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Chronic Pain & The Opioid Epidemic: A View in Black & White

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I wake up every morning in chronic pain. The pain I suffer is vaguely diagnosed after going to the doctor several times this year to address the aches in my lower back and pelvis. I’ve even gone as far as getting an ohio marijuana card, just so I can see if the use of medical marijuana could help me with these pains that I am dealing with. In all honesty, I am willing to try anything out if it means finding a solution. So far, the treatment has been a combination of ibuprofen and, at one point, six weeks of physical therapy.

However, like many Americans who live with ongoing aches in their own bodies, the low to moderate pain persists. Despite this, because I’m a young, healthy Black woman, I continue throughout my days uncertain of when my body will actually be pain-free.

In 2012, the National Health Interview Survey (NHIS) concluded that 11.2% of American adults (25.3 million people) have experienced some form of pain every day over the course of three months. So, while chronic pain is new to me, it is not a new phenomenon among Americans.

I bring this up to paint the story of how opioid addiction became a national epidemic, yet is not the burden of Black Americans, at large. Though a growing number of hip hop artists like Lil Wayne, The Weeknd and Meek Mill are a case study for the burgeoning prescription drug crisis in urban communities with the emergence of “Modern Drug Rap,” the mainstream perception is that the opioid crisis is that of white America.

Fact is, the diagnosis of “chronic pain” officially became treatable during the mid-90s when doctors, who were once wary of prescribing opioid medication, were lured by Big Pharma into making painkillers widely available.

A fascinating Last Week Tonight with John Oliver segment points out how the pharmaceutical industry began amplifying the message that opioids were appropriate to use not only for acute pain but for all manner of conditions that cause common body aches.

In 1996, Purdue released the blockbuster drug, OxyContin through an aggressive marketing strategy that boasted relatable testimonials of pain patients whose lives were miraculously turned around by the opioid.

At the time, Purdue claimed that less than 1% of patients who took opioid medication became addicted, and went as far as to have doctors on payroll called Pain-Management Specialists insist that “pseudoaddiction” is “relief-seeking behavior mistaken as drug addiction.”

This justified their appealing message of a quick, easy cure for pain, available to those with the medical insurance plans or social influence to acquire the prescriptions. Mainly the dwindling middle class, and affluent whites. By 2000, doctors were writing nearly 6 million oxycodone scripts per year and, shortly thereafter, the headlines began to reflect the true risk of the highly addictive medication.

By 2007, Purdue admitted responsibility and paid $634 million in fines for lying to the public with misleading marketing about the safety of OxyContin. Other prescription opioid companies also paid multimillion dollar fines after being sued for over-marketing to the public and convincing insurances companies to pay for drugs like, Fentanyl, the drug 100-times more powerful than morphine that ultimately claimed Prince’s life.

While the pharmaceutical companies bare a great deal of responsibility for the epidemic, where more than 250 million opioid prescriptions are written every year, the fact that the epidemic is overwhelming affecting white Americans is telling. And the response to this crisis by the Federal government, declaring the Opioid Epidemic a Public Health issue as opposed to a Criminal Justice one, is rooted in the country’s institutional and structural racism.

If I were a white woman in my late 30s living in Suburbia, USA with excellent health coverage, the theory goes, the mere mention of the chronic pain I currently suffer would afford me a refillable opioid prescription. However, being a 30-something Black woman in Brooklyn, grateful for the therapy provided by my Obamacare, there was never any mention of an opioid painkiller remedy with my zero-refill 90 count ibuprofen.

Not that I desired one. That’s not that point. The point is that doctors have historically undertreated African Americans for pain in comparison to whites by not prescribing painkillers for reasons ranging from the false belief that Blacks have a higher tolerance for pain to the belief that they may sell the medication for profit. An example given by journalist Soledad O’brien is that a Black patient who’s had teeth extracted may not get the same 90-day supply of Vicodin that a white person with better health coverage might receive.

This is one theory that explains why many Blacks have not been as adversely affected by the prescription opioid epidemic. We simply do not get the same access to pain pills as whites. With this context, it’s better understood why the opioid and heroin crisis is a white American epidemic. With many looking to somewhere like for help with recovering from such an addiction.

For the addicts who initially had access to prescription opioids, heroin became a much cheaper and more easily accessible option once the scripts ran out. 75% of heroin abusers started with pharmaceutical pain opioids such as Oxycontin, Vicodin, or Percocet, which are taken both by prescription and recreationally. And, in the last five years when whites, from suburban and wealthy to rural and lower class, became addicted to heroin, America declared the Opioid Epidemic a Public Health Crisis.

Enter, Michael Botticelli, the Obama administration’s Drug Czar and Director of the White House Office of National Drug Control Policy (ONDCP) from March 2014 until the end of the 44th presidency. Without saying he single-handedly spearheaded the shift from treating drug epidemics as a criminal justice issue to a public health one, it is accurate that in becoming head of ONDCP, Botticelli had long been a critic of the nation’s previous failed approach to dealing with drug issues stating that, “We can’t arrest and incarcerate addiction out of people.”

Instead of viewing addicts as violent “super-predators” with innate criminal pathologies, as disenfranchised crack addicts and their crack babies were universally characterized in the ‘80s and ‘90s, being siphoned onto the conveyor belt of mass incarceration, the national push today is for empathy, compassion, tolerance and accessible treatment for the nation’s addicted. News media headlines tout “The New Face of Addiction” within families “who did everything right.” Could this shift in perception be because overdoses have reached the doorsteps of government-elected officials?

New York State Assemblywoman Diana C. Richardson has been trending on social media for her 2016 response to the opioid epidemic in comparison to the crack crisis. In her remarks, she highlights the racial disparity and hypocrisy in the way the two drug crises have been handled. Crack was an indisputable criminal justice agenda, in no way considered a national public health priority. It was met by the New York Rockefeller Drug Laws during the relentless War on Drugs.

diana c. richardson

Prior to crack, when heroin plagued the Black community post-Vietnam, it was a criminal justice issue. Richardson is spirited and resolute in exclaiming that because the opioid crisis affects a “different demographic of race and class,” it has become a public health issue diverting the addicted from prison into treatment facilities. She ends her speech by declaring what’s missing from the drug epidemic discussion: the Restorative Justice element toward the individuals who were jailed or now have permanent records.

For all the families who were ripped apart due to the criminal justice handling of the crack epidemic, as opposed to establishing a public health-based treatment infrastructure, in what way are they made whole by their government? Black Americans who faced addictions that equate the same issues of whites addicted to opioids and heroin have absolutely nothing to show for the lack of humanity, compassion, empathy and foresight that the government has granted this current whitewashed drug epidemic. And that is quite the national tragedy.

– Contributed by Mai Perkins

Mai Perkins, aka FlyMai, is Cali girl in a Bed Stuy world with global bon vivant flair and the passport stamps to prove it. She currently works in Edtech, and is the author of several blogs including and and is a columnist for the music publication With an MFA in Creative Writing from Sarah Lawrence College and an MA in International Affairs from The New School Milano, she reps her beloved alma mater Howard University every chance she gets. As a poet and a creative non-fiction writer, she looks forward to soon publishing her first manuscript, The Walking Nerve-Ending.

Insta: @flymai16

Twitter: @flymai on Twitter

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