When it comes to addiction in America, the issue is black and white. And Native American. And Latino. No one is exempt. Addiction plagues communities of every race and nationality. And yet, for minority communities — especially the African-American community — addiction is compounded by historical and institutional factors that make the issue even more destructive and complex.

Consider these facts:

  • The opioid crisis in America — recently declared a national emergency — has been largely reported as a crisis of white suburbia. All the while, African-American and Latino populations have seen a dramatic increase in opioid deaths between 2015 and 2016, while other populations have seen a decrease. In five states, the death rates are higher among minority populations than among the general population. And in one, West Virginia, the death rate among black Americans is double that among whites.1
  • Heroin overdose deaths have more than doubled among African-Americans, Latinos and Native Americans but have been largely overlooked by the media.2
  • African-American drug users are three times more likely to be arrested for illegal drug use.3 Currently, two-thirds of people incarcerated for drug-related offenses are people of color.1

Sadly, these statistics are but a few among many that support the undercurrent of racism that influences society and the institutions designed to serve the public good.

Historically, drug addiction has been widely viewed as a problem primarily afflicting racial minorities, especially black Americans, which has led to treating it as a criminal justice issue instead of a medical problem.4 So while addiction has been a reality in the US since before the turn of the 20th century, it’s a reality distorted by something even more sinister than drugs.

According to a 2014 report by the National Research Council, drug use among the black community is slightly higher than among whites for illicit drugs and slightly lower for prescription drugs. The difference is not substantial. And when all classes of drugs are considered, there is little evidence that African-Americans sell drugs more often than whites.5

“The reality is that African Americans and whites use drugs at roughly the same rates,” The Chicago Reporter explains. “Yet the narrative that most Americans believe, and that the media perpetuates, is that African Americans are more likely to use drugs. And not just any drugs, but especially ‘hard drugs’ like cocaine and heroin. This false narrative also says that African American people and communities cannot control themselves in the face of these drugs, so the only corrective course of action is swift, punitive control.”1

The Aftermath of the War (on Drugs)

Young mixed-race girlSo how has the African-American community been impacted by this false narrative about drug use and addiction?

The first effect is what we haven’t done to address it, Heather McGhee, President of the left-leaning public policy group Demos, tells Vox. “Racial bias distorts our response and … [it] made it so we did not create the infrastructure and the policy understanding during earlier drug epidemics.”4

The war on drugs in the 1970s and 1980s criminalized addiction in such a way that, today — almost 40 years down the road — we’re just beginning to destigmatize addiction and pass legislation to try to make treatment more accessible. For example, the 21st Century Cures Act, passed in December 2016, authorized $6.3 billion in funding to accelerate the discovery, development and delivery of cures for drug addiction. Most of this money was allocated for the National Institutes of Health (NIH).8

And yet for minority communities, even that isn’t particularly comforting. Some argue that racism permeates the NIH, whose research overlooks social-economic inequalities and gives a lot of credit for drug use to genetics. In fact, out of 22,000 studies sponsored by the NIH, only 44 grants were awarded to research the connection between health, racism and socioeconomic disparities.3

“The NIH continues to chase down theories of genetic difference instead of pausing to survey and study a field rife with segregation, supremacy and subprime health,” asserts Scientific American. “We need to look beyond the barrel of the microscope. This one-track mindset is costly to communities that need open playgrounds and safe housing options rather than powders or pills.”3

The truth is, addiction in the black community — like poverty, lack of education and lack of access to healthcare — has been exacerbated by decades of systemic racial discrimination. Making a dent in the problem will take a widespread change of perspective — especially among those who have the power to bring about change.

New Approaches, More Awareness, Greater Access

Given the pervasiveness of discrimination, what can be done for minority communities to give more people struggling with addiction access to the treatment they need?

For starters, healthcare providers need relevant training to develop better communication and culturally sensitive, non-discriminatory care.

Did you know that one distinctive characteristic of the heroin epidemic in the African-American community is that — unlike white suburbia’s opioids-to-heroin pathway — addicts are much less likely to become addicted to heroin through prescription opioids. Why is that? Multiple studies show that doctors are much less likely to prescribe opioid painkillers to blacks than to whites for the same health issues. “There’s a well-known phenomenon that there’s less opioids available in segregated minority communities,” Dr. Wilson Compton, Deputy Director of the National Institutes of Health, tells Frontline. “You can’t find them in the pharmacies. There’s less medical access.”2

Secondly, the black community needs considerably more programs aimed at mental health awareness and addiction literacy. There are so many inroads to awareness — in schools, in churches, in law enforcement, in the courts, in community organizations — but real change will require utilization of all these resources and new ones.  After all, awareness is the first step toward eliminating the stigma of addiction.

And last, but perhaps most importantly: The key is greater access to addiction treatment and mental health care. This disparity, this gap in access, is the best solution for the addiction crisis in minority communities.

Programs like LEAD (Law Enforcement Assisted Diversion), in which police officers can refer drug users to addiction case workers instead of arresting them for low-level offenses, could do a lot of good if made available more widely available in minority and lower socioeconomic communities.

The situation could also benefit from more organizations like the Urban Minority Alcoholism and Drug Abuse Outreach Programs (UMADAOP) of Ohio, which exists to mind the disparity gap, providing culturally appropriate prevention services to underserved communities.7

“We must think about more specific resources by looking at why people use drugs in the first place, then develop resources around those issues,” Dr. Calondra Tibbs, Senior Advisor for the National Association of County and City Health Officials (NACCO), says in an interview with BlackDoctor.org. “Whether it is an issue of jobs, housing, systems, economy, etc., we must consider what may be driving health inequities.”6

Vision That Becomes Action

The challenges facing the African-American community related to addiction are great. And it’s compounded by the continuing ramifications of racism. To achieve lasting cultural change, we must begin to view addiction as a public health crisis for all people that must be treated with attention to the unique needs of each community.

And this vision must grow into action. Government, private and healthcare industry initiatives must do more to eliminate systemic barriers that keep minorities struggling with addiction from getting the information, access and resources they need to find hope.

Here at Skywood, we are committed to providing comprehensive addiction treatment and mental health care that meets people of all backgrounds right where they are. Call us today to begin the road back to life.

By Melissa Riddle Chalos, contributing writer


1 Kane-Willis, Kathy, and Stephanie Schmitz Becteler. “Opioid crisis ‘whitewashed’ to ignore rising black death rate.” The Chicago Reporter, January 22, 2018.

2 Childress, Sarah. “How the Heroin Epidemic Differs in Communities of Color.” Frontline, February 23, 2016.

3 Tsai, Jennifer. “Racial Differences in Addiction and Other Disorders That Aren’t Mostly Genetic.” Scientific American, January 30, 2018.

4 Lopez, German. “The deadliness of the opioid epidemic has roots in America’s failed response to crack.” Vox, October 5, 2017.

5 Emery, C. Eugene, Jr. “Van Jones claim on drug use, imprisonment rates for blacks, whites is mostly accurate.” PunditFact, July 13, 2016.

6 Hand, Jamelia R. “From The ‘War On Drugs’ To ‘National Health Emergency’: Opioid Addiction & Health Disparities In Black Communities.” BlackDoctor.org. Accessed February 12, 2018.

7Urban Minority Alcoholism and Drug Abuse Outreach Programs.” Mental Health & Addiction Services of Ohio, Accessed February 12, 2018.

821st Century Cares Act.” Wikipedia, Accessed February 12, 2018.