The Washington PostDemocracy Dies in Darkness

The opioid crisis isn’t limited to white Americans in rural pro-Trump counties

President Trump speaks during an event to declare the opioid crisis a national public health emergency in the East Room of the White House on Oct. 26. (Evan Vucci/Associated Press)
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After promising to do so this past summer and speaking about it repeatedly on the campaign trail, President Trump declared the opioid crisis a public health emergency Thursday.

He discussed the magnitude of the drug problem in a speech at the White House.

“Addressing it will require all of our effort, and it will require us to confront the crisis in all of its real complexity,” he said, joined by first lady Melania Trump and New Jersey Gov. Chris Christie (R), chairman of a presidential commission on combating the crisis.

“As Americans, we cannot allow this to continue,” Trump said. “It is time to liberate our communities from the scourge of drug addiction. We can be the generation that ends the opioid epidemic.”

The current crisis is a serious one, especially in many of the rural counties populated with white working-class voters who supported Trump in the 2016 election. This recent epidemic traces some of its roots back to Washington, given how the drug industry and drug distributors pumped huge numbers of opioids into communities before working with members of Congress to pass a law that would weaken the Drug Enforcement Administration.

This is not the first time disenfranchised communities have seen an opiate devastate their communities.

The Washington Post's Nick Miroff wrote “lesser waves of opiate abuse, especially heroin” were notable in large cities during the 1970s in his piece about the history of opioid abuse in America going back to the Teddy Roosevelt administration.

What's most notable to some Americans is just how differently Washington is responding to the current crisis now that the face of the current epidemic is often a white one, wrote Ekow N. Yankah, a law professor at Yeshiva University, in a New York Times op-ed.

It is hard to describe the bittersweet sting that many African Americans feel witnessing this national embrace of addicts. It is heartening to see the eclipse of the generations-long failed war on drugs. But black Americans are also knowingly weary and embittered by the absence of such enlightened thinking when those in our own families were similarly wounded. When the face of addiction had dark skin, this nation’s police did not see sons and daughters, sister and brothers. They saw “brothas,” young thugs to be locked up, rather than “people with a purpose in life.”
The heroin epidemic shows that how we respond to the crimes accompanying addiction depends on how much we care about the victims of crime and those in the grip of addiction. White heroin addicts get overdose treatment, rehabilitation and reincorporation, a system that will be there for them again and again and again. Black drug users got jail cells and “Just Say No.”

There are some differences between what is happening now and what happened in the heroin epidemic of the 1970s, according to health-care experts. A Washington Post analysis revealed that since 2010, death rates have risen among Americans ages 25 to 44 in nearly every racial and ethnic group and almost every state.

Despite how much the current conversation has centered on rural, white Americans, the impact of the drug is not limited to those spaces. Opioid addiction is more widespread ethnically and geographically than some Americans realize.

Outreach workers in urban areas told PBS while funds and attention have been directed to white opioid and heroin users in suburbs, they struggle to get resources to help people of color fighting the same addiction.

“Our job is to help those services really make it deep into the community,” said Jacqueline Robarge, founder and director of Baltimore-based Power Inside, which serves drug users who are mainly African American women. “And if they aren’t going to arrive, we want to have an accounting that these people have been suffering for decades. It really is disingenuous if the resources are only going to be directed at the suburbs and the counties where, basically, the white folks are getting high.”

The death rate among African Americans has risen 4 percent, Hispanics 7 percent, whites 12 percent and Native Americans 18 percent since the beginning of the decade. The rate for Asian Americans also has increased, but at a level that is not statistically significant.

Drug crisis is pushing up death rates for almost all groups of Americans

This rise has tragic consequences. Following a century of decreases in the overall death rate for Americans in that 25 to 44 age bracket, the overall death rate for Americans in these prime years rose 8 percent between 2010 and 2015.

White House officials said they plan to roll out more initiatives in the coming days and weeks. One change they expect to happen quickly is patients in Appalachia will have greater access to opioid treatment with the help of telemedicine.

Many Americans are relieved Trump appears to be moving forward on a campaign promise that made him popular with so many in his base. Others are just wondering whether that investment will arrive in the urban areas he promised black and Latino voters he'd “straighten out.”