Heroin usage and addiction has increased, particularly among white Americans, prompting Congress and political candidates to propose ways to assist and treat this population.With the current heroin crisis in rural areas and suburbs, addicts are perceived as individuals who need help, not a criminal record. However, the focus is in stark contrast with prison and mandatory sentencing, a preferred response, when the crack cocaine epidemic descended upon African-American and Hispanic communities.
1. Overdose death toll Although crack cocaine is a dangerous drug which has the potential to carry devastating effects from first time use, most people didn’t and still don’t die from using crack cocaine alone. Most deaths related to the crack cocaine epidemic were the result of crime associated with the epidemic and opportunistic infection, but not the drug itself. However, today we have evidence that one hit of heroin, an opiod, and a synthetic form of morphine cut with fentanyl, another opiod, has proven fatal for many regualr and first users to the point where some county morgues have run out of space and at times unable to accept more bodies into their facilities.
2. Physician induced epidemic The hallmark of the Hippocratic oath is to do no harm. Unlike the crack epidemic, the heroin crisis started with Oxycontin, as patients became addicted to narcotic prescriptions. These patients moved on to drugs they could buy more readily on the street once their medical treatment ended. The failure of providers to prescribe addictive drugs without the initial and subsequent screening of patients who may or may not be prone to addiction has been the basis of this epidemic. Further, studies have found doctors are much more reluctant to prescribe narcotics to minority patients, concerned they might sell them or become addicted. White privilege has been a double edged sword here.
3. The emergence of widespread violence. Gang violence left many inner city neighborhoods in ruins as a result of the crack epidemic. Growing up, I lived two houses down the street from one of the largest crime families in the city. They were known for selling heroin in the 1950s and in the late 80s, early 90s, they sold crack cocaine. There were frequent assaults, turf wars resulting in shootouts, homicides, thefts, burglaries among other illegal activities associated with this criminal enterprise. To this day, many of the neighborhoods directly affected by the crack cocaine epidemic have never fully recovered.
The Opioid Crisis: Anatomy of a Doctor-Driven Epidemic – Medscape – Apr 01, 2016.