The “Opioid Epidemic” is NOT and Never Will Be an Epidemic for Black People; It Is a White Problem, Always Has Been
White people have been — and continued to be — over-prescribed pain medications while black people have been — and continue to be — under-prescribed and under-treated.
This is a subject that I am well versed in. As a healthcare, social work, and addictions professional — who comes from a low-income background and who also suffers from chronic pain — I have a unique prospective and can examine this issue — because it is certainly an issue — from just about all sides. That said, I think everyone can agree that the opioid epidemic — as the widespread abuse of prescription opioids has been termed here in the United States — has been, and continues to be, in the forefront of the medical and political arenas. This has been the case for at least a decade. After all, hardly a day goes by in the — local and national — media where there isn't a story — celebrity OD or death — or prime-time special that highlights the problem.
Most scholars and medical professionals agree that the opioid epidemic is a predominately white problem and/or issue (Hansen & Netherland, 2016).
And while I will be the first to admit that prescription opioids are indeed a problem in some black communities, it is nowhere near an epidemic, and it will never be, or at least not anytime soon. There are several reasons — some more complex than others — why the opioid epidemic — by and large — has had significantly less effect on black people, many of which I will save for later posts. However, I will discuss two of the most pertinent reasons here. Those reasons being: medical white privilege and racism.
I had been left in severe pain so much and by so many physicians that I didn’t even know that there was an “opioid epidemic” in the U.S. until I entered nursing school.
Being a black woman — and former CNA, nursing student — and trained healthcare administrator, I have both witnessed and experienced medical racism and white privilege firsthand. You see, I have personally experienced being in agonizing and completely verifiable pain — such as being involved in a car crash that very nearly killed me, and in which I received several broken and dislocated bones, which in turn resulted in 10 surgeries — and been left without the pain medications needed to adequately treat my pain. In fact, several of my orthopedic doctors — when my mother would inevitably seek treatment for my high levels of pain— told my mother and I that pain medications weren't prescribed to “children.” I was forced to rely on gargantuan doses of OTCs which, needless to say, lead to several adverse reactions.
Moreover, I have had several doctors — and witnessed the very same situation occur with other black patients — outright refuse to prescribe pain medications despite a complete lack of risk factors — such no history of substance abuse, drug seeking behaviors, or mental health issues — and articulating that fact that they KNEW — based off of my diagnostic results and medical history of course — that I was in horrible pain but could do nothing due to “opioid epidemic regulations.” At the same time, I have witnessed white individuals — some of whom with histories of substance abuse AND without a documented painful/concrete medical condition such as migraines and fibromyalgia — walk into healthcare facilities and ER’s and receive powerful pain medications without a hassle or fuss on behalf of the prescribing physician. Over the years, I witnessed physicians give a myriad of ridiculous — and often completely irrelevant — justifications for their refusal to prescribe pain medications from they’ll make me “loopy” to they have had “little old ladies addicted.”
It wasn’t until I was 29-years-old that I found a doctor who was willing to at least try and treat my pain with medication. All told, I suffered for nearly 20 years in severe and chronic pain without pain medication.
These occurrences are so common — although they shouldn't be and I wish they weren’t— with black patients that I wasn't the least bit surprised when a recent study revealed that black people were more much more likely to be left untreated and/or under-treated for their pain than white people. The study revealed that many white medical students and residents hold racist misconceptions — such as that blacks have less sensitive nerve endings than whites or that black people’s blood coagulates more quickly — and beliefs about black people which contributes to the rampant under-treatment of pain in black patients. The study also found that the medical students and residents who held these false beliefs often rated black patients’ pain as lower than that of white patients and made less appropriate recommendations about how they should be treated. Since the beginnings of the epidemic, there has been a high concentration of prescription opioids within rural mostly white populations and little has changed in the years since even with all the new regulations in place. What makes the results of this study even more disturbing is the fact that numerous other studies have concluded that not only do white people use and abuse opioids at higher rates than black people but that they are also more likely to overdose.
Roughly 82 percent of the people who died of opioid overdose in 2015 were white. The rate of opioid overdose deaths per 100,000 in 2015 was 13.9 for whites, 6.6 for blacks and 4.6 for Hispanics (Castillo, 2017).
All of the above clearly demonstrates how pervasive white privilege and racism is within our healthcare system and how both have vastly contributed to the over-treatment of millions of [white] people. This, in turn, feeds painkiller abuse while at the same time contributes to the — recently medically acknowledged — “pain gap” that exists between white and black patients due to systematic under-treatment of pain for millions of [mostly black] minorities. What’s worse, is that not only are black people suffering needlessly — like I did all those years, but these vary same physicians than turn around and use the opioid epidemic — a problem they themselves created — as an excuse for continuing to refuse to prescribe pain medication to the people who need them the most. I’m not saying that there aren’t any white chronic pain suffers who are also getting the short end of the stick — especially when it comes to the ever stringent DEA regulations and the resulting prescribing fear— because I know that there are. However, I am saying that the opioid epidemic began with white people, mostly affects white people — and if it ever ends — it will end with white people.
#WhitePrivilege #WhiteSupremacy #WhiteOpioidEpidemic
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Latagia Copeland-Tyronce, MSW, CADAS, is a longtime parental rights and social justice advocate, child welfare reform activist, writer/blogger, and journalist whose work has been featured in BlackMattersUs and Rise Magazine. She is the founder, president, and executive director of the National African American Families First and Preservation Association (NAFPA) a groundbreaking 501c4 nonprofit origination, the first of its kind, devoted exclusively to the protection and preservation of the African American (Black) Family though policy and legislative advocacy.
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References
Hansen, H., & Netherland, J. (2016). Is the Prescription Opioid Epidemic a White Problem? American Journal of Public Health, 106(12), 2127–2129. http://doi.org/10.2105/AJPH.2016.303483
Castillo, T. (2017, October 28). White Privilege Helps Explain The Opioid Epidemic. Retrieved July 20, 2018, from https://www.huffingtonpost.com/entry/white-privilege-helps-explain-the-opioid-epidemic_us_59f0d806e4b078c594fa14a9
Castillo, T. (2017, July 01). What About People of Color Who Use Opioids? Retrieved July 17, 2018, from https://www.huffingtonpost.com/entry/what-about-people-of-color-who-use-opioids_us_5953adb6e4b0c85b96c65e15
Wailoo, K. (2016, April 11). The Pain Gap: Why Doctors Offer Less Relief to Black Patients. Retrieved July 20, 2018, from https://www.thedailybeast.com/the-pain-gap-why-doctors-offer-less-relief-to-black-patients
