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White Privilege Helps Explain The Opioid Epidemic


There is much talk nowadays about the “white face” of the opioid epidemic and how sympathetic media coverage of white drug users has inspired compassionate policies that differ markedly from the country’s draconian response to crack use.

While this is true (although we shouldn’t overlook the impact of opioids on communities of color), there is less talk about why the opioid epidemic has hit Caucasians so hard.

Several theories have been bantered around. First, there is the explanation that whites are more likely than people of color to have access to health insurance and prescription opioids, which also pave the way for alternatives such as heroin and illicit fentanyl.

Second, research has demonstrated bias among some physicians who prescribe painkillers. Some providers have a tendency to think it’s safe to prescribe to white patients while worrying that black patients might misuse or divert the pills. Third, we still live in a largely segregated society, so a drug that becomes popular among a particular racial demographic stays largely limited to that demographic even as use spreads.

Each of these theories may help piece together the story of how opioids came to have a disproportionate impact on white communities, but there is another explanation: white privilege.

White privilege is rarely mentioned by name when talking about opioids, but it is glaringly obvious in almost every discussion. Time and time again, a white person with a loved one using opioids will say something like: “I couldn’t believe my daughter was using heroin. I never thought something like this would happen to our family,” or “We raised our children in a good family. How did this happen?”

There are some very disturbing implications in these phrases ― namely, that white families are by definition “good” and immune from certain problems. This is white privilege incarnate – the belief that white families aren’t or shouldn’t be affected by the kinds of problems that impact families of color. Silence, stigma and denial allowed the opioid problem to metastasize in white communities until it was too big to hide anymore. We were blindsided by widespread drug addiction: This can’t be real! These kinds of things don’t happen to us!

Another part and parcel of white privilege can be expecting a life free of pain. This can mean freedom from the pain of loss, discrimination, marginalization and criminalization, but also freedom from physical pain. For many white people whose lives have been suddenly turned upside down by job markets moving away, chronic pain issues or depression, opioids promise an antidote to these unexpected challenges. I don’t see this reaction as often in communities of color, where pain, both physical and otherwise, manifests in the form of injustice and prejudice every day.

Understanding white privilege and the many ways in which it manifests in our lives is a critical part of moving toward effective and equitable drug policy. It’s not enough to simply point out that the response to drug use is more compassionate now because users are white. That is only a piece of the problem. Many people now know that response to drug use is racially biased, yet we continue to push for opioid-centric programs, which sets us up for a return to punitive policies once the drug du jour changes and the user demographic shifts hue.

To create lasting, permanent change, we need not only to understand and challenge the ways that race has impacted drug policy from our first anti-drug laws until now, but also to anticipate the ways that race will continue to be used to determine future drug policy. We need to craft a response against efforts to turn us back toward punitive drug policy aimed at people of color before the demographic shift even happens. Because it is coming. And we aren’t ready.

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