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How a heroin epidemic among white Americans led to a softer war on drugs

Race and class have helped shape criminal justice policy.

Public officials have by and large responded to the ongoing opioid painkiller and heroin epidemic with a softer approach, focused more on public health than criminal justice policies, compared to previous drug crises. Part of that is states trying to save money after decades of expensive tough-on-crime policies. But some critics have pointed to two very different factors: race and class.

In light of that, the New York Times in October 2015 published a revealing story by Katharine Seelye — and followed it up with the video above — about how race and class are driving a different reaction to the opioid epidemic compared with previous drug crises. Take, for instance, this quote from a police officer:

So officers like Eric Adams, a white former undercover narcotics detective in Laconia, are finding new ways to respond. He is deployed full time now by the Police Department to reach out to people who have overdosed and help them get treatment.

"The way I look at addiction now is completely different," Mr. Adams said. "I can't tell you what changed inside of me, but these are people and they have a purpose in life and we can't as law enforcement look at them any other way. They are committing crimes to feed their addiction, plain and simple. They need help."

Adams can't explain what changed inside of him. But it's possible that race or class could have played a factor: Maybe Adams and other police officers are more likely to see a heroin addict as a victim simply because the addict is now more likely to be white and middle class.

Race and class may affect responses to drug epidemics

As Marc Mauer, executive director of the criminal justice reform group the Sentencing Project, told the Times, "Both the image and reality is that this is a white and often middle-class problem. And appropriately so, we're having a much broader conversation about prevention and treatment, and trying to be constructive in responding to this problem. This is good. I don't think we should lock up white kids to show we're being equal."

Mauer isn't alone in his thinking. The focus on race and class is something I've heard time and time again from drug policy experts and activists. It's one of the common responses I get when I write about the opioid epidemic.

It's true that the current opioid epidemic has affected predominantly white victims in less urban areas: A 2014 study published by JAMA Psychiatry found that nearly 90 percent of treatment-seeking patients who began using heroin in the previous decade were white — a big shift from equal racial representation prior to the 1980s. And it's true that the public and police generally possess subconscious biases that make them more likely to view black people and other minorities as less innocent and more criminal, according to a lot of empirical evidence.

The history of past drug epidemics also tells the story. During the 1970s and '80s, federal and state lawmakers reacted to the heroin and crack cocaine epidemics of those times with punitive tough-on-crime policies, including the launch of the war on drugs. And those older epidemics primarily hurt lower-class, minority groups in urban areas — not the middle-class and wealthier white people in rural and suburban places mostly hurt by the opioid epidemic of today.

To understand why, consider the dominant narratives of the past and current drug epidemics. In the 1980s, the narrative around drug users tended to focus on gangs, "crackheads," "crack houses," and "crack babies" — all of which carry tones of criminality and wrongdoing. Today, the narrative around the opioid epidemic is more likely to treat drug users as patients who need help, not scorn or punishment. Does race have something to do with these differences, given the research that shows the public is more likely to associate black people — who are more likely to use crack — with criminality?

Race and class also may play a role even for someone who's free of subconscious or overt racial bias. Since lawmakers tend to be whiter and wealthier, they may not have had personal contact with victims of past drug crises. But they do today — and many of them even share personal stories in their push for drug policy and criminal justice reform. By simply having personal contact with drug users, lawmakers may have been driven to treat the current epidemic in a more humane, public health–oriented way.

This is essentially what Michael Botticelli, head of the White House Office of National Drug Control Policy, told the Times: "Because the demographic of people affected are more white, more middle class, these are parents who are empowered. They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation."

Race and class probably don't explain the entire story

There is one caveat to the race and class explanation: The opioid epidemic coincides with a criminal justice reform effort that largely began before the current drug crisis was well-known in the mainstream. So before the public and lawmakers knew much about the opioid epidemic, they were already preparing to draw down the harsh anti-drug policies of the past.

The opioid epidemic didn't gain widespread media attention until 2011 and 2012, around when the Centers for Disease Control and Prevention began referring to the crisis as an epidemic. Before then, lawmakers had already started changing state laws to ease criminal sentences for drug offenders — largely to reduce the strain that high incarceration rates had put on state budgets, particularly in the aftermath of the Great Recession.

This chart by the Pew Research Center demonstrates this, with criminal justice reform efforts going back to at least 2009:

A map and chart by the Pew Research Center show the progress of state-level drug policy reforms. Pew Research Center

So chances are the next drug epidemic would have received a softer policy approach no matter whom it affected. Still, the race and class makeup of the current opioid epidemic may have contributed to the continuation of softer policies.

Of course, that caveat doesn't do anything for the millions of minority Americans who were disproportionately arrested and incarcerated for their addiction in previous decades. For them, it increasingly looks like if they had been born at a different time or of a different class and race, their lives wouldn't have been ruined by an approach to justice that the public and political leaders now by and large see as far too harsh.

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