Opioid crisis points to racial divide

Kevin McKenzie | USA TODAY NETWORK

The circle of patients gathered for group therapy at a doctor’s family practice in McKenzie, Tennessee, could well 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.

Of all deaths in 2015 from opioid and heroin overdoses nationwide, about 90percent of the people were white.

Black people accounted for little more than 8 percent, according to U.S. Centers for Disease Control and Prevention data.

Among African-Americans critical of the modern drug war launched four decades ago by President Richard 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,” said 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 said. “But now that it’s taking the lives of European-Americans, we find that it’s at a time of crisis.”

Michael Eric Dyson, a Georgetown University sociology professor as well as minister and author, offered a similar view after an appearance in February at the University of Memphis.

“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,” said Dyson, whose latest book is “Tears We Cannot Stop: A Sermon to White America.”

Ironically, physicians’ under-treatment of pain for black patients might have helped prevent higher opioid addiction among African-Americans, experts and studies suggest.

Dr. Daniel Sumrok, who was treating patients at his practice in McKenzie, and other health care professionals are careful not to paint the current 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 said. “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.”

But when it comes to race, clear differences emerge.

The National Institutes of Health recently warned that yearly percent increases in deaths among white Americans ages 25 to 30 from 1999 to 2014 rose at rates comparable to the onset of the nation’s AIDS epidemic. Premature deaths for African-Americans, Hispanics, and Asians and Pacific Islanders continued to decline.

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

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

Black Tennesseans made up 62percent of 1,176 treated for cocaine or crack and 45percent 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 a criminal behavior epidemic, said Dr. Altha Stewart, a psychiatrist and director of the Center for Health in Justice Involved Youth at UTHSC.

“It was considered acceptable that drugs were within the purview of people who were already morally corrupt anyway,” Stewart said.

For today’s opioid crisis, policymakers are more likely to have experienced children or grandchildren taking grandma’s pain medicine and then shifting to cheaper heroin on the street, said Stewart, who is slated to become the first African-American president of the American Psychiatric Association in mid-2018.

“I think that the fact that the people who are experiencing are also the people who are responsible for shaping the policy, there is a natural inclination, I think, to see it differently and to respond to it differently,” she said.