Ira Sliver | Professor of Sociology, Framingham State ...
CHAPTER 4
Handcuffs for Some Addicts, Help for Others: Our Colored
Thinking about Drug Abuse
The judge told Ashley Radliff that if she didn’t accept help, she’d return to prison. So the 28-year old checked into The Next Step, an addiction treatment center for women in Albany, New York. As part of her rehab program, Ashley was required to compute the dollar value of the opioids she’d used over the past 11 years. The realization that it was upwards of $1 million injected a shot of sobriety through her bloodstream. “You don’t really get it until you see it in front of your face.” [i]
Ashley is among the roughly 2.5 million Americans addicted to opioids. Every day in the United States, over 1000 people receive treatment in hospital emergency rooms for not using opioids as directed and more than 90 people die of overdoses. There are now more deaths a year from opioids than from auto accidents, and more than from HIV/AIDS when that epidemic peaked in the mid-nineties. Between 2000-2015, more than half a million people died of opioid overdoses. As grim as these statistics are, they only begin to capture the devastation opioids have inflicted on addicts, their loved ones, and their communities. [ii]
For Ashley it all started with a skateboard accident. She felt excruciating pain and went to her doctor, who prescribed oxycodone – a narcotic that effectively manages pain yet can be highly addictive. And indeed it was. Like so many other users of prescription painkillers, Ashley became hooked. Sometimes she’d pop pills and others she’d crush and snort them. In either case she constantly had to figure out how to get more. This became harder in the late 2000s as states started placing limits on prescriptions of addictive opioid painkillers – not just oxycodone, but also hydrocodone and methadone. Ashley still managed to find a way to get her fix, until eventually she faced another hurdle: she couldn’t afford the amount she needed to satisfy her habit. So she turned to heroin, a much cheaper street drug that produces a similar high and is easier to get. She was hardly alone in making the switch. Between 2010-12, as restrictions on prescriptions led to decreased abuse of opioid painkillers, heroin abuse soared. [iii]
Ashley’s life was unraveling. She dropped out of college, lost her job, totaled five cars, and started stealing – even from her own parents. All she lived for was to get high with her girlfriend, Stephanie, who was an addict too. As their relationship progressed, they decided to have a baby. Stephanie would be the birth mother. After she lied to her doctor about being clean, Stephanie started receiving sperm injections and eventually became pregnant. She then admitted that she was still shooting up, yet her doctor did not contact the police. He didn’t even tell her to quit because experiencing withdrawal symptoms might cause her to miscarry. Her and Ashley’s baby was born a heroin addict.
Figure 1: For most recent opioid addicts, their troubles didn’t begin with shady drug deals in dark alleys but at the local pharmacy.
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A generation before Ashley Radliff became addicted to heroin, Beverly Black was part of a different drug epidemic. She became hooked on the powerful street drug, crack cocaine. Beverly started using it in her early 20s, amidst a long bout of depression that set in after her brother committed suicide. The relentless need to satisfy her habit led to Beverly losing her job and turning to theft. She smoked crack while pregnant with her second child (she had given birth to her first before she got hooked) and, not surprisingly, her baby was born an addict. [iv]
During Beverly’s third pregnancy eight years later, smoking crack caused her to go into early labor while she was still at home. After the birth, a firefighter escorted her and her newborn to the hospital for routine neonatal care. The fire station called the local media to ask them to chronicle the tale of Beverly’s heroic impromptu delivery without medical assistance. Beverly agreed to allow a reporter to interview her, and one of his questions was why her baby was born a crack addict. The next morning, a police officer came to the hospital to arrest Beverly for attempted manslaughter and barred her from taking her newborn home. She was also restricted from seeing her two older kids.
The good news is that Beverly eventually regained custody of all her children and has been sober for over 25 years. However, she didn’t begin to turn her life around until after serving time in prison, and she became sober without a government directive. Whereas Ashley Radliff was referred to The Next Step for treatment, such places were rarely options the courts considered for dealing with addicts during the crack epidemic. Even though this organization has been in existence since the mid-seventies, reducing the harms associated with addiction has been a prevalent response to drug abuse only during the opioid epidemic that’s taken hold in the United States since the late nineties. Harm reduction is based on the idea that addicts have a disease which should be treated by the healthcare system. The goal is to minimize the problems associated with addiction and help addicts kick the habit. During the crack epidemic, punishment was the common response to drug abuse. The prevalent belief was that addicts like Beverly Black were criminals who needed to be incarcerated in order to learn to act lawfully. [v]
Despite obvious differences, these two strategies also share a core similarity: both regard drug abuse as an individual problem. During the 1980s the poster child for punishment was First Lady Nancy Reagan and her “Just Say No” antidrug campaign (see Figure 2). I was in my teens when I first heard this phrase. I recall frequently seeing her uttering it in TV ads and hearing parents and teachers saying it too. The clear message in these three words was that resisting drugs was easy and that individuals who didn’t make this choice were deviants deserving of harsh treatment.
Figure 2: In presenting her “Just Say No” anti-drug campaign with a gentle demeanor, Nancy Reagan became an ideal spokesperson for the view that avoiding drugs was an easy choice.
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The image that best captures the individual perspective behind the harm reduction model is a circle with arrows going in opposite directions. This is the logo for needle exchange programs, which are part of some heroin addicts’ treatment plans. These programs, which aim to prevent the spread of HIV/AIDS and hepatitis from infected needles, regard addiction as a sickness requiring an individually-tailored response.
Figure 3: Needle exchange programs, which permit addicts to continue using heroin but in a way that prevents the spread of disease, are based on the view that addiction is a disease that needs to be individually managed.
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It may seem that we’ve merely replaced one individually-oriented approach to drug addiction with another. Perhaps lawmakers and drug abuse experts have learned it’s more effective to reduce the harms associated with addiction than to punish people for having one. It’s certainly tempting to believe this is why opioid addicts in the first two decades of the 21st century have been met with compassion whereas crack addicts in the last two decades of the 20th century experienced contempt. Yet, we will see that there is a lot more behind the shift in approach to drug addiction. [vi]
This chapter uncovers the hidden stories behind the significantly different responses to the crack and opioid epidemics. We’ll trace why punishment had become the dominant approach by the time crack became popular in the eighties, and why during the opioid epidemic of the past 20 years there has been a growing preference for harm reduction over punishment. The departure point for our analysis is the vignettes about Ashley Radliff’s and Beverly Black’s respective paths towards addiction and recovery. Using our sociological imaginations, we will expose from these personal accounts the social forces shaping the lives of drug abusers across different eras.
Figure 4: Beverly Black (left) and Ashley Radliff (right) became hooked on different drugs in different centuries. Using your sociological imagination can enable you to see why they encountered such different responses.
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THE SAME DRUG SEEN DIFFERENTLY
Take a close look at Figure 4. The reason for the shift from handling addiction punitively through the criminal justice system to more compassionately through the health care system can be seen deep within the faces of these two women. This shift is about race and our societal tendency to look upon drugs differently depending on who’s using them. I don’t expect that you will easily accept this explanation, and you may even resist it. For starters, we certainly can’t say with conviction that race plays a role simply because one of these addicts is Black and the other is White. Second, even though many crack addicts in the eighties and nineties were Black whereas many recent opioid addicts have been White, anyone can abuse drugs. And finally, the two epidemics have involved substances with unique chemical properties. It would seem that the varying responses to these epidemics reflect differences between the drugs, not between the people abusing them. [vii]
But before discounting the possibility that race may play a role in our society’s different responses to the crack and opioid epidemics, it’s useful for you to know more. Take a look at how public attitudes towards three commonly abused drugs have fluctuated over time.
• Marijuana – Mexicans who moved to the United States after the 1910 Mexican revolution were the first to use marijuana recreationally. People who resented the influx of these Spanish-speaking immigrants came to believe that pot caused them to commit violent crimes. Labeling it “killer weed” was part of a successful effort to criminalize the drug in 1937. Pot took on a different meaning in the 1960s. Instead of seeing it as leading to crime among immigrants, anti- marijuana advocates viewed it as causing middle-class teens to reject their parents’ conventional values. All of this opposition to pot now seems like ancient history. As of 2017, 44 states have legalized marijuana for at least limited medical purposes and seven for recreational use. [viii]
• Cocaine: Powder cocaine use quadrupled during the 1970s, with this increase concentrated among middle and upper class Whites. Users would either snort it or cook it into crystals and then smoke it. Only when drug traffickers started selling these crystals within low-income minority communities in the 1980s did the drug begin to get negative media attention and receive a punitive response. Renamed “crack,” possession of a single gram carried the same mandatory-minimum sentence as 100 grams of powder cocaine. Though a 2010 law reduced this disparity to 18:1, low-income minority cocaine users continue to be more harshly punished than affluent White users. [ix]
• Heroin: The federal government’s creation of the “war on drugs” in the late 1960s and early 1970s was largely a response to heroin abuse, which at the time appeared to be concentrated among low-income urban Blacks. The drug war significantly increased the policing and incarceration of heroin addicts. However, Whites had not received this punitive response when they comprised the majority of heroin addicts in earlier eras, nor have they during the current heroin epidemic when 9 in 10 first-time users are White. [x]
Each of these cases reveals that the very same drug has taken on different meanings reflecting public attitudes about the people who use it most frequently. These examples illustrate that drugs are socially constructed – we define the ways we think about them, according to how we view their users. Our thoughts about a drug and responses to drug abuse aren’t simply a reflection of the drug itself. Its particular chemical properties and mild-altering effects neither determine the ways we see it nor the government’s policies toward drug addicts.
The recent success of the marijuana legalization movement vividly illustrates the point. This movement has gained traction during the very same years that pot became significantly more potent. Nowadays, it typically has levels of THC, the plant’s psychoactive compound, of about 30 percent whereas in the 1980s THC concentration was generally 10 percent or less. If the societal response to marijuana was merely a reflection of the drug’s chemical properties or mind-altering strength, we’d expect opposition to be greater now than it was 30 years ago. And yet, we’ve seen just the opposite. [xi]
Figure 5: The fact that attitudes towards marijuana and cocaine have changed dramatically over the years illustrates that drugs are socially constructed. Pot is now legally available for purchase in many states (left), a sea change from its one-time image as “killer weed.” Whereas in the 19th century cocaine was an accepted medicinal remedy for kids’ toothaches (right), possession is now illegal.
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THE WAR ON DRUGS
“America’s public enemy number one” is how Republican President Richard Nixon characterized drug abuse during a 1971 press conference. He subsequently laid out plans for his administration to wage a war on drugs, which redirected resources from treatment and prevention to policing and incarceration. Of course, there’s legitimate reason to be concerned about the dangers of drugs. You don’t have to be a criminologist to know about these dangers. The stories that opened this chapter make them plain and clear. You may know people who’ve struggled with addiction. Perhaps you yourself have. You get that drug abuse is a serious social problem. [xii]
Yet, looking back at the war on drugs with nearly 50 years of hindsight reveals that it wasn’t simply a reaction to the harms caused by drugs. Rather, this war was socially constructed upon racial fears. The Nixon Administration’s frequent mention of heroin addicts living in urban ghettos was a clear reference to Black drug abusers. The massive escalation of the war on drugs in the eighties and nineties through the expansion of police surveillance and the building of more prisons also targeted a group of addicts perceived to be predominantly Black. These were crack abusers like Beverly Black, one of the women chronicled at the beginning of this chapter.
Figure 6: This powerful ad campaign in the 1980s by the Partnership for a Drug-Free America had a clear message: anyone who chose to use drugs after knowing that they were frying their brains deserved to be harshly punished.
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To understand how and why several American presidents framed the war on drugs around racial bias, we need to situate it in relation to prior historical events. When World War II ended in 1945, it was still legally permissible in the United States to discriminate on the basis of race. Employers could refuse to hire Black job applicants and universities could bar students solely because of their race. In Southern states – where slavery had been abolished just 80 years earlier – there remained a segregated system of “Jim Crow” laws. Blacks attended separate schools from Whites, had to use different bathrooms and water fountains, and were required to ride in the back of city buses. Rosa Parks and Martin Luther King, Jr. are the best known among the many activists who mobilized in the 1950s for Blacks to gain equal protection under the law. The most significant development toward this goal was passage of the Civil Rights Act of 1964, which outlawed discrimination on the basis of race, color, religion, sex, and national origin.
When he signed this law, Democratic President Lyndon Johnson supposedly turned to an aide and said: “I think we just delivered the South to the Republican Party for a long time to come.” It’s not certain whether these were his exact words or whether he even said anything of this kind at all. It doesn’t matter. The point is that this prophecy came true. The South, which for years had been a Democratic stronghold, became red and has remained largely that way ever since. The racially coded crafting and implementation of the war on drugs by Richard Nixon and several other presidents played a decisive role in this seismic political shift. [xiii]
Since the Civil Rights Act of 1964 had inscribed racial equality into law, President Nixon thought using overtly racist language to tap into Southern bigotry risked alienating the growing segment of people who supported greater equality for Blacks. So instead, coming across as tough on drugs became a veiled way of appealing to this same racist sentiment. Doing so stirred public fears around a non-politicized problem of universal concern – drugs – by using code words that tapped into anti-Black prejudices. John Ehrlichman, one of the president’s top aides and a key figure in the Watergate scandal that led to Nixon’s resignation from office in 1974, acknowledged in a 2016 interview that racism was the basis for the war on drugs.
You want to know what this was really all about? The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or blacks, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did. [xiv]
Just as the war on drugs was founded on coded racism, Republican Ronald Reagan’s attacks on welfare built on these same prejudices. On the campaign trail in 1976, he often spoke about a “welfare queen” in Chicago whose deception enabled her to collect over $150,000 in undeserved government assistance. After he won the presidency in 1980, Reagan frequently invoked this same image. Its subtext was clear: there were many poor Blacks like this woman who preferred to collect welfare than to work to get ahead. This racially veiled attack on welfare continued under Republican President H.W. Bush and achieved a political consensus in 1996 when Democratic President Bill Clinton signed a law which would, in his words, “end welfare as we know it.” The war on welfare and the war on drugs went hand in hand as policies that, at their core, fed on and stoked anti-Black sentiment. What began as coded republican opposition to the civil rights movement became, over several decades, a bipartisan consensus. [xv]
Figure 7: In a 1989 speech where he called for doubling spending on drug enforcement, President George H.W. Bush held up a bag labeled “evidence.” He said it was proof that drugs were “turning our cities into battle zones and murdering our children.” Bush told the nation that the contents of the bag had been seized from Lafayette Park, across the street from the White House. The truth was the drug deal to get that crack had been staged. [xvi]
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THE NEW JIM CROW
Michelle Alexander began her legal career in the early 1990s working for the American Civil Liberties Union in Oakland, California. One day on her way to work, a poster stapled to a telephone pole caught her eye. It said "The drug war is the new Jim Crow." This comparison to the system of racial segregation in the South following the Civil War seemed a bit far-fetched to her. Like many Black women and men of her generation, she had benefited from the civil rights movement. They had come of age believing our country was on a steady path toward ongoing racial progress. Alexander’s parents had instilled in her that the Jim Crow era was a part of American history Blacks had overcome. Nonetheless, that poster never strayed far from her mind.
Over the next few years, as she provided legal counsel to Black victims of police brutality and other forms of racial profiling, Alexander gradually began to see how much racism remained etched into the criminal justice system. This recognition led her, several years later, to begin researching how the implementation of the war on drugs affected different communities of drug abusers. Continuing to do criminal defense work while conducting this research led her to connect the dots. Alexander began to see how much truth there was in that poster she’d seen years earlier. She recognized that "we hadn't ended racial caste in America. We had just re-designed it." Her book The New Jim Crow presents rich evidence of how the war on drugs has quietly and invisibly contributed to the re-segregation of a sizable segment of Black America. [xvii]
The drug war significantly increased incarceration rates for first-time, nonviolent offenders. From 1985 to 2000, the number of inmates soared, with drug felons accounting for two-thirds of the rise in the federal prison population and half of the growth in the number of people incarcerated in state penitentiaries. The passage of mandatory-minimum sentencing laws meant that even people convicted of possessing small amounts of drugs were locked up for long stints. “Three Strikes and You’re Out” statutes stipulated that the third such offense carried a life sentence. The United States has the highest incarceration rate among all countries. Although it has less than five percent of the world’s population, it has about 25 percent of the world’s inmates. [xviii]
Figure 8: During the Reagan and Bush administrations, annual federal spending to combat drugs went from under $2 billion to over $12 billion. Bill Clinton signed the largest anti-crime bill in U.S. history, providing substantially increased funding for the hiring of new police officers and building of more prisons. [xix]
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It may seem that mass incarceration has little to do with race, since drug abusers come from all segments of our society. However, we need to keep in mind that drugs believed by many to be used predominantly by Blacks – heroin in the sixties and seventies, crack in the eighties and nineties – were particular target of the war on drugs. Over the last several decades Black drug users have been under especially close police surveillance. As a result, more Blacks are under the control of the corrections system today than were enslaved in 1950. Black men are more likely to be in prison than to have gone to college. Roughly one in nine Black children grows up with an absent father behind bars, about twice as many as White children. This disparity is a key reason why, on the whole, Black kids lag significantly behind their White peers in academic achievement. [xx]
Not only has mass incarceration segregated a vast segment of Black Americans behind bars, but this new Jim Crow system continues long after inmates have served prison sentences. Ex-convicts are denied public housing, are not permitted to serve on juries, and cannot vote. The most devastating effect of having a criminal record occurs in the search for employment. If you’ve ever filled out a job application, you know employers often ask about felony convictions. This obviously means they view ex-cons as less employable. While any person with a record faces tough prospects in landing a job, Blacks have a particularly hard time. Figure 9 shows the results of a study by sociologist Devah Pager which found that whereas 17 percent of Whites who listed a nonviolent drug felony conviction on their applications received a callback for a job, only five percent of Black jobseekers with identical applications got a callback. In the minds of many employers, the association between being Black and being a thug is so strong that the callback rate for Black applicants with no criminal record (14 percent) was actually lower than for White applicants with a nonviolent drug felony conviction (17 percent). How can we possibly explain this? It may be that the war on drugs, which was founded on racist beliefs about Black criminality, furthered those beliefs to the point where even law-abiding Black citizens cannot sufficiently impress upon an employer that they are responsible and trustworthy. [xxi]
Figure 9: It might not be news to you that having a criminal record hurts a person’s chances of getting a job. But, what you might not know is how much the mark of a criminal record differs depending on the job applicant’s race.
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NOTE: The dark boxes indicate jobseekers who listed on their application that they had been convicted of a nonviolent drug offense. The shaded boxes are job applicants with no criminal record.
“DON’T DO THE CRIME IF YOU DON’T WANT TO DO THE TIME”
When I first heard Michelle Alexander speak about her research in a podcast several years ago, I had similar doubts to the ones she felt earlier in her career when she saw the poster stapled to the telephone poll. As someone who teaches about the war on drugs, I was keenly interested in what she had to say. Yet, I was skeptical about the comparison she was drawing. Whereas during the Jim Crow era Blacks were segregated simply because of their race, a person can choose not to do drugs. I certainly wasn’t alone in thinking this. Seeing drug use as a choice is a prevalent view; it’s one that Nancy Reagan reinforced in her “Just Say No” campaign during the eighties, and it remains part of our conventional wisdom today.
Just as Michelle Alexander eventually recognized the truth in that poster, after I read her book I too came around. She details that the new Jim Crow differs in several ways from the old system of segregation. One way is how this belief that people choose to use drugs keeps the injustices of the new system invisible. She offers a strong case for rethinking the view that if Black people want to avoid the devastating effects of mass incarceration, they should just obey the law. By looking at race and crime from a sociological perspective, we can begin to see why the choice to resist drugs isn’t as easy or simple as it appears. That’s because the reasons why so many Black Americans have been convicted of drug offenses go well beyond individual willpower.
For starters, the high conviction rate is not because Blacks use or sell drugs more than members of other racial groups; on the whole, they do not. This is true even for the so-called “Black” drugs that fueled and sustained the war on drugs. In 1991, two years after President George H.W. Bush held up a bag of crack in a televised speech as evidence of how the drug was destroying cities, a study by the National Institute on Drug Abuse found that people who’d admitted to using crack were 52 percent White, 38 percent Black, and 10 percent Hispanic. Data about marijuana provide another telling illustration. Blacks are arrested for possession nearly four times more often than Whites, even though people from both groups are comparably likely to use the drug. Given that marijuana is the illicit drug college students abuse most frequently, this statistic has significant consequences. For White pot users, it doesn’t really matter if they go to school in a state where it remains illegal because they’re unlikely to get arrested for using it anyway. But for Blacks, it most certainly does. Since they are the group of users most likely to be arrested and therefore made into criminals, they’re also the likeliest to have to pay a price for the rest of their lives. [xxii]
Figure 10: Blacks are much more often arrested for drugs than are Whites. But, that doesn’t mean Black communities deserve to be more heavily policed. The fact that Blacks are no more likely to use drugs indicates that the heavier policing of their communities explains the racial disparity in drug arrests.
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Moreover, the idea that getting involved with drugs simply reflects bad decision making rests on the flimsy assumption that users are throwing away future opportunities merely for the sake of getting high. It certainly makes sense to apply this line of thinking to your own life. If in the near future you were to get convicted of a drug offense, you’d find it more difficult to finish college and much harder to get a job. But, this reasoning doesn’t hold true for kids growing up in low-income, predominantly Black neighborhoods. From a very young age, these kids learn to expect what is perhaps the most damning everyday effect of the war on drugs: that they, their families, and their neighbors will be under constant police surveillance. Even kids who avoid drugs and stay clear of other criminal activity grow up accustomed to being stopped and interrogated by the police, and quite possibly also searched, beaten, or detained. These humiliating experiences exact a devastating psychological toll, giving kids the message that they’re worthless and can’t achieve a better life. With these feelings ingrained in their heads, the short-term high of using drugs appears to them to carry little cost. Since these kids have been primed to feel deserving of punishment whether or not they break the law, why not get high? [xxiii]
There’s a similar rational calculation going on in their minds of Blacks who get arrested on a second or third drug offense. The choice to use, and especially to sell, drugs again even after serving time in prison makes sense given their dim job prospects. Recall Devah Pager’s research showing that Black ex-cons – even nonviolent drug offenders – have very low prospects of finding a job. The combination of being unable to get legitimate work and desperately needing cash is practically a guarantee for dealing and using drugs. Yes it’s a choice, but it’s one people make amidst extraordinary constraints.
Figure 11: A picture is worth 1000 words. Behind these hands lies a detailed story of how racism was built into the policies that led to mass incarceration.
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The sociological perspective, therefore, refines the dominant frame that low-income Black Americans are prone toward doing drugs because they lack the willpower to resist them. This dominant frame only captures half the story – that using drugs worsens the many problems these people often experience: such as joblessness, homelessness, and depression. The sociological perspective gives us the other half – that these problems are the root causes of why these people “choose” to get involved with drugs in the first place. There’s just so much more to the story than meets the eye when it comes to the conventional wisdom that Blacks whose lives have been devastated by mass incarceration shouldn’t have done the crime if they didn’t want to do the time. [xxiv]
TREATING ADDICTS WITH COMPASSION
The war on drugs appears finally to be over. The most common response to drug abuse nowadays is harm reduction, which treats addiction as a disease rather than a crime. The goal isn’t to punish addicts but to manage the problems associated with addiction. This shift away from locking up drug abusers is part of a broader movement against mass incarceration. There is bipartisan agreement that the exponential growth in imprisonment over the past several decades was not only expensive and did little to deter crime, but also destroyed families and communities. [xxv]
Therefore, just as the conventional wisdom used to be that heroin addicts deserved contempt, nowadays it makes sense to show sympathy toward the people who shoot up this very same drug. It’s no coincidence that we’ve seen a backpedaling away from punitive responses to nonviolent drug offenses at a time when there has been a surge in addiction that has largely affected Whites. “This new turn to a more compassionate view of those addicted to heroin is welcome,” commented Kimberlé Williams Crenshaw, an expert on racial inequality in the criminal justice system. “But, one cannot help notice that had this compassion existed for African-Americans caught up in addiction and the behaviors it produces, the devastating impact of mass incarceration upon entire communities would never have happened.” [xxvi]
It would be convenient to see this shift in approach to drug abuse as merely reflecting a lesson learned – that punishment is expensive and ineffective. But, you now know too much to accept this explanation. You’ve seen examples of how the push for more severe punishments has historically grown for minority drug abusers and softened for Whites. And that’s exactly what has been happening again during the opioid epidemic. The sympathy lawmakers have shown toward addicts is night and day from the vindictiveness leveled against heroin addicts in the 60s and 70s and crack addicts in the 80s and 90s. The stories of the two women profiled at the beginning of this chapter underscore this difference. Ashley Radliff, a recent White heroin addict, got the chance to rehabilitate herself whereas Beverly Black, an African American who became a crack addict in the early 1990s, was locked up and had to seek out recovery on her own.
Since most addicts during the current opioid epidemic have been White and middle-class, they and their families have been able to use their advocacy skills to put pressure on legislators to support harm reduction policies. As a result, many states now have “Good Samaritan” laws that protect people who report an opioid overdose from being prosecuted. Most states also now have statutes enabling family members to get a prescription for naloxone, a drug that counters the effects of a heroin overdose. [xxvii]
Even though the war on drugs has officially ended, its legacy of coded racism endures. A fascinating study published in 2016 uncovered significant differences in media coverage of the current opioid epidemic depending on the addict’s race. News stories of suburban or rural, therefore largely White, addicts provided more details about why people abused opioids than did accounts of urban, more typically Black or Latino, addicts. These details depicted suburban and rural addicts as victims of a devastating disease and therefore deserving help. The absence of these details in news stories about urban addicts sustains the conventional wisdom that minority drug abusers lack the willpower to just say no and as a consequence must be harshly treated. [xxviii]
These varying media images of opioid addicts both reflect and contribute to different public attitudes toward drug addicts depending on the user’s race. And these different attitudes, in turn, shape the types of treatment that heroin addicts receive. Whites more typically are given buprenorphine, which can be taken at home. Blacks and Latinos, on the other hand, are more likely to be required to take methadone at clinics under the supervision of personnel from the federal Drug Enforcement Administration – an indicator that they’re not seen as responsible enough to treat themselves. [xxix]
These recent, racially different responses to heroin addiction mirror something we saw earlier: the varying ways our criminal justice system addresses cocaine abuse. Laws passed during the war on drugs created a double standard – much harsher punishments for possessing crack cocaine, which Blacks disproportionately use, than for powder cocaine, which is more popular among Whites. Clearly, we’d be naïve to believe our society’s response to drug abuse has become colorblind during the opioid epidemic. Just because nowadays we often hear politicians using compassionate language in endorsing policies that offer help instead of handcuffs hardly means race has ceased being a key part of the social construction of drug abuse. To the contrary, race still matters a lot; it’s just that its significance has become more insidious. [xxx]
HISTORY REPEATING ITSELF
“Drug scares are never about drugs per se,” writes sociologist Craig Reinarman, “because drugs are inanimate objects without social consequences until they are ingested by humans. Rather, drug scares are about the use of a drug by particular groups of people who are, typically, already perceived by powerful groups as some kind of threat.” In the case of the war on drugs, the aim was to scapegoat Blacks for violent crime, which was on the rise in the United States from the 1960s to the early 1990s. A scapegoat is an easy target of blame for a social problem that has much larger causes than the particular target being attached. Drug panics have long been, at their core, about creating scapegoats. Not only was this true of the war on drugs, but also of the campaign that led to the prohibition of the sale of alcohol in the U.S. from 1920-33. The temperance movement that spearheaded prohibition gained momentum by feeding on native-born Whites’ hostility toward alcohol-consuming European immigrant groups that they saw as dangerous and threatening. [xxxi]
The scapegoating of minority groups has been a recurring theme throughout our history. If this sounds like a familiar story, that’s because it’s been at the forefront of American politics in recent years. This time, the plotline is about the supposed dangers posed by undocumented immigrants. Donald Trump built his 2016 presidential campaign around portraying these immigrants as dangerous. And, of course, some of them are. But, so are some angry old White men. The truth is violent crime is no higher among undocumented immigrants than among any other segment of the population. Indeed, violent crime in the United States has been steadily declining since the early 1990s, the very period when the number of undocumented immigrants escalated significantly. [xxxii]
Violent crime is, of course, still a problem. However, deporting undocumented immigrants does little to make America safer, just as incarcerating Black drug abusers hasn’t. That’s because violent crime has deep-seated sociological causes; it’s not fundamentally attributable to being an undocumented immigrant or a Black citizen. What targeting undocumented immigrants does certainly do is cause millions of people to live in daily fear of deportation and tear parents away from children, just as the war on drugs did to so many Black families.
We’ve seen this movie before. Making a scapegoat of people without legal status, most of whom are Brown, is a form of racial exclusion strikingly similar to the New Jim Crow. Instead of mass incarceration, this time it’s mass deportation. We are nearly a quarter of the way into the 21st century, and yet it often feels like we’re living in one of the darker moments of our history. The more things seem to have changed in our society, the more they appear to remain the same.
References
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[i] This chronicling of Ashley Radliff’s story is based on how it’s reported in Claire Hughes, “Outrunning Heroin Addiction: Ashley’s Story.” Times Union, October 14, 2015, .
[ii] The estimate of Americans addicted to opioids is based on 2012 data and comes from Nora D. Volkow, “America’s Addiction to Opiods: Heroin and Prescription Drug Abuse.” National Institute on Drug Abuse, May 14, 2014, . Data about emergency room visits and overdoses comes from the Centers for Disease Control and Prevention, . The comparison with annual auto deaths and deaths from HIV/AIDS at the height of that epidemic come from Atul Gawande, “It's Time to Adopt Electronic Prescriptions for Opioids.” Annals of Surgery 2017 265(4): 693–694.
[iii] As of 2016, 16 states had passed laws placing limits on doctors’ capacity to prescribe these addictive painkillers. See Christine Vestal, “The Days of Freely Prescribed Painkillers are Ending. Here’s What’s Next. Washington Post, May 20, 2016, . Data about the correlation between decreased painkiller abuse in the wake of prescription restrictions and increased heroin abuse come from Volkow 2014.
[iv] These details come from an interview with Beverly Black in The Fix: Addiction and Recovery, Straight Up, February 3, 2017, . The fact that the details of Beverly’s and Ashley’s stories are similar reveals a pattern in the collateral damage surrounding addiction.
[v] Beverly Black recounts her period of addiction and recovery in her 2016 memoir A Wretch like Me.
[vi] Andrew Cohen, “How White Users Made Heroin a Public-Health Problem.” The Atlantic, August 12, 2015, .
[vii] The popular perception of crack as a “Black” drug rested on the fact that it was much more prevalent among Blacks than among other racial groups. See Kristen Gwynne, “4 Things You Probably Didn't Know About Crack, America's Most Vilified Drug.” Alternet, August 2, 2013, . A widely publicized 2014 study indicated that close to 90 percent of those who had tried heroin over the past 10 years were White. See Theodore J. Cicero, Matthew S. Ellis, Hilary L. Surratt, and Steven P. Kurtz, “The Changing Face of Heroin Use in the United StatesA Retrospective Analysis of the Past 50 Years.” JAMA Psychiatry 2014 71(7): 821-826, .
[viii] Craig Reinarman, “The Social Construction of Drug Scares.” Pp. 92-104 in Constructions of Deviance: Social Power, Context, and Interaction. Edited by Patricia A. Adler and Peter Adler. Belmont, CA: Wadsworth, 1994, 95. PBS Marijuana timeline, .
[ix] Craig Reinarman and Harry G. Levine, “Waging War on Drugs.” Pp. 32-50 in Social Problems: Readings. Edited by Ira Silver. New York: WW Norton, 2008, 33. Joseph J. Palamar, Shelby Davies, Danielle C. Ompad, Charles M. Cleland, and Michael Weitzman, “Powder Cocaine and Crack Use in the United States: An Examination of Risk for Arrest and Socioeconomic Disparities in Use.” Drug and Alcohol Dependence 2015 149: 108-16.
[x] Heroin abuse appeared to be concentrated in Black urban neighborhoods because these were the places the Nixon administration directed its attention, and consequently where the news media focused its coverage. The truth is that although Blacks in the late sixties and early seventies were more likely than Whites to abuse heroin, in other eras Whites have comprised at least half of all heroin addicts. See Cicero et al. 2014 (Figure 3) and Maia Szalavitz, “These ‘New Face of Heroin’ Stories Are Just the Old Face of Racism.” – The Stuff That Hooks Us, June 8, 2014, .
[xi] These potency differences are based on research by Andy LaFrate reported in Alice G. Walton, “New Study Shows How Marijuana's Potency Has Changed over Time.” Forbes, March 23, 2015, .
[xii] Richard Nixon, “Remarks About an Intensified Program for Drug Abuse Prevention and Control.” June 17, 1971, .
[xiii] The Johnson quote, as well as skepticism about whether he even actually said it, comes from Steven J. Allen, “’We Have Lost the South for a Generation’: What Lyndon Johnson Said, or Would Have Said if Only He Had Said It.” Capital Research Center, October 7, 2014, .
[xiv] Michelle Alexander, The New Jim Crow: Mass Incarceration in the Age of Colorblindness. New York: The New Press, 2010, 186. John Ehlichman spoke these words to journalist Dan Baum for his article “Legalize it All: How to Win the War on Drugs.” Harper’s Magazine, April 2016, .
[xv] Ronald Reagan’s started referring to this “welfare queen” during his unsuccessful presidential campaign in 1976. He returned to this image after winning the presidency in 1980. See Ian Haney-Lopez, “The Racism at the Heart of the Reagan Presidency.” Salon, January 11, 2014. . Alana Semuels, “The End of Welfare as We Know It.” The Atlantic April 1, 2016, .
[xvi] Reinarman and Levine, 2008, 35-37.
[xvii] When she is interviewed, Michelle Alexander often recounts this story of the poster stapled to the telephone poll. See for example the April 21, 2016 interview she did for On Being with Krista Tippett, .
[xviii] Julie Netherland and Helena B. Hansen, “The War on Drugs That Wasn’t: Wasted Whiteness, ‘Dirty Doctors,’ and Race in Media Coverage of Prescription Opioid Misuse.” Culture, Medicine, and Psychiatry 2016 40(4): 664–686. Adam Liptak, “U.S. Prison Population Dwarfs That of Other Nations.” New York Times, April 23, 2008, .
[xix] Reinarman and Levine 2008, 34. Details about the Violent Crime Control and Law Enforcement Act of 1994 can be found in a fact sheet published by the U.S. Department of Justice, .
[xx] Alexander 2010, 175, 185. Data about children growing up with fathers in prison come from David Murphey and P. Mae Cooper, “Parents Behind Bars: What Happens to Their Children.” Child Trends, October 2015, . Data about the effects of mass incarceration on inequalities in academic achievement come from a 2016 Economic Policy Institute report by Leila Morsy and Richard Rothstein, “Mass incarceration and children’s outcomes: Criminal justice policy is education policy.” .
[xxi] Devah Pager, “The Mark of a Criminal Record.” American Journal of Sociology 2003 108(5): 937–75.
[xxii] The 1991 National Institute on Drug Abuse data about crack users is reported in Gwynne 2013. Data about the racial disparity in marijuana arrests are from 2010 and published in “The War on Marijuana in Black and White: Billions of Dollars Wasted on Racially Biased Arrests.” American Civil Liberties Union, June 2013, . For the past several decades, marijuana has been the illicit drug abused most often by college students. See Lloyd D. Johnston, Patrick M. O’Malley, Richard A. Miech, Jerald G. Bachman, and John E. Schulenberg, “Monitoring the Future: National Survey Results on Drug Use, 1975–2016.” The University of Michigan Institute for Social Research, January 2017, 11, . The notion that the racial disparity in marijuana arrests means Black are made into criminals comes from Alexander 2010, 192
[xxiii] For a general discussion of the significant police presence in Black kids’ lives from a very young age, see Alexander 2010, 194-95. Based on a six-year study, sociologist Alice Goffman offers a gripping picture of the everyday experience of living amidst police surveillance in On the Run: Fugitive Life in an American City. New York: Farrar, Strauss, and Giroux, 2015.
[xxiv] Reinarman and Levine, 2008, 42.
[xxv] Tina Rosenberg, “Even in Texas, Mass Imprisonment is Going Out of Style.” New York Times, February 14, 2017, .
[xxvi] Quoted in Seelye 2015.
[xxvii] Katharine Q. Seelye, “In Heroin Crisis, White Families Seek Gentler War on Drugs.” New York Times, October 30, 2015.
[xxviii] Netherland and Hansen 2016, 672–76.
[xxix] The notion that media images are both a reflection of existing public attitudes and contribute toward shaping those attitudes comes from William A. Gamson, David Croteau, William Hoynes, and Theodore Sasson, “Media Images and the Social Construction of Reality.” Annual Review of Sociology 1992 18: 373-93. Racial differences in treatment for opioid addiction are reported in Andrea Acevedo, Deborah W. Garnick, Robert Dunigan, Constance M. Horgan, Grant A. Ritter, Margaret T. Lee, Lee Panas, Kevin Campbell, Karin Haberlin, Dawn Lambert-Wacey, Tracy Leeper, Mark Reynolds, and David Wright, “Performance Measures and Racial/Ethnic Disparities in the Treatment of Substance Use Disorders.” Journal of Studies on Alcohol and Drugs 2015 76(1): 57-67.
[xxx] Netherland and Hansen 2016, 665–66.
[xxxi] Quoted in Reinarman 1994, 97. Trends in violent crime come from the U.S. Department of Justice, Federal Bureau of Investigation, Crime in the United States, . Discussion of efforts by the temperance movement to scapegoat European immigrant groups come from Reinarman 1994, 97-98.
[xxxii] David Green, “The Trump Hypothesis: Testing Immigrant Populations as a Determinant of Violent and Drug-Related Crime in the United States.” Social Science Quarterly 2016 97(3): 506-524. U.S. Department of Justice, Federal Bureau of Investigation, Crime in the United States, .
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