Opioid Addicts Get Compassion. Crack Addicts Get Mass Incarceration

Communities are scrambling to save lives and get people into rehabilitation, but it wasn’t always that way.
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Mike, a heroin addict who wants to get help, prepares to inject himself in the Kensington section of Philadelphia which has become a hub for heroin addicts. Over 900 people died last year in Philadelphia from opioid overdoses, a 30 percent increase from 2015. As the epidemic shows no signs of weakening, the number of fatalities this year is expected to surpass last year's numbers. Heroin use has doubled across the country since 2010, according to the DEA, part of an epidemic of opioid abuse that began in the 1990s, when doctors began prescribing higher doses of powerful painkillers.

Photo by Spencer Platt/Getty Images.

Drug-addled babies clinging to life in hospital nurseries. Strung-out young people, lying and stealing their way to the next fix. One hundred seventy-five dead Americans every day.

These are images of the toll of the opioid drug epidemic.

President Trump on Thursday declared opioid addiction a public health emergency, a move that will free up some resources for treatment and bring new focus on this growing public scourge.

But those same images are familiar to many who remember another era, when a different drug crisis seized cities, hollowing out neighborhoods and destroying lives. Unlike the heroin and prescription drug-addiction that today affects mostly suburban and rural whites, the crack cocaine rage of the 1980s and 90s ravaged the African-American community.

More than 2 million Americans last year were addicted to opioids.

Back then the response wasn’t rehabilitation centers and overdose treatment but prison cells and “Just Say No.” The crack cocaine epidemic was treated as a war, not a public health crisis. And young African Americans—the addicts as well as those who preyed on them—were swept up, prosecuted, and sent away.

“It shows the remarkable difference in how we are viewing this,” said Ekow Yankah, a Cardozo School of Law professor whose work focuses on questions of criminal theory and punishment. “There was no wave of national compassion. Some liberals and representatives of minority communities in particular were desperate for America to take a public health view of drug addiction in the 1980s and 1990s.”

In fact, Yankah says America’s willingness to embrace the drug epidemic’s newest addicts with compassion is a perfect example of racism. “Confronted by two people facing the exact same problem, one of whom looks like your child or your neighbor’s child: Is it fundamentally you?” he asked. “When it is a black face, we don’t see the same humanity.”

More than 2 million Americans last year were addicted to opioids, a class of drugs that include the illegal drug heroin, synthetic opiates such as fentanyl as well as legally available prescription painkillers such as OxyContin. More than 64,000 Americans died from addiction to these drugs last year. In fact, the National Institutes of Health released a recent study attributing some of the increase in premature death for white men due in large part to accidental drug overdoses.

Trump’s announcement on Thursday fell short of the “national emergency” declaration that addiction and health experts had hoped for and that an opioid crisis commission his own administration created earlier this year had recommended. The national emergency designation would have freed up funds for treatment, ensured wider access to anti-overdose drugs, and improved monitoring of opioid prescriptions to prevent abuse.

A public health emergency designation gives the administration access to the Public Health Emergency Fund, although that fund is practically empty. The administration will need to work with Congress to fund it. What’s more, “public health emergencies” like this one expire after 90 days, though they can be renewed.

What the administration is proposing is the worst of both worlds.

Among the administration’s initiatives are plans to step up efforts to block the flood of fentanyl, a powerfully potent and cheap synthetic opioid manufactured in China that is 50 times stronger than heroin. The administration will also launch a massive advertising campaign depicting the devastation the drug can have on people’s lives as a way to discourage their use, especially among children.

“This opioid epidemic is unlike anything anyone has ever seen,” Trump said. “It is time to liberate our communities from this scourge of drug addiction. It's never been this way. We can be the generation that ends the opioid epidemic.”

Yankah says that while the language from Trump and Republicans has been more humanizing and they have been less willing than politicians 30 years ago to see today's addicts “as pathologically making bad decisions,” the president’s recipe of drug policies is simply rehashed, failed policies from that era.

“It’s something rhetorically exactly on point and at the same time something rhetorically exactly painful, considering that’s what we wanted,” he said. In the 1980s, “the response always was, ‘we can do a little of this and a little of that, but we can’t ignore the importance of personal responsibility; you are asking us to go soft on crime.’”

He said what the administration is proposing is the worst of both worlds. “The compassion that was withheld from minority communities is painful, but at least we thought the change in mentality would be accompanied by a change in federal policies that might save lives,” he said. “The rhetorical change is symbolically important, but Trump's ideas would make it empty as actual policy.”

There’s been a proliferation across the country of needle exchange programs.

From New England to the Deep South to America’s Heartland, the opioid epidemic is spreading. But even before Thursday’s announcement there had been a powerful community responses to addressing the problem. For example, there’s been a proliferation across the country of needle exchange programs, a practice that has long been socially stigmatized, and the number of treatment facilities and the people seeking help have similarly increased.

In March, the Centers for Disease Control announced guidelines for doctors to reduce the amount of opioid painkillers prescribed nationwide. The CDC estimates that most new heroin addicts first became addicted to prescription pain medication before graduating to the cheaper and stronger drug.

This summer, the grocery store chain Kroger began making the heroin overdose drug naloxone available without a prescription. And this month, CVS Caremark pharmacies announced they would limit the amount and strength of prescription opioid painkillers they provide to patients taking the drugs for the first time.

In Summit County, Ohio, the County Executive signed a proclamation declaring the opioid crisis a state of emergency. Her county plans to join the state of Ohio, which has been hard hit by the epidemic, in suing drug companies for downplaying the risks of opioid painkillers OxyContin and Percocet.

But such outpouring was missing in the 1990s, as the black community struggled with the devastation crack cocaine visited upon their families, including  mass incarceration. Since the official beginning of the war on drugs in 1982, the number of people incarcerated for drug offenses in the U.S. skyrocketed from 40,900 in 1980 to 469,545 in 2015, according to the Sentencing Project, a prison sentencing reform group. Yankah said, “With this [opioid] epidemic, police departments are responding much differently, not by invoking war but by trying to save lives and get people into rehabilitation.”