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The Opioid Crisis in Black Communities

Published online by Cambridge University Press:  01 January 2021

Keturah James  and
Ayana Jordan
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Extract

While much of the social and political attention surrounding the nationwide opioid epidemic has focused on the dramatic increase in overdose deaths among white, middle-class, suburban and rural users, the impact of the epidemic in Black communities has largely been unrecognized. Though rates of opioid use at the national scale are higher for whites than they are for Blacks, rates of increase in opioid deaths have been rising more steeply among Blacks (43%) than whites (22%) over the last five years. Moreover, the rate of opioid overdose deaths among Blacks already exceeds that of whites in several states. The lack of discussion of Black overdose deaths in the national opioid discourse further marginalizes Black people, and is highly consistent with a history of framing the addictions of people of color as deserving of criminal punishment, rather than worthy of medical treatment. This article argues that, because racial inequalities are embedded in American popular and political cultures as well as in medicine, the federal and state governments should develop more culturally targeted programs to benefit Black communities in the opioid crisis. Such programs include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and the formal consideration of Black people's interaction with the criminal justice system in designing treatment options.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 46 , Issue 2: Law and the Opioid Crisis: An Inter-Disciplinary Examination , Summer 2018 , pp. 404 - 421
Copyright
Copyright © American Society of Law, Medicine and Ethics 2018

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References

Streitfeld, R., “The New Face of Drug Addiction,” CNN Politics, May 4, 2011, available at <http://politicalticker.blogs.cnn.com/2011/05/24/the-new-face-of-drug-addiction/> (last visited May 8, 2018); J. Lee, “The New Face of Drug Addiction,” Fox News, July 19, 2013, available at <http://fox40.com/2013/07/19/new-face-of-drug-addiction/> (last visited May 8, 2018).+(last+visited+May+8,+2018);+J.+Lee,+“The+New+Face+of+Drug+Addiction,”+Fox+News,+July+19,+2013,+available+at++(last+visited+May+8,+2018).>Google Scholar
Rudd, R. A. et al., “Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010-2015,” MMWR Morbidity and Mortality Weekly Report 65, nos. 50-51 (2016): 1445–1452, at 1445.Google Scholar
Id. See also Centers for Disease Control and Prevention, Prescription Opioid Overdose Data, Dec. 16, 2016, available at <https://www.cdc.gov/drugoverdose/data/overdoes.html> (last visited May 8, 2018).+(last+visited+May+8,+2018).>Google Scholar
Cicero, T.J., Ellis, M.S. and Kasper, Z.A., “Increased Use of Heroin as an Initiating Opioid of Abuse,” Addictive Behaviors 74, (2017): 63-66.Google Scholar
National Center for Health Statistics, Center for Disease Control and Prevention, U.S. Department of Health and Human Services, “Drug Overdose Deaths in the United States, 1999–2015,” NCHS Data Brief, no. 273 (Feb. 2017), available at <https://www.cdc.gov/nchs/data/databriefs/db273.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Hart, C., “People Are Dying Because of Ignorance, not Because of Opioids,” Scientific American, Nov. 1, 2017, available at <https://www.scientificamerican.com/article/people-are-dying-because-of-ignorance-not-because-of-opioids/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See generally Drucker, E., “Population Impact of Mass Incarceration under New York’s Rockefeller Drug Laws: An Analysis of Years of Life Lost,” Journal of Urban Health Bulletin of the New York Academy of Medicine 79, no. 3 (2002): 434-444.Google Scholar
See Rudd, supra note 2.Google Scholar
It is important to note that overdose deaths from opioids alone account for a minority of the thousands of opioid-related deaths. Many overdose deaths are caused when people combine an opioid with another sedative, an antihistamine, or a benzodiazepine. See Hart, supra note 6.Google Scholar
National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, “Compressed Mortality File 1968-1978 on CDC WONDER Online Database,” available at <http://wonder.cdc.gov/cmf-icd8.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Modarai, F. et al., “Relationship of Opioid Prescription Sales and Overdoses, North Carolina,’ Drug and Alcohol Dependence 132, no. 1 (2013): 81-86; A.S. Bohnert et al., “Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths,” JAMA 305, no. 13 (2011): 1315-1321.Google Scholar
Schottenfeld, J., Waldman, S., Gluck, A., and Tobin, D., “Pain and Addiction in Specialty and Primary Care: The Bookends of a Crisis,” Journal of Law, Medicine & Ethics 46, no. 2 (2018): 220-237.Google Scholar
Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Results from the 2008 National Survey on Drug Use and Health: National Findings, Sept. 2009, available at <http://www.dpft.org/resources/NSDUHresults2008.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, Results from the 2016 National Survey on Drug Use and Health: Detailed Tables, Sept. 7, 2017, available at <https://www.samhsa.gov/data/sites/default/files/NSDUHDetTabs-2016/NSDUH-DetTabs-2016.pdf> (last accessed May 9, 2018).+(last+accessed+May+9,+2018).>Google Scholar
Fair Sentencing Act of 2010, Pub. L. No. 111-220, 124 Stat. 2372-75 (codified in scattered sections of 21, 28, and 42 U.S.C.).Google Scholar
Id.Google Scholar
Childress, S., “How the Heroin Epidemic Differs in Communities of Color,” PBS Frontline, Feb. 23, 2016, available at <http://www.pbs.org/wgbh/frontline/article/how-the-heroin-epidemic-differs-in-communities-of-color/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Data from NCHS, National Vital Statistics System, Mortality. Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Deaths for Hispanic persons may be underreported by about 5%.Google Scholar
“Opioid Overdose Deaths by Race/Ethnicity,” Kaiser Family Foundation, available at <https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Bechteler, S.S. and Kane-Willis, K., Chicago Urban League, Whitewashed: the African American Opioid Epidemic, Nov. 2017, available at <https://www.thechicagourbanleague.org/cms/lib/IL07000264/Centricity/Domain/1/Whitewashed%20AA%20Opioid%20Crisis%2011-15-17_EMBARGOED_%20FINAL.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Grey cells indicate states in which rates of opioid overdose deaths among Black Americans exceed those of the general population.Google Scholar
NR: Data not reported. Data unreliable.Google Scholar
Id.Google Scholar
Id.Google Scholar
Office of the Chief Medical Examiner, Government of the District of Columbia, Opioid-related Fatal Overdoses: January 1, 2014 to February 28, 2017, Apr. 19, 2017, available at <https://ocme.dc.gov/sites/default/files/dc/sites/ocme/Opioid%20related%20Overdoses%20Deaths_04.19.17.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Scruggs, A.E., “Sharp Rise in African American Opioid Overdoses has Cleveland Officials Worried,” Washington Post, June 9, 2017, available at <https://www.washingtonpost.com/national/sharp-rise-in-african-american-opioid-overdoses-has-cleveland-officials-worried/2017/06/08/6501f13a-4b75-11e7-9669-250d0b15f83b_story.html?utm_term=.8937525ab9ad> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Id. See also Drug Enforcement Administration (DEA), “DEA Issues Nationwide Alert on Fentanyl as Threat to Health and Public Safety,” Mar. 18, 2015, available at <http://www.dea.gov/divisions/hq/2015/hq031815.shtml> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See DEA, supra note 27.Google Scholar
See Scruggs, supra note 26. See also Adams, M., “Fentanyl-Laced Cocaine Becoming A Deadly Nuisance,” High Times, Dec. 4, 2017, available at <https://hightimes.com/health/fentanyl-laced-cocaine-becoming-deadly-nuisance/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Cuyahoga County Medical Examiner’s Office, Final Drug Deaths Report, updated on May 25, 2017, available at <http://medicalexaminer.cuyahogacounty.us/pdf_medicalexaminer/en-US/2016-CCMEO-FinalDrugReport.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See SAMHSA, supra note 14.Google Scholar
Cuyahoga County Medical Examiner’s Office, Heroin/Fentanyl/Cocaine Related Deaths in Cuyahoga County, June 8, 2017, available at <http://medicalexaminer.cuyahogacounty.us/pdf_medicalexaminer/en-US/HeroinFentanylReports/060817-HeroinFentanylReport.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Katz, J. and Goodnough, A., “The Opioid Crisis Is Getting Worse, Particularly for Black Americans,” New York Times, Dec. 22, 2017.Google Scholar
See Office of the Chief Medical Examiner, supra note 25.Google Scholar
See Office of the Chief Medical Examiner, supra note 25.Google Scholar
See Bechteler and Kane-Willis, supra note 20.Google Scholar
See Bechteler and Kane-Willis, supra note 20.Google Scholar
While the CDC analyzes synthetic opioids (other than metha-done) separately from other prescription opioids, it does not distinguish fentanyl from other synthetic opioids, such as tramadol, within this category. The CDC also does not distinguish pharmaceutical fentanyl from illegally-made fentanyl.Google Scholar
Data are “suppressed” when the data meet the criteria for confidentiality constraints. Death rates are flagged as “unreliable” when the rate is calculated with a numerator of 20 or less.Google Scholar
National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, “Multiple Cause of Death 1999-2016 on CDC WONDER Online Database,” available at <http://wonder.cdc.gov/mcd-icd10.html> (last visited May 9, 2018). Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug overdose deaths are identified using multiple cause-of-death code T40.4 for “synthetic opioids other than methadone.”+(last+visited+May+9,+2018).+Deaths+are+classified+using+the+International+Classification+of+Diseases,+Tenth+Revision.+Drug+overdose+deaths+are+identified+using+multiple+cause-of-death+code+T40.4+for+“synthetic+opioids+other+than+methadone.”>Google Scholar
Grey cells indicate states in which rates of opioid overdose deaths among Black Americans exceed those of white Americans.Google Scholar
For example, the 2016 Drug Report from the Cuyahoga County Medical Examiner’s Office offers a demographic analysis of overdose deaths by fentanyl, fentanyl combined with heroin, fentanyl combined with cocaine, and fentanyl combined with both heroin and cocaine. See Cuyahoga County Medical Examiner’s Office, supra note 30.Google Scholar
National Public Radio, “Why Is The Opioid Epidemic Overwhelmingly White?” Nov. 4, 2017, available at <https://www.npr.org/2017/11/04/562137082/why-is-the-opioid-epidemic-overwhelmingly-white> (last visited May 9, 2018); G. Kolata and S. Cohen, “Drug Overdoses Propel Rise in Mortality Rates of Young Whites,” New York Times, Jan. 16, 2016, available at <https://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html?mtrref=undefined> (last visited May 9, 2018).+(last+visited+May+9,+2018);+G.+Kolata+and+S.+Cohen,+“Drug+Overdoses+Propel+Rise+in+Mortality+Rates+of+Young+Whites,”+New+York+Times,+Jan.+16,+2016,+available+at++(last+visited+May+9,+2018).>Google Scholar
Jones, C P., “Levels of Racism: A Theoretic Framework and a Gardener’s Tale,” American Journal of Public Health 90, no. 8 (2000): 1212–1215.Google Scholar
Hoffman, K.M. et al., “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about Biological Differences between Blacks and Whites,” Proceedings of the National Academy of Sciences 113, no. 16 (2016): 4296-4301; A.J. Kposowa and G.T. Tsunokai, “Searching for Relief: Racial Differences in Treatment of Patients with Back Pain,” Race and Society 5, no. 2 (2002): 193-223; K.H. Todd et al., “Ethnicity and Analgesic Practice,” Annals of Emergency Medicine 35, no. 1 (2000): 11-16.Google Scholar
Green, C.R. et al., “The Unequal Burden of Pain: Confronting Racial and Ethnic Disparities in Pain,” Pain Medicine 4, no. 3 (2003): 277–294; R. Bernabei et al., “Management of Pain in Elderly Patients with Cancer,” JAMA, 279, no. 23 (1998): 1877-1882. (Black nursing home residents 63% less likely than similarly situated whites to receive opioids for cancer pain.)Google Scholar
Meghani, S. H. et al., “Time to Take Stock: A Meta-Analysis and Systematic Review of Analgesic Treatment Disparities for Pain in the United States,” Pain Medicine 13, no. 2 (2012): 150-174.Google Scholar
See Cicero et al., supra note 4.Google Scholar
See Cicero et al., supra note 4.Google Scholar
See Cicero et al., supra note 4.Google Scholar
Dowell, et al., Opinion Editorial, “Underlying Factors in Drug Overdose Death,” JAMA 318, no. 23 (2017): 2295-2296.Google Scholar
Cicero, T.J. et al., “The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years,” JAMA Psychiatry 71, no. 7 (2014): 821-826.Google Scholar
Mars, S.G. et al., “Every ‘Never’ I Ever Said Came True: Transitions from Opioid Pills to Heroin Injecting,” International Journal of Drug Policy 25, no. 2 (2014): 257-266; T.J. Cicero et al., “Effect of Abuse-Deterrent Formulation of OxyContin,” N. Engl. J. Med. 367, no. 2 (2012): 187-189; S.E. Lankenau et al., “Initiation into Prescription Opioid Misuse Amongst Young Injection Drug Users,” International Journal of Drug Policy 23, no. 1 (2012): 37-44; N.D. Volkow, “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse,” Testimony to Senate Caucus on International Narcotics Control, May 14, 2014, available at <https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse> (last visited May 9, 2018).Google Scholar
Human Rights Watch, Decades of Disparity: Drug Arrests and Race in the United States, Mar. 2009, available at <https://www.hrw.org/sites/default/files/reports/us0309web_1.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice, Drug Offenders in Federal Prison: Estimates of Characteristics Based on Linked Data, SPECIAL REPORT, Oct. 2015, available at <https://www.bjs.gov/content/pub/pdf/dofp12.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
NAACP, Criminal Justice Fact Sheet, available at <http://www.naacp.org/pages/criminal-justice-fact-sheet> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
ACLU, War Comes Home: The Excessive Militarization of American Police, June 2014, available at <https://www.aclu.org/sites/default/files/assets/jus14-warcomeshome-report-web-rel1.pdf> (last visited May 7, 2018).+(last+visited+May+7,+2018).>Google Scholar
See Human Rights Watch, supra note 54. See also Bigg, M., “Report says U.S. Jails More Blacks than Whites for Drugs,” Reuters, Dec. 4, 2007, available at <http://www.reuters.com/article/2007/12/05/us-usa-drugs-race-idUSN0453686820071205> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
ACLU, Racial Disparities in Sentencing, Oct. 27, 2014, available at <https://www.aclu.org/sites/default/files/assets/141027_iachr_racial_disparities_aclu_submission_0.pdf> (last visited May 9, 2018); United States Sentencing Commission, “Demographic Differences in Sentencing,” 2012 Report To The Congress: Continuing Impact of United States v. Booker on Federal Sentencing, Dec. 2012, available at <https://www.ussc.gov/sites/default/files/pdf/news/congressional-testimony-and-reports/booker-reports/2012-booker/Part_E.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018);+United+States+Sentencing+Commission,+“Demographic+Differences+in+Sentencing,”+2012+Report+To+The+Congress:+Continuing+Impact+of+United+States+v.+Booker+on+Federal+Sentencing,+Dec.+2012,+available+at++(last+visited+May+9,+2018).>Google Scholar
Tsimbinos, S.A., “Is It Time to Change the Rockefeller Drug Laws?” St. John’s Journal of Legal Comment 13, no. 3 (1999): 613-634, at 613 (stating that Governor Rockefeller and the Legislature enacted toughest drug laws in country in response to increased drug use); T.M. Quinn and G.T. McLaughlin, “The Evolution and Present Status of New York Drug Control Legislation,” Buffalo Law Review 22, no. 3 (1973): 705-736, at 733 (stating that Rockefeller Drug Laws evidence ‘strict law enforcement attitude’ regarding drug crime in New York).Google Scholar
Underwood, J.E. and Daniels, W.J., Governor Rockefeller in New York: The Apex of Pragmatic Liberalism in the United States (Westport: Greenwood Press, 1982): at 139.Google Scholar
Id.Google Scholar
N.Y. Penal Law, § 70.06 (McKinney 1998).Google Scholar
“Excerpts From the Message by Governor Rockefeller on the State of the State,” New York Times, Jan 4. 1973, available at <http://www.nytimes.com/1973/01/04/archives/excerpts-from-the-message-by-governor-rockefeller-on-the-state-of.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Connery, R.H. and Benjamin, G., Rockefeller of New York: Executive Power in the Statehouse (Ithaca, N.Y.: Cornell University Press, 1979): at 272.Google Scholar
Drucker, E., “Population Impact of Mass Incarceration under New York’s Rockefeller Drug Laws: An Analysis of Years of Life Lost,” Journal of Urban Health Bulletin of the New York Academy of Medicine 79, no. 3 (2002): 434-444.Google Scholar
Id. See also Nakdai, L.R., “Are New York’s Rockefeller Drug Laws Killing the Messenger for the Sake of the Message,” Hofstra Law Review 30, no. 2 (2001): 557-587.Google Scholar
See generally Maggio, E.J., “New York’s Rockefeller Drug Laws, Then and Now,” NYSBA Journal 78, no. 9 (2006): 30-34.Google Scholar
Anti-Drug Abuse Act of 1986, Pub. L. No. 99-570, 100 Stat. 3207 (codified in various sections of 21 U.S.C.).Google Scholar
See generally Hart, C.L., High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society (New York: HarperCollins Publishers, 2013) [herein after Hart, High Price].Google Scholar
U.S. Department of Justice, Federal Cocaine Offenses: An Analysis of Crack and Powder Penalties, Mar. 17, 2002.Google Scholar
Baum, D., “Legalize It All: How to Win the War on Drugs,” Harper’s Magazine, Apr. 2016, available at <https://harpers.org/archive/2016/04/legalize-it-all/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Hart, C.L., “How the Myth of the ‘Negro Cocaine Fiend’ Helped Shape American Drug Policy,” The Nation, Jan. 29 2014, available at <https://www.thenation.com/article/how-myth-negro-cocaine-fiend-helped-shape-american-drug-policy/> (last visited May 9, 2018) [hereinafter Hart, “Myth”].+(last+visited+May+9,+2018)+[hereinafter+Hart,+“Myth”].>Google Scholar
NYCLU, Stop-and-Frisk 2012, NYCLU BRIEFING, May 22, 2013, available at <https://www.nyclu.org/sites/default/files/releases/2012_Report_NYCLU.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See Hart, High Price, supra note 70, at 191.CrossRefGoogle Scholar
See Hart, “Myth,” supra note 73.Google Scholar
Kerr, P., “New Violence Seen in Users of Cocaine,” New York Times, March 7, 1987, available at <http://www.nytimes.com/1987/03/07/nyregion/new-violence-seen-in-users-of-cocaine.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Vaughn, M.G. et al., “Is Crack Cocaine Use Associated with Greater Violence than Powdered Cocaine Use? Results from a National Sample,” The American Journal of Drug and Alcohol Abuse 36, no. 4 (2010): 181-186.CrossRefGoogle Scholar
Richards, E., Cocaine True, Cocaine Blue, available at <https://eugenerichards.com/cocaine-true-cocaine-blue/2m337jr7x4r50qrbixmaywetv53k1m> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
du Cille, M., “Photo Gallery: Michel du Cille’s Pulitzer Prizewinning photography,” Miami Herald, Dec. 12, 2014, available at <http://www.miamiherald.com/news/local/obituaries/article4452322.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Burston, B.W., “Drug Use and African Americans: Myth Versus Reality,” Journal of Alcohol and Drug Education 40, no. 2 (1995): 19-39.Google Scholar
PBS, “There Was no Wave of Compassion when Addicts were Hooked on Crack,” PBS News Hour, Mar. 29, 2016, available at <https://www.pbs.org/newshour/show/there-was-no-wave-of-compassion-when-addicts-were-hooked-on-crack#transcript> (last visited May 9, 2018). See also E.N. Yankah, “When Addiction Has a White Face,” New York Times, Feb. 9 2016, available at <https://www.nytimes.com/2016/02/09/opinion/when-addiction-has-a-white-face.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).+See+also+E.N.+Yankah,+“When+Addiction+Has+a+White+Face,”+New+York+Times,+Feb.+9+2016,+available+at++(last+visited+May+9,+2018).>Google Scholar
Prison Policy Initiative, Mass Incarceration: The Whole Pie 2017, Mar. 14, 2017, available at <https://www.prisonpolicy.org/reports/pie2017.html> (last visited May 9, 2018). See also Prison Policy Initiative, United States Incarceration Rates by Race and Ethnicity, 2010, available at <https://www.prison-policy.org/graphs/raceinc.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).+See+also+Prison+Policy+Initiative,+United+States+Incarceration+Rates+by+Race+and+Ethnicity,+2010,+available+at++(last+visited+May+9,+2018).>Google Scholar
Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice, Probation and Parole in the United States, 2015, Bulletin, Feb. 2, 2017, available at <https://www.bjs.gov/content/pub/pdf/ppus15.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice, Drug Offenders in Federal Prison: Estimates of Characteristics Based on Linked Data, SPECIAL REPORT, Oct. 2015, available at <https://www.bjs.gov/content/pub/pdf/dofp12.pdf> (last visited May 9, 2018) [hereinafter BJS, Estimates]. See also “Inmate Race,” Federal Bureau of Prisons, available at <https://www.bop.gov/about/statistics/statistics_inmate_race.jsp> (last visited May 9, 2018).+(last+visited+May+9,+2018)+[hereinafter+BJS,+Estimates].+See+also+“Inmate+Race,”+Federal+Bureau+of+Prisons,+available+at++(last+visited+May+9,+2018).>Google Scholar
See BJS, Estimates, supra note 85.Google Scholar
See BJS, Estimates, supra note 85.Google Scholar
See BJS, Estimates, supra note 85. See also Werle, N. and Zedillo, E., “We Can’t Go Cold Turkey: Why suppressing drug markets endangers society,” Journal of Law, Medicine & Ethics 46, no. 2 (2018): 325-342.Google Scholar
Gostin, L.O. et al., “Reframing the Opioid Epidemic as a National Emergency,” JAMA 318, no. 16 (2017): 1539-1540.Google Scholar
Cohen, A., “How White Users Made Heroin a Public-Health Problem,” The Atlantic, Aug. 12, 2015, available at <https://www.theatlantic.com/politics/archive/2015/08/crack-heroin-and-race/401015/> (last visited May 9, 2018). See also M. Alexander, Keynote speech at 2017 International Drug Policy Reform Conference, Atlanta, Georgia, Oct. 11, 2017, available at <http://www.theroot.com/michelle-alexander-delivers-fiery-keynote-at-dpa-s-2017-1819453125?utm_source=theroot_facebook&utm_medium=socialflow> (last visited May 9, 2018).+(last+visited+May+9,+2018).+See+also+M.+Alexander,+Keynote+speech+at+2017+International+Drug+Policy+Reform+Conference,+Atlanta,+Georgia,+Oct.+11,+2017,+available+at++(last+visited+May+9,+2018).>Google Scholar
Lassiter, M., “Impossible Criminals: The Suburban Imperatives of America’s War on Drugs,” Journal of American History 102, no. 1 (2015): 126-140.Google Scholar
Id.Google Scholar
Id.Google Scholar
Id.Google Scholar
Seelye, K.Q., “In Heroin Crisis, White Families Seek Gentler War on Drugs,” New York Times, Oct. 30, 2015, available at <https://www.nytimes.com/2015/10/31/us/heroin-war-on-drugs-parents.html> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Stockbridge, J. and Rothman, L., “A Caring Lens on the Opioid Crisis,” Time, available at <http://time.com/jeffrey-stock-bridge-kensington-philadelphia-photographs> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Talbot, M., “The Addicts Next Door,” New Yorker, June 5, 2017, available at <https://www.newyorker.com/magazine/2017/06/05/the-addicts-next-door> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Shaw, M., “Photos Reveal Media’s Softer Tone on Opioid Crisis,” Columbia Journalism Review, Jul. 26, 2017, available at <https://www.cjr.org/criticism/opioid-crisis-photos.php> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Holloway, K., “The Massive Discrepancies Between Media Coverage of Mythical Crack Babies and Opiate-Dependent Babies,” Alternet, Jan. 12, 2016, available at <https://www.alternet.org/drugs/massive-discrepancies-between-media-coverage-mythical-crack-babies-and-opiate-dependent-babies> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Lee, J., “The New Face of Drug Addiction,” Fox News, July 19, 2013, available at <http://fox40.com/2013/07/19/new-face-of-drug-addiction/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Schwartz, Y., “Painkiller Use Breeds New Face of Heroin Addiction,” NBC News, Jun. 19, 2012, available at <http://dailynightly.nbcnews.com/_news/2012/06/19/12303942-painkiller-use-breeds-new-face-of-heroin-addiction?lite> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Michels, S., “Heroin in Suburbia: the New Face of Addiction,” ABC News, Aug. 4, 2008, available at <http://abcnews.go.com/TheLaw/story?id=5494972> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Netherland, J. and Hansen, H.B., “The War on Drugs That Wasn’t: Wasted Whiteness, ‘Dirty Doctors,’ and Race in Media Coverage of Prescription Opioid Misuse,” Culture, Medicine, and Psychiatry 40, no. 4 (2016): 664-686.CrossRefGoogle Scholar
Id.Google Scholar
U.S. Drug Deaths Continue Rapid Rise, Zimbio, Jun. 6, 2017, available at <http://www.zimbio.com/pictures/iBt9c-QnHnaD/Drug+Deaths+Continue+Rapid+Rise/xo1_tcX-6ckH> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See Netherland and Hansen, supra note 103.Google Scholar
See Netherland and Hansen, supra note 103.Google Scholar
See Netherland and Hansen, supra note 103.Google Scholar
Pew Research Center, America’s New Drug Policy Landscape, April 2014, available at <http://www.people-press.org/files/legacy-pdf/04-02-14%20Drug%20Policy%20Release.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Oliphant, B., Prescription Drug Abuse Increasingly Seen as a Major U.S. Public Health Problem, Pew Research Center, available at <http://www.pewresearch.org/fact-tank/2017/11/15/prescription-drug-abuse-increasingly-seen-as-a-major-u-s-public-health-problem/> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
Id.Google Scholar
Lopez, G., When a Drug Epidemic’s Victims are White, Vox, available at <https://www.vox.com/identities/2017/4/4/15098746/opioid-heroin-epidemic-race> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
See Seelye, supra note 95.Google Scholar
See, e.g., Comprehensive Addiction and Recovery Act of 2016, Pub. L. No. 114-198, 130 Stat. 695 (codified in scattered sections of 21 and 42 U.S.C.).Google Scholar
President’s Commission on Combating Drug Addiction and the Opioid Crisis, Interim Report, Aug. 2017, available at <https://www.whitehouse.gov/sites/whitehouse.gov/files/ondcp/commission-interim-report.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
President’s Commission on Combating Drug Addiction and the Opioid Crisis, Final Report, Nov. 2017, available at <https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final_Report_Draft_11-1-2017.pdf> (last visited May 9, 2018).+(last+visited+May+9,+2018).>Google Scholar
U.S. General Accountability Office, Youth Illicit Drug Use Prevention: DARE Long-Term Evaluations and Federal Efforts to Identify Effective Programs, Jan 15. 2003, available at <https://www.gao.gov/assets/100/91676.pdf> (last visited May 9. 2018); Office of the Surgeon General, Department of Health and Human Services, Youth Violence: A Report of the Surgeon General, 2001; D. R. Lynam et al., “Project DARE: No Effects at 10-Year Follow-Up,” Journal of Consulting and Clinical Psychology 67, no. 4 (1999): 590–593.+(last+visited+May+9.+2018);+Office+of+the+Surgeon+General,+Department+of+Health+and+Human+Services,+Youth+Violence:+A+Report+of+the+Surgeon+General,+2001;+D.+R.+Lynam+et+al.,+“Project+DARE:+No+Effects+at+10-Year+Follow-Up,”+Journal+of+Consulting+and+Clinical+Psychology+67,+no.+4+(1999):+590–593.>Google Scholar
See Final Report, supra note 116 at 10.Google Scholar
See Final Report, supra note 116 at 7.Google Scholar
Daley, M.C., “Race, Managed Care, and the Quality of Substance Abuse Treatment,” Administration and Policy in Mental Health and Mental Health Services Research 32, no. 4 (2005): 457-476; M. Alegria, G. Canino, and R. Rios, “Inequalities in Use of Specialty Mental Health Services Among Latinos, African Americans, and Non-Latino Whites,” Year Book of Psychiatry & Applied Mental Health 1 (2004): 184-185; K. Wells et al., “Ethnic Disparities in Unmet Need for Alcoholism, Drug Abuse, and Mental Health Care,” American Journal of Psychiatry 158, no. 12 (2001): 2027-2032; D. Longshore et al., “Ethnic Patterns in Drug Abuse Treatment Utilization,” The Journal of Behavioral Health Services and Research 19, no. 3 (1992): 268-277.Google Scholar
See Final Report, supra note 116 at 24-25.Google Scholar
See Final Report, supra note 116 at 24-25.Google Scholar
Substance Abuse and Mental Health Services Administration, Office of the Surgeon General, U.S. Department of Health and Human Services, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, Nov. 2016, available at <https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf> (last accessed May 9, 2018).+(last+accessed+May+9,+2018).>Google Scholar
Substance Abuse & Mental Health Services Administration, U.S. Department of Health & Human Services, Results From The 2010 National Survey On Drug Use And Health: Summary of National Findings, Sept. 2011, available at <https://www.samhsa.gov/data/sites/default/files/NSDUHNationalFindingsResults2010-web/2k10ResultsRev/NSDUHresultsRev2010.pdf> (last accessed May 9, 2018).+(last+accessed+May+9,+2018).>Google Scholar
Wells, K. et al., “Ethnic Disparities in Unmet Need for Alcoholism, Drug Abuse, and Mental Health Care,” American Journal of Psychiatry 158, no. 12 (2001): 2027-2032.Google Scholar
Lipari, R. N. and Hager, C., “Substance Abuse and Mental Health Administration, Need for and Receipt of Substance Use Treatment among Blacks,” The CBHSQ Report, Feb. 21, 2013.Google Scholar
Cook, B. Lê and Alegría, M., “Racial-Ethnic Disparities in Substance Abuse Treatment: The Role of Criminal History and Socioeconomic Status,” Psychiatric Services 62, no. 11 (2011): 1273-1281; J.L. Rounds-Bryant and J. Staab, “Patient Characteristics and Treatment Outcomes for African American, Hispanic, and White Adolescents in DATOS-A,” Journal of Adolescent Research 16, no. 6 (2001): 624-641.Google Scholar
Barnett, J.C. and Vornovitsky, M.S., U.S. Census Bureau, Health Insurance Coverage in the United States: 2015, Current Population Reports, Sept. 2016, available at <https://www.census.gov/content/dam/Census/library/publications/2016/demo/p60-257.pdf> (last visited May 9, 2018); J.R. Cummings et al., “Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States,” JAMA Psychiatry 71, no. 2 (2014): 190-196.+(last+visited+May+9,+2018);+J.R.+Cummings+et+al.,+“Race/Ethnicity+and+Geographic+Access+to+Medicaid+Substance+Use+Disorder+Treatment+Facilities+in+the+United+States,”+JAMA+Psychiatry+71,+no.+2+(2014):+190-196.>Google Scholar
See Cummings et al., supra note 128.Google Scholar
Ayres, I. and Jalal, A., “The Impact of Prescription Drug Monitoring Programs on U.S. Opioid Prescriptions,” Journal of Law, Medicine & Ethics 46, no. 2 (2018): 387-403.CrossRefGoogle Scholar
Netherland, J. and Hansen, H.B., “White Opioids: Pharmaceutical Race and the War on Drugs that Wasn’t,” BioSocieties 12, no. 2 (2017): 217-238; H. Hansen et al., “Buprenorphine and Methadone Treatment for Opioid Dependence by Income, Ethnicity and Race of Neighborhoods in New York City,” Drug and Alcohol Dependence 164 (2016): 14-21. See also J.A. Del Real, “Opioid Addiction Knows No Color, but Its Treatment Does,” New York Times, Jan. 12, 2018, available at <https://www.nytimes.com/2018/01/12/nyregion/opioid-addiction-knows-no-color-but-its-treatment-does.html> (last visited May 9, 2018).Google Scholar
See Barnett and Vornovitsky, supra note 128.Google Scholar
See, e.g., Cummings, J.R. et al., “Geography and the Medicaid Mental Health Care Infrastructure: Implications for Health Care Reform,” JAMA Psychiatry 70, no. 10 (2013): 1084-1090; R.Y. Hsia and Y. Shen, “Rising Closures of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations,” Health Affairs 30, no. 10 (2011): 1912-1920; M. Komaromy et al., “The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations,” New England Journal of Medicine 334, no. 20 (1996): 1305-1310; A. Schatzkin, ‘The Relationship of Inpatient Racial Composition and Hospital Closure in New York City,” Medical Care 22, no. 5 (1984): 379-387.Google Scholar
Cooper, L.A. et al., “Delving Below the Surface: Understanding how Race and Ethnicity Influence Relationships in Health Care,” Journal of General Internal Medicine 21, no. S1 (2006): S21–S27; R.L. Johnson et al., “Racial and Ethnic Differences in Patient Perceptions of Bias and Cultural Competence in Health Care,” Journal of General Internal Medicine 19, no. 2 (2004): 101-110.Google Scholar
Sorkin, D.H., Ngo-Metzger, Q., and De Alba, I., “Racial/Ethnic Discrimination in Health Care: Impact on Perceived Quality of Care,” Journal of General Internal Medicine 25, no. 5 (2010): 390-396; T.C. Collins et al., “Racial Differences in How Patients Perceive Physician Communication Regarding Cardiac Testing,” Medical Care 40, no. 1 (2002): I27–I34; J. Malat, “Social Distance and Patients’ Rating of Healthcare Providers,” Journal of Health and Social Behavior 42, no. 4 (2001): 360-372; S. Saha et al., “Patient-Physician Racial Concordance and the Perceived Quality and Use of Health Care,” Archives of Internal Medicine 159, no. 9 (1999): 997-1004.Google Scholar
Alvidrez, J., Snowden, L.R., and Kaiser, D.M., “The Experience of Stigma among Black Mental Health Consumers,” Journal of Health Care for the Poor and Underserved 19, no. 3 (2008): 874-893.CrossRefGoogle Scholar
Id.Google Scholar
The Center for Faith-based and Neighborhood Partnerships, U.S. Department of Health and Human Services, “A Practical Toolkit for Faith and Community Leaders in the Face of the Opioid Epidemic,” available at <http://www.ahecwest.org/uploads/files/Toolkit%20for%20community%20leaders.pdf> (last visited May 9, 2017). See also W. Bielefeld and W.S. Cleveland, “Defining Faith-Based Organizations and Understanding them Through Research,” Nonprofit and Voluntary Sector Quarterly 42, no. 3 (2013): 442-467; M. K. Campbell et al., “Church-based Health Promotion Interventions: Evidence and Lessons Learned,’ Annual Review of Public Health 28 (2007): 213-234.+(last+visited+May+9,+2017).+See+also+W.+Bielefeld+and+W.S.+Cleveland,+“Defining+Faith-Based+Organizations+and+Understanding+them+Through+Research,”+Nonprofit+and+Voluntary+Sector+Quarterly+42,+no.+3+(2013):+442-467;+M.+K.+Campbell+et+al.,+“Church-based+Health+Promotion+Interventions:+Evidence+and+Lessons+Learned,’+Annual+Review+of+Public+Health+28+(2007):+213-234.>Google Scholar
Molock, S.D. et al., “Developing Suicide Prevention Programs for African American Youth in African American Churches,” Suicide and Life-Threatening Behavior 38, no. 3 (2008): 323-333; T. Moore, “Promoting Change through the African American Church and Social Activism,” Journal of Psychology & Christianity 22, no. 4 (2003): 357-362; M. Sanders, “The Response of African American Communities to Alcohol and other Drug Problems: An Opportunity for Treatment Providers,” Alcoholism Treatment Quarterly 20, no. 3-4 (2002): 167-174; J.R. Morris and D.T. Robinson, “Community and Christianity in the Black Church,” Counseling and Values 41, no. 1 (1996): 59-69; T. Moore, “The African-American Church: A Source of Empowerment, Mutual Help, and Social Change,” Prevention in Human Services 10, no. 1 (1991): 147-167.Google Scholar
Walton-Moss, B., Ray, E.M., and Woodruff, K., “Relationship of Spirituality or Religion to Recovery from Substance Abuse: A Systematic Review,” Journal of Addictions Nursing 24, no. 4 (2013): 217-226; D.D. Chitwood, M.L. Weiss, and C.G. Leukefeld, “A Systematic Review of Recent Literature on Religiosity and Substance Use,” Journal of Drug Issues 38, no. 3 (2008): 653-688; K.S. Kendler et al., “Dimensions of Religiosity and their Relationship to Lifetime Psychiatric and Substance Use Disorders,” American Journal of Psychiatry 160, no. 3 (2003): 496-503; T.A. Wills, A.M. Yaeger, and J.M. Sandy, “Buffering Effect of Religiosity for Adolescent Substance Use,” Psychology of Addictive Behaviors 17, no. 1 (2003): 24-31; H.G. Koenig and D.B. Larson, “Religion and Mental Health: Evidence for an Association,” International Review of Psychiatry 13, no. 2 (2001): 67-78.Google Scholar
Stahler, G.J., “A Faith-Based Intervention for Cocaine-Dependent Black Women,” Journal of Psychoactive Drugs 39, no. 2 (2007): 183-190.Google Scholar
Conner, B.T. et al., “Effect of Religiosity and Spirituality on Drug Treatment Outcomes,” The Journal of Behavioral Health Services & Research 36, no. 2 (2009): 189-198.Google Scholar
Sisk, T., “Offering Syringes Along With Prayers, Churches Help IV Drug Users,” Kaiser Health News, Jan. 3, 2017.Google Scholar
Taylor, R.J. et al., “Black and White Differences in Religious Participation: A Multisample Comparison,” Journal for the Scientific Study of Religion 35, no. 4 (1996): 403-410.CrossRefGoogle Scholar
Chatters, L.M., Taylor, R.J., and Lincoln, K.D., “African American Religious Participation: A Multi-Sample Comparison,” Journal for the Scientific Study of Religion 38, no. 1 (1999): 132-145.Google Scholar
Levin, J.S., Taylor, R.J., and Chatters, L.M., “A Multidimensional Measure of Religious Involvement for African Americans,” The Sociological Quarterly 36, no. 1 (1995): 157-173.CrossRefGoogle Scholar
See Netherland and Hansen, supra note 103.Google Scholar
See, e.g., Fiscella, K. and Sanders, M.R., “Racial and Ethnic Disparities in the Quality of Health Care,” Annual Review of Public Health 37 (2016): 375-394; W. Kennedy, G. Sonnad and S. Hing, “Putting Race Back on the Table: Racial Impact Statements,” Clearinghouse Review: Journal of Poverty Law and Policy 47 (2013): 154-162.Google Scholar
London, C., “Racial Impact Statements: A Proactive Approach to Addressing Racial Disparities in Prison Populations,” Law & Inequality: A Journal of Theory and Practice 29, no. 1 (2011): 211-248; M. Mauer, “Racial Impact Statements-Changing Policies to Address Disparities,” Criminal Justice 23, no. 4 (2009): 16-21.Google Scholar
See Netherland and Hansen, supra note 103.Google Scholar
See Netherland and Hansen, supra note 103.Google Scholar
National Center for Health Statistics, Center for Disease Control and Prevention, “Drug Overdose Deaths in the United States, 1999–2015,” NCHS DATA BRIEF, no. 273 (Feb. 2017), available at <https://www.cdc.gov/nchs/data/databriefs/db273.pdf> (last visited May 7, 2018).+(last+visited+May+7,+2018).>Google Scholar
See Bechteler and Kane-Willis, supra note 20.Google Scholar
See Yankah, supra note 82.Google Scholar