Pubdate: Sun, 08 May 2016
Source: Dayton Daily News (OH)
Copyright: 2016 Dayton Daily News
Author: Nick Glunt, The Akron Beacon Journal


Society Goes From Racist Approach to Empathy.

The Rev. Mike Starks witnessed the destruction of crack cocaine, but 
not from the sidelines - he was a self-described gangster and drug 
addict before he became a minister.

The Akron community activist recalls authorities responding to the 
epidemic, which is said to have lasted from 1984 to the early 1990s, 
with the all-out War on Drugs. Lawmakers enacted mandatory prison 
sentences for dealers. Stories in the media blamed addicts for their 
choices and told of gang-ravaged inner cities.

Starks was caught up in the middle of the war. Drugs ruled his life, 
and he spent several stints in prison in the 1980s and '90s.

He said the public and politicians have reacted very differently to 
the ongoing opiate epidemic.

Today, news outlets tell of parents who've lost children to 
overdoses, addicts overcoming drug dependency and politicians pushing 
compassion for substance abusers. The talks have peppered campaign 
trails and even inspired President Barack Obama to label addiction a 
public health crisis rather than a moral failing. So what changed? 
Starks and local experts agree public opinion shifted because today's 
epidemic of addiction to heroin and prescription drugs affects every 
facet of society - regardless of race, region or social class.

Starks, who's been sober since 2002, said the public has become more 
compassionate because opiates have a longer reach than crack ever had.

"You can't centralize addiction to the ghetto anymore," he said. 
"It's not an urban problem; it's an America problem, even a world problem."

Institutional racism

According to a 2006 study by Harvard University, poor black people 
were at the epicenter of crack-related crime and addiction. Homicide 
rates for young black men doubled, and spikes were recorded for the 
black population's rates of fetal deaths and weapons arrests.

There's little evidence of parallel spikes in the white population at 
the time, the report found. As a result, policies targeting drug 
dealers affected black populations much more than whites.

Liz Piatt, chair of Hiram College's sociology department, said it was 
a case of institutional racism. "I think the interesting thing about 
institutional racism is that when people think of racism, they think 
of individual acts. In this case, it's not people who are racist; 
it's the system and policies that are experienced more by one subset 
of the population."

With today's epidemic, Piatt said whites are much more affected by 
opiate-related crime and addiction.

Greater compassion is a natural result, Piatt said.

There's so much empathy that prosecutors are viewing those who die of 
overdoses as crime victims, slapping people with charges of 
involuntary manslaughter for giving victims the drugs that killed 
them. Before, prosecutors focused on punishing dealers for 
trafficking illegal drugs and damaging society as a whole, rather 
than for causing individual deaths.

Empathy for addicts

Sally Longstreth, clinical director for Oriana House drug treatment 
centers, said the severity of heroin's withdrawal symptoms and 
overdose risk compared to crack also plays a part.

She said crack addicts experience severe psychological cravings, but 
the sickness from withdrawal is less severe.

Withdrawal is much more severe for heroin addicts. Family and friends 
watching a loved one suffering might prompt a change of heart for 
some, Longstreth said.

Dr. Alan Shein, medical director for Summa Health System's Addiction 
Medicine Services, said the sheer number of people dying from opiate 
overdoses might be leading to more compassion.

Of the 213 people in Summit County who died in 2015 of drug 
overdoses, 153 overdosed on heroin or the more deadly fentanyl, the 
medical examiner's office reported. In 2014, about 100 died of 
overdoses on all opiates, including heroin, fentanyl and prescription 

The county tracked all overdoses as one set of data in the 1980s and 
'90s, so no specific comparisons could be drawn for the two epidemics 
locally. However, national numbers suggest total overdose rates rose 
exponentially since the crack epidemic, in part because of opiates' lethality.

"We didn't see nearly the deaths with crack that we see now with 
heroin," Shein said.

Shein said the severity of heroin withdrawal is contributing to the 
deaths. Heroin addicts are overwhelmed with desire to use the drug - 
no matter the risk - so they can avoid excruciating withdrawal symptoms.

Crack addicts died from health complications brought on by their 
addictions, he said. With heroin, the drug itself is lethal.

'Legitimate' addiction

Robert Peralta, an associate professor of sociology at the University 
of Akron, said greater empathy might be happening because many of 
today's opiate addicts got their start more "legitimately" by abusing 
prescription pills rather than experimenting with illegal drugs.

Doctors in the 1990s began prescribing greater amounts of opiates to 
treat pain, which officials say led to more people becoming addicts. 
Many pill addicts then turned to heroin because it's more accessible 
and causes a similar high. The shift to heroin was exacerbated by 
crackdowns on medical "pill mills" that overprescribed painkillers. 
When it became harder for pill addicts to get their fix from doctors, 
many of them turned to heroin to ease their cravings.

Everyone vs. opiates

Like Hiram's Piatt, Peralta stressed that race plays an important 
part in discussing the shift in compassion.

"White people are seeing people like themselves using these drugs," 
he said, "and that hits closer to home for many of them."

But for Ophelia Averitt, former president of the Akron branch of the 
NAACP, there's more to the issue than race. "Crack didn't start with 
colors of any kind. It was more of a location issue," she said. "This 
epidemic we have now - nothing can match it."
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