Differences in coverage of and response to crack and opioid crises

Discussion in 'Politics, Religion, Social Issues' started by Rogifan, Jun 10, 2018.

  1. Rogifan macrumors Core

    Rogifan

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    #1
    Interesting article in Politico about how the opioid crises is covered and dealt with compared to the crack epidemic in the 80s & 90s. I’m sure race plays a factor but I think it’s more than that. Opioids are affecting people with chronic pain who got hooked on prescription drugs from a doctor. I think people are more accepting towards/sympathetic to people who use drugs for physical pain and this crisis is easier to understand. The medical community decided to make pain a 5th vital sign and doctors, hospitals etc. were quality rated on how they dealt with pain. And then you had pharmaceutical claiming these painkillers were less addictive than they really were. Understanding the underlying causes of the crack epidemic in the black community isn’t as simple. And then throw in the racial aspect and it’s easy to see why the current crisis is getting much more sympathetic coverage.

    https://www.politico.com/magazine/a...donald-trump-218602?__twitter_impression=true
     
  2. GermanSuplex macrumors 6502a

    GermanSuplex

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    They’re not going to chastise people in predominantly white New England towns the same way they would people of all ethnicities in inner-cities. Socio-economic issues that lead to crack abuse are as much as something to discuss as pain, but it is what it is. It may be a good thing in the long run to get people to understand abuse and physical dependency.
     
  3. A.Goldberg macrumors 68020

    A.Goldberg

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    #3
    I believe we had a thread about this not too long ago...

    I mean maybe race was a factor, but I’m not sure there is a reliable way to prove. I was born in the 80’s so I can’t say I experienced that time period, but I do work in mental health and a lot of my work pertains to addiction. I think there are far more significant factors.

    1) The entire way mental health problems are approached have rapidly changed only until relatively recently in history. It wasn’t long alcoholics were put into asylums for the rest of their life or that people were lobotomized for every reason under the sun. It’s not surprising to me addiction is treated more compassionately now compared to 40 years ago.
    2) Public understanding and compassion for addiction has changed massively even over the past 20 years.
    3) Our knowledge and understanding of addiction probably wasn’t as developed as it was 40 years ago.
    4) The war on drugs was just still in its early days. Just how poorly the program would work was probably not yet realized to the degree it is today. The overall approach to drug law enforcement/criminal justice has been slowly been charging from a largely punishment based system to one that promotes recovery, especially in more progressive areas.
    5) The consequences of using crack vs heroin are a bit different. For one, the risk of heroin overdose is quite high, crack on the other hand is not nearly as bad. Crack due to the stimulant nature and aggressive addiction formation makes people commit more unreasonable crimes- therefore probably associated with more criminal behavior. Heroin addicts are for more mellow, but can do crazy things out of desperation- but it’s not like heroin will cause mania or psychosis in otherwise normal people.
    6) Medically speaking crack and heroin addictions are very different animals due to their different effects on the body. Heroin is far more physically addicting. Physical detox systems are far more dramatic. There are drugs to treat opiate withdrawal directly (basically longer acting but less euphoria inducing opioids). Unfortunately there is no crack detox protocol that treats the w/d directly- it’s all treating the withdrawal symptoms. Most insurances won’t pay for stimulant drug detox because it’s not life threatening and no real detox protocol exists as there’s no drug to do it with.
    7) It’s my understanding it was largely black communities and politicians that pushed for stronger criminal laws due because the problem was affecting their communites.

    I think also important to note all substance addicts in general are treated far better than they were 40 years ago. If you live in at least fairly progressive state for your first offense a possession charge of any drug will probably put you in a diversionary program rather than give you a criminal record.

    Again, rather race may play a factor, the fact perceptions and understanding of mental health has changed is far more significant.

    If you want to talk about discrepancies in addiction treatment, the biggest problem today is financial status. If you have the money for private pay you’ll get a much better experience than some cash-strapped, overcrowded state run program.

    I feel like this article is a little misleading by convoluting drug addicts and drug dealers. I think stronger punsishment for people who deal is a fair argument to have. It’s one thing to use drugs, it’s another to sell them.

    I didn’t live through the 70’s, but I’d be curious to know how the treatment of the 70’s heroin epidemic compared to the 80’s crack epidemic.
     
  4. VulchR macrumors 68020

    VulchR

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    My second post-doctoral fellowship was funded to study the neurophysiological effects of cocaine on the reward system. I did the work at NIMH because NIDA could not spend its cocaine research budget because it was so big, so they farmed out work to NIMH. There was a massive effort to understand cocaine addiction. Indeed, my impression is that cocaine is only second to alcohol in terms of research directed at it.
     
  5. hulugu macrumors 68000

    hulugu

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    I highly recommend "Dreamland" by Sam Quinones, which explains the interaction of big pharmaceutical companies with low-level black-tar heroin dealers from one town in Mexico.

    One caution today is that politicians are using the opioid crisis as another pressure point to argue for "securing the border," which totally ignores the underlying aspects that drive the opioid crisis.
     
  6. alex2792 macrumors 6502a

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    Well, the fact that opioids are LEGAL prescription drugs while crack cocaine is an ILLEGAL street drug could probably explain the reaction. Occam razor and all.
     
  7. A.Goldberg, Jun 10, 2018
    Last edited: Jun 10, 2018

    A.Goldberg macrumors 68020

    A.Goldberg

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    #7
    Well, heroin is a schedule 1 drug in the United States, not an Rx, and no recognized therapeutic value.

    Whole crack is illegal, technixally cocaine is a schedule II prescription. Desoxyn is Rx methamphetamine. There are of course many other Rx prescriptions.
     
  8. JayMysterio macrumors 6502

    JayMysterio

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    The article itself isn't misleading, it's trying to point out an important part on the war on drugs during the 80's. The primary focus was on drug dealers, while little to no concern seemed to be shown the addicts or victims of crack. There was an almost demonization of dealers, and by some default the addicts themselves for empowering the dealers. Especially in light of the disparity of penalties of crack vs cocaine, which was often seen as a black vs white drug.

    What was very noticeable if you lived in an environment that was affected by the crack epidemic is the almost neck snapping startling approach for victims of opioids vs crack nowadays. Almost to the point of there being an almost literal sensitivity for opioid victims, while there was a disdain for crack addicts. If you think hard, there aren't many humorous portrayals of opioid victims, while there have a been a few joke crack addict characters.

    As I said it can heavily be a perception issue. If you were around for the crack era, the approach to the opioid crisis with police literal carry life saving injections for victims seems like something from the Twilight Zone. While in the 80's it was just leave the junkie to get picked up by someone ( i.e. trash collectors ) else. I believe it was the running Dave Chappelle line when the police wanted to cover up doing something to a black person, "Just sprinkle some crack on him". Crack was an easy way to demonize dealers & victims alike, while opioid victims have been seen mostly with sympathy, while the drug companies are the demonized ones.



    While I can't testify what drug treatment was like during the 80's. I do remember the constant criticism for the war on drugs and prevention was heavily based laughably on D.A.R.E., and "Just Say No" campaigns. Which turned out to have the opposite effect. Treatment wasn't really a hot button issue for the suburbs, as crack cocaine was an urban issue for those that 'live over there' and 'do that to themselves', so money wasn't exactly flowing.

    http://www.chicagotribune.com/news/...emic-dahleen-glanton-met-20170815-column.html

     
  9. VulchR macrumors 68020

    VulchR

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    #9
    Cocaine was once legal, but indeed the war on drugs has turned out to be a war on people.
     
  10. shinji macrumors 65816

    shinji

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    It's hard to deny the role race and class played. People viewed crack as something that affected "them," whereas opioids today affect "any of us."
     
  11. Rogifan thread starter macrumors Core

    Rogifan

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    CBS news recently did a story on some researchers that came up with something as powerful as an opioid but it targets different receptors in the brain and doesn’t have the negative side effects of opioids. Of course back in the mid 90s the Rx companies were telling doctors Oxy wasn’t addictive too. Fingers crossed though that something can be discovered.
    --- Post Merged, Jun 11, 2018 ---
    I honestly don’t remember that much news coverage of the opioid crisis prior to 2015. I’m sure it was put there but not the kind of coverage it’s getting now. I don’t think it’s a coincidence we’re seeing all this coverage considering a lot of the areas impacted are considered Trump country.
     
  12. VulchR macrumors 68020

    VulchR

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    Honestly I think the best hope for a biological treatment is antibodies (indeed, in the long-run it might be possible to develop anti-drug vaccines). The problem is, though, that all these addictive drugs mimic natural brain chemicals. Thus, it is hard to suppress the impact of the addictive drugs without disrupting normal brain processing. Regrettably I do not think there are going to be any magic bullets, but it won't be for the wont of researchers trying. :(
     

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