care professionals call for a healthcare-led response to the opioid epidemic. Their strategies include curbing use of painkillers like oxycodone, making wider use of medications to treat opioid dependence as a chronic disease and increasing mental health services and therapy to attack root causes of addictions.

“I would say the good news in Tennessee is that the number of narcotic units prescribed has gone down by almost half,” says Daniel Sumrok, a physician in McKenzie, a West Tennessee city with a population of more than 5,500 about 130 miles northeast of Memphis. “The bad news is that overdose deaths have gone up, and oxycodone has gone up,” says Sumrok, director of the Center for Addiction Science at the University of Tennessee Health Science Center based in Memphis.

Sumrok and other health care professionals are careful not to paint the drug crisis in terms of rich or poor, urban or rural, black or white. “My patients are district attorneys and teachers and nurses and doctors,” he says. “They’re not what you might think of as a TV bum; they’re people who have real lives, real jobs, real families, real values who found themselves opiate-dependent and need some help.”

Still, when it comes to race, clear differences emerge.

The National Institutes of Health recently warned that yearly percentage increases in deaths among white Americans ages 25 to 30 from 1999 to 2014 rose at rates comparable with the

“White brothers and sisters have been medicalized. ... Black and brown people have been criminalized.”

Michael Eric Dyson, Georgetown University sociology professor

onset of the nation’s AIDS epidemic or in Russia after the collapse of the Soviet Union. Premature deaths for African Americans, Hispanics and Asian and Pacific Islanders continued to decline.

Drug overdoses, suicide and liver disease stoke the rise in premature accidental deaths among whites, as well as among American Indians and Alaskan natives, the study found.

“In high-income countries, you expect us to make progress over time, you expect the death rate to decrease, you expect life expectancy to increase,” says Meredith Shiels, a National Cancer Institute researcher and lead author of the study. “So when something comes in and reverses that, and suddenly the mortality rate is increasing in any given group, that’s an alarm that there is something very serious and epidemic going on.”

Statewide statistics for the Tennessee Department of Mental Health and Substance Abuse Services point to differences between the illegal drugs by race.

For 2015, white Tennesseans made up 89.5% of 839 people treated primarily for heroin and 95% of 4,071 treated for prescription opioids, according to the department.

Black Tennesseans made up 62% of 1,176 treated for cocaine or crack and 45% of 2,065 in treatment for marijuana use.

The nation’s previous heroin crisis struck during the Vietnam War era, giving rise to the drug war and “just say no” responses to what was viewed as a criminal behavior epidemic, says Altha Stewart, director of the Center for Health in Justice Involved Youth at the health science center. “It was considered acceptable that drugs were within the purview of people who were already morally corrupt anyway, and so these were things that they did to themselves and you could not rehabilitate them, you had to incarcerate them.”