In a letter sent to legislators in states with forms of legal marijuana, drug- prevention organization Drug Free America claims pot use is. Of the active patients on the Colorado Medical Marijuana Drug Free America Believes Legal Weed Exploits the Opioid Epidemic. Recovery Magazine is free to download with embedded audio link to the interview. January 17, Using neuroscience to prevent drug addiction among teenagers Although“legalization hasn't led to a big increase in Americans trying the drug, .. June 1, Prevalence of Marijuana and Opioids Increasing Among.
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Social issues, such as the mass incarceration of African Americans under harsh drug laws or the lack of viable economic opportunities beyond the drug trade in Black and Latino neighborhoods, have no place in neuroscientific discourse.
As we discuss further below, this neuroscientific racial recoding of prescription opioid addiction was one basis for legislative innovations that created a new, separate track for treating the addiction of White opioid users.
Opioids have long blurred the line between legitimate medications and drugs of abuse. Morphine went into widespread use during the Civil War in the treatment of injured soldiers, and among middle class White Victorian housewives for a range of problems including menstrual pain.
However, changes in medical practice and international drug policy led the media and policymakers to associate opiates with poverty and ethnic minorities, and prohibitionists succeeded in banning opiate maintenance from clinical practice with passage of the Harrison Act Musto, ; Courtwright, New opioids have therefore undergone a predictable cycle of optimism touted as the holy grail of a non-addictive pain reliever, followed by challenges to their legitimacy as medications, their association with poverty and ethnic minorities, and stigmatization as addictive drugs.
In a race- and class-stratified health-care system, such as that in the United States, where doctors are privatized and access to them largely limited to those who can pay, technologies of pharmaceutical delivery in themselves encoded whiteness by assuring the identity and legitimacy of medication users as patients within a medical context. Rather, it was developed in , failed to sell as an opioid analgesic, and was brought back to market 30 years later at a time when White opioid use was on the rise, a medical solution to addiction was being fervently sought, and neuroscientific understandings of addiction were gaining momentum in the scientific and popular press.
FDA officials state that when OxyContin was approved, the agency believed that the controlled-release formulation would result in less abuse potential, because when taken properly, the drug would be absorbed slowly, without providing the rapid, intense drug effect sought be abusers. According to recent studies, oxycodone, the active ingredient in OxyContin, is twice as potent as morphine. Neurochemistry, not a failure of will or character is the root of the problem, and a neurochemical fix, not prison or a punitive behavioral intervention, is the solution.
Inherent in the effort to distinguish licit from illicit drugs is an often unspoken racial symbolism of White biology and Back crime, least visible at the molecular level of pharmaceutical development, but progressively more apparent in the State apparatus of drug control and in the corporate apparatus of marketing in popular media.
The focus on pharmaceutical and clinical, rather than punitive, interventions for White prescription opioid addiction necessitated a third technology of whiteness. This was a novel set of legislative and regulatory guidelines: These legislative innovations are notable, not only because they create access to opioids and opioid dependence treatment for Whites that is largely unavailable for Black and Brown opioid users, but also because they shift the focus of law enforcement from drug users to surveillance of physicians and pharmacies.
States with rigorous prescription monitoring have shown a decrease in the number of opioid prescriptions filled, but neighboring states without such laws have shown an increase in filled opioid prescriptions Manchikanti, As of , Florida was home to 97 of the top practitioners purchasing bulk Oxycodone in the country; these Florida physicians bought The state of Florida followed with legislation banning pain clinics from advertising that they sell narcotics and from dispensing more than a 72 hour supply of narcotics at a time, as well as requiring physicians in the clinics to have formal training in pain management and to be free of a history of conviction or revoked registration Santos, The other innovation to curb the abuse of prescription opioids has been DEAs National Prescription Drug Take-Back programs, which allow individuals to dispose of unused prescription medications.
Partnering with local law enforcement agencies, the DEA program collected 2 million pounds tons of prescription medications in 4 years DEA, undated. Before the passage of the Act, there were no legal means for transferring possession of controlled substance medications from prescription holders to other individuals for disposal. The Act specifically cites the rising number of deaths, violent crime and property crime from the abuse of prescription medications as the reason for the new piece of legislation Secure and Responsible Drug Disposal Act, Like drug-monitoring programs, this strategy is notable for its non-punitive nature and its focus on upstream causes of use, rather than on penalizing individual users, even though the Act explicitly acknowledges the death and crime associated with the misuse of prescription medications.
It strains the imagination to picture a similar program aimed at reducing the death and crime associated with heroin use. In fact, although by prescription opioids overtook heroin as the primary opiate of abuse in the United States, arrests of prescription opioid abusers and street-level dealers were far outnumbered by arrests of users and dealers of illicit narcotics.
For example, in , the arrest rate per was 7. Census Bureau, , even though the prevalence of prescription drug misuse far exceeds that of heroin.
Because of the highly racialized war on drugs, stereotypes of heroin users tend to cast them as Black urban dwellers see Scotti and Kronenberg, ; Steiner and Argothy, and as the appropriate targets for law enforcement. The language of control used by the DEA and other regulators paints prescription opioid abusers as patients who ultimately deserve protection from unscrupulous prescribers and suppliers. Inconveniently, a series of Federal and state-level crackdowns on physician and pharmacy-run prescription opioid rings were followed by news reports that prescription opioid users were turning to heroin as the street prices of prescription opioids rose.
The reporter sums up the problem with a rare explicit reference to race: The same story then moves to another case, that of a White college student from a wealthy Boston suburb who graduated from pills to heroin. This story foreshadows the racial threat of this migration to heroin: Such a mingling could preclude therapeutic, rather than punitive, responses for White youth, a threat that the reporter forestalls with a hopeful reference to treatment in his closing line: One under-examined question is the degree to which the new prescription opioid drug monitoring programs not only encouraged White suburban heroin use, but also discouraged overburdened public sector physicians from legitimately prescribing opioid pain relievers to non-White and low income people, possibly reinforcing what has been described as systematic under-treatment of pain among ethnic minority patients Hausmann et al , Between and s, when methadone was first introduced, doctors were not allowed to prescribe any opioids as a treatment for addiction.
While methadone marked an important turning point in drug policy as the first opioid-based addiction treatment since the Harrison Act, it never entered the medical mainstream. To the present day, methadone is restricted to specialized clinics with strict DEA oversight, directly observed dosing and frequent urine toxicology screens. Methadone clinics are typically concentrated in African American and Latino communities Hansen and Roberts, ; Hansen et al , The policy responses seen as appropriate for Black and Brown addicts — methadone and prison — were not seen as a viable option for White addicts.
New alternatives were needed, and DATA provided them. An analysis of the congressional records surrounding the passage of DATA shows Congress turning to a medicalized response for addiction, especially for certain kinds of addicts they characterized as young and suburban. The congressional record seldom mentions race explicitly. For example, we learn from the congressional record that: Methadone treatment is largely reserved for those who have been addicted to relatively high levels of opioids generally heroin for a relatively long period of time.
In contrast, Alan Leshner of NIDA testifies at length about how buprenorphine is uniquely appropriate for a new kind of opioid user:.
Narcotic addiction is spreading from urban to suburban areas. The current system, which tends to concentrated in urban areas, is a poor fit for the suburban spread of narcotic addiction … [There is] an increase in the number of younger Americans experimenting with and becoming addicted to heroin. Buprenorphine products will likely be the initial medications for most opioid-dependent adolescents. Congressional Record, a , p.
It would be available not just to heroin addicts, but to anyone with an opiate problem, including citizens who would not normally be associated with the term addiction.
Congressional Record, , p. They summarized their opposition this way:. The bill may help some … These will be mild to moderately addicted persons with the financial resources to obtain access to a physician or other healthcare provider who will either dispense or prescribe the medication. The bill does not address the need of most heroin addicts; namely, those who are severely addicted or who lack the financial resources to see a doctor. Presumably, DATA could have, and perhaps should have, changed the landscape for all opioid users, not just White ones.
However, as presaged by the legislators above, DATA had the effect of creating two tiers of treatment. DATA kept the methadone system intact and did nothing to alter the draconian drug laws that mandate thousands of people of color to prison, but it did create a new treatment track for those had the resources to take advantage of it. Nor did DATA move beyond a medical model to envision a response to drug use rooted in public health — one that accounts for the social determinants of health, such as geography, race and class.
By retaining focus on the individual level, systemic issues, such as racism, poverty and inequality are essentially erased, while, as pointed out by Smith , racial segregation in American health care persists into the present due to systems of finance and regulation that address health care as a business, rather than social investments. Finally, buprenorphine is only covered by State funded Medicaid in some states Clark et al , Pharmaceutical regulations and reimbursements, therefore, direct buprenorphine to uniquely affluent, White markets building in an invisible but enduring racial bias see also, Braun, The fourth technology that created White opioids was marketing.
Pharmaceutical manufacturers shape markets by selectively targeting consumer groups, cultivating the public image of their drug and its benefits. In fact, the markets to which manufacturers attached each drug were critical to their gaining FDA approval.
Their marketing efforts moved from their original extended release tablets — no longer on patent — to new tamper-resistant, patented formulations that had the potential to shut incoming generics out of the market. To cultivate that market, the manufacturer selected its medium carefully with target audiences in mind: I used to look at people who used and abused drugs as people who were making a choice … this disease devours your total being; I had to get better … being able to visit the doctor like an ordinary patient has made all the difference in the world to my recovery.
The recent history of White opioids shows that whiteness is a moving target. The whiteness of a given product, and thus, of its consumer base, is continuously under threat of invasion and miscegenation. A more remote history indicates that, while many opiates have been introduced to the market as non-addictive pain relievers or even cures for opiate addiction, including heroin in , no opiate has managed to stay a medication and concomitantly no opiate has managed to stay White.
The constant threat of miscegenation and invasion requires marketers, legislators and manufacturers to stay one step ahead of the darkening of the drug; they ultimately fail and have to re invent new White opioids. Another aspect of the racialization of drugs revealed by White opioids is the way that racial ideology works as a crucial element of post-industrial narco-capitalism.
The very racial segmentation of markets into licit and illicit, White and Black, clinical and recreational as dictated by the War on Drugs and by the profit imperative of opioid manufacturers helps to drive cycles of demand and sustains a moving target of time-bound patents on new technologies of bioactive molecules and delivery devices.
Pharmaceutical manufacturers exploit this temporal cycle in their claim to bring the latest technology to bear to limit the consumption of narcotics by the wrong people for the wrong reasons.
The trope of racial invasion and miscegenation upon the province of a White narcotic also builds public political support for segmented marketing and regulation of reformulated drugs and creates pharmaceutical demand among Whites for whom the trope augments the appeal of reformulations as legitimate products for White consumption, while eventually heightening demand among non-Whites for whom such new reformulations are aspirational products, such as among Blacks and Latinos among whom a discourse of unequal treatment and need for access to opioid analgesics for undertreated pain and to buprenorphine for opioid dependence is building.
An international comparison reveals how profoundly the racial political agendas underlying drug control shape population patterns of drug consumption.
In France, where buprenorphine was adopted for generalist physician treatment of opiate dependence in , well before the United States, buprenorphine was billed as a public health intervention to stem HIV transmission and opiate overdose deaths among low income, largely immigrant heroin injectors.
Public health may be a third alternate ideology to a medical or punitive frame — one that may be able to encompass important structural issues, such as race, geography and class. However, to date, the discourse surrounding addiction and drug policy remain largely driven by NIDAs commitment to the brain disease model; public health frameworks have not been a large part of the public debate surrounding drug policy. Rather, whether operating within the criminal justice or medical frame, addiction remains a highly individualized problem, making it easy to erase systemic factors and obscure built in biases cf, Pollock, ; Braun, Since whiteness is a designation of exclusion — signaled by the absence of mention of race itself — these arenas will not lend themselves to an easy reading of their racial intents and effects.
However, a racially segregating drug policy can only be sustained if there is a separate route to categorizing and disciplining drug use for Whites, and that route must appear, at least on its face, to be race neutral. The authors wish to acknowledge Sonia Mendoza, Laura Duncan, Alyson Kaplan, and Danae DiRocco for their help with media analysis for this paper, as well as the helpful comments of David Herzberg, Donna Murch and Jessie Daniels on an earlier draft of this paper, and the useful suggestions of three anonymous reviewers.
This paper was supported by a U. National Center for Biotechnology Information , U. Author manuscript; available in PMC Jul 7. Find articles by Julie Netherland. Find articles by Helena Hansen. Author information Copyright and License information Disclaimer. See other articles in PMC that cite the published article. Addiction Neuroscience as a Technology of Whiteness The mass incarceration of people of color for drug offenses is, in part, legitimated by the belief that drug use results from a failure of will or morality.
In the article, Leshner argues that addiction is as much a medical as a social problem and that the field and the public has focused too much attention on the latter: Pharmaceutical Technologies of Whiteness Opioids have long blurred the line between legitimate medications and drugs of abuse.
Legislating and Regulating Whiteness The focus on pharmaceutical and clinical, rather than punitive, interventions for White prescription opioid addiction necessitated a third technology of whiteness. They summarized their opposition this way: Crafting White Markets The fourth technology that created White opioids was marketing.
Discussion The recent history of White opioids shows that whiteness is a moving target. Acknowledgments The authors wish to acknowledge Sonia Mendoza, Laura Duncan, Alyson Kaplan, and Danae DiRocco for their help with media analysis for this paper, as well as the helpful comments of David Herzberg, Donna Murch and Jessie Daniels on an earlier draft of this paper, and the useful suggestions of three anonymous reviewers.
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These prescription drug abuse statistics show that the use of prescription medications for non-medical reasons is growing in America — and the effects are evident. If you or someone you love is addicted to prescription drugs, call our toll-free helpline now. Our admissions coordinators are available 24 hours a day to answer your questions and help you find treatment. Ahrnsbrak, Rebecca, et al. Young People at Risk.
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Carmen Brace to speak at Marijuana for Medical Professionals with the Holistic Drug Free America Believes Legal Weed Exploits the Opioid Epidemic. Critics say the drug could fuel the opioid epidemic. While an FDA advisory committee recommended approval of Dsuvia last month, the. The Marijuana Policy Project promotes their drug as a substitute for opiate pain pills. It's easy for those who believe legalized marijuana would be wrong for our state to . legalization in the midst of the most deadly drug abuse epidemic in American history. .. Cannabis Capitalists Exploit Loopholes by 'Gifting' the Drug.