Political leaders are displaying increasing amounts of empathy for those suffering from addiction. But, in a society still largely divided along racial lines, our willingness to express compassion is all too often a function of how much we can personally identify with those who are suffering – and that goes for presidential candidates too.

At this week’s forum on substance abuse in New Hampshire, which was attended by several Republican candidates, the talk was all about treating drug abuse as a disease to be addressed with compassion. The subject matter was very timely, with the state having experienced a surge of heroin abuse in recent years, concentrated in its overwhelmingly white population.



Some presidential candidates, such as Jeb Bush and Carly Fiorina, described the struggles of family members with substance abuse, while others like Chris Christie and John Kasich, displayed pride in having expanded access to treatment in their home states. Along with similar sentiments among the Democratic candidates, these developments would seem to suggest an emerging consensus on drug policy.

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Actually, the two parties have had a long history of bipartisanship on drug policy, though one which for many years could hardly be characterized as compassionate.

At the inception of the war on drugs in the 1980s, leaders of both parties endorsed harsh punishments and mandatory sentencing as their preferred approach to substance abuse, with seemingly little interest in supporting prevention and treatment. Three decades later, there is unity again, but now characterized by a broader vision of the problem. So how did this come about?

One would hope that this shift, in part, reflects an understanding of the failure of the punitive “war on drugs” approach to substance abuse. But it also seems clear that the political environment is related to how racial perceptions frame our attitudes on social policy.

In the 1980s, the “drug scare” was all about crack cocaine, the newly developed substance that caused havoc in many low-income communities. Whether accurately or not, crack was perceived as a “black drug”. Images of black crack users graced the cover of Time magazine and were the subject of countless sensational newscasts.

During the national panic about drugs, mandatory sentencing laws were adopted by Congress in virtual record time, punishing crack offenses far more harshly than powder cocaine crimes, where users were much more likely to be white. Shortly after being enacted into federal law, prisons began to be filled with African Americans serving prison terms of five to 10 years or longer for these offenses.

In contrast, the surge in heroin use in recent years has been largely a white phenomenon, particularly in states such as New Hampshire. Research published in the journal Jama Psychiatry found that 90% of recent heroin users entering treatment programs have been white.

The intersection of race and drug policy is hardly a new development, as illustrated by public perceptions of marijuana. In the 1930s, marijuana was perceived to be used by black hipsters and Mexican Americans in the “racy” parts of town, and gained notoriety in the days of “reefer madness”.

Then along came the 1960s, and millions of white middle class people began consuming large quantities of the drug. Virtually overnight, societal attitudes toward the drug changed. Marijuana became celebrated in popular culture, and calls for decriminalization became widespread. Nothing had changed about the drug itself, only the perception of the user.

Some might suggest that the way to remedy this disparity would be to subject white heroin users to the harsh penalties that apply to crack and other drugs. But that would only compound the ineffectiveness and inhumanity of current drug policy.

We would be better served by recognizing that the compassionate approaches being proposed for heroin abusers can be applied equally well to other drug users, regardless of race. Elements of such a strategy have begun to be put in place in recent years, with the expansion of drug courts and treatment diversion programs.



Barack Obama has recently announced that he will increase access to treatment for heroin and prescription drug abusers, along with enhanced training for doctors. But until we acknowledge the complex ways in which racial perceptions frame public policy, we risk reinforcing a two-tiered approach that only hardens social divisions.





