Recent reports released by the CDC and the Washington, DC Medical Examiner’s Office are sounding the alarm of the toll opioid drug misuse is having on the lives of District residents. The CDC reports that Washington, DC has one of the highest rates of drug overdose deaths in the U.S., at 44.0 deaths per 100,000 residents, more than double the national average rate of 21.7 per 100,000.
In the nation’s Capital, the medical examiner reports a 178% increase in drug overdose deaths from 2014 (n=83) to 2016 (n=231), and a 21% increase in such deaths from 2016 to 2017 (n=279). In just the first 3 months of 2018, the Office reported 83 overdose deaths occurred in DC by March 31. The overwhelming majority – approx. 80% – of these deaths in DC are among black males between the ages of 40-69.
Unfortunately, high rates of illicit drug use in large cities and among minorities is not a new problem. And even more unfortunately, the willful neglect by lawmakers of addressing the problem of substance use in these populations is not a new issue. Even now that substance use is in the public spotlight as a major public health crisis, it only came to such prominence once it started to affect rural and suburban whites. Opioid misuse as ravished inner-city communities for decades, and when largely unchecked and ignored. It only became a “crisis” when lawmakers saw it affected citizens they actually feel are valuable and “worthy” of saving. That is the frank reality of this situation. When crack cocaine took hold in the inner cities of the 1980s, the government called for a “WAR ON DRUGS” and levied the same penalties for use and possession of 5 grams crack cocaine that was given to someone in possession of 500 grams of powder cocaine. What was the difference? Was crack 100 times for potent and deadly, thus 100 times a greater threat? No, but crack was held as the symbol of all that was morally woeful and degrading in society at the time, and a massive campaign was undertaken to combat its effects. But, again, the frank truth that would not be overlooked is powder cocaine was the more pure and expensive drug of yuppies, celebrities, and those who could afford its hefty price tag, while crack was the cheap version of cocaine popular amongst poor minorities.
The response to today’s opioid epidemic portrays those using illicit drugs as people in crisis who are dealing with a mental and physical medical condition and who need treatment and compassion. Even the words used when describing those affected is carefully crafted to minimize offense or stigma. “Drug abuse” is now a taboo term, with terms like “substance use” or “drug misuse” currying more favor. This was hardly the case during the height of the crack epidemic. Users were called “abusers” or “junkies.” Drug tests that indicated the presence of illegal substances were called “dirty.” Users were seen as having fundamental moral and character flaws that led them to “choose” a life of drug abuse and sometimes crime, and never seen as having a health condition that would warrant compassion or sympathy. They were criminals outside the bounds of decent society who needed to be disciplined.
Today in cities such as Washington, DC, those poor minority men who fell victim to the pull of crack cocaine in their youth in the 1980s – and who were left with few resources from the government to get treatment and social service support to overcome their addiction – are now middle aged men still struggling with addiction with a new drug-of-choice – opioids. As this article shows, their needs are still being overlooked and ignored by those in power. It is a shameful reality that needs a lot more sunlight shone upon it. The government will have the general public believe that the response and abundance of newly-authorized resources to the nation’s opioid epidemic is reaching all segments of the population affected, when the truth is there are still clearly defined priorities within this response that is still leaving millions of Americans without help. The DC government and policymakers writ large should be ashamed of themselves AND held accountable for the disparate response to the opioid epidemic and for the lives being lost as a result.
The Washington Post has written some fantastic articles on the effects of the opioid crisis in Washington, DC. Find them here.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.