Racism in the War on Drugs: The Crack-Cocaine vs. Opioid Epidemics

“When you look overall at drug use trends in the country, you see that people of color and whites use drugs at similar rates—so then, why is it that we see such a larger proportion of African Americans in particular arrested for drugs compared to whites?”

Dr. Nazgol Ghandnoosh, Senior Research Analyst at The Sentencing Project

The opioid crisis in the United States began with the over-prescription of opioids in the 1990s, with pharmaceutical companies skirting concerns that patients could become addicted to opioid pain relievers. As a result, healthcare providers began to prescribe them at greater rates, which led opioids to become the most prescribed class of medications in the country.

Over the past decade, the federal government has treated the crisis as a public health emergency—increasing spending to expand access to treatment and creating a task force to study different methods to combat the largely white epidemic.

In 2016, the Obama administration and the 114th Congress passed the Comprehensive Addiction and Recovery Act (CARA), which authorized over $181 million to respond to the opioid epidemic and increased both prevention programs and the availability of treatment programs. And in 2017, the Trump administration declared the opioid crisis a public health emergency, creating a commission to combat the crisis.

But some are questioning why other drug crises—especially crack-cocaine—haven’t been met with the same preventative and treatment-oriented approach, but rather, a more punitive reaction. In 2017, The Annals of Internal Medicine found that the rate of opioid overdose-related deaths in white Americans is comparable to that of cocaine-related deaths among African Americans.

According to a report from the Bureau of Justice Statistics looking at 2012 data, more than half of drug offenders in the federal prison system had a form of cocaine (powder or crack) as the primary drug type. Methamphetamine offenders accounted for the next largest share, followed by cannabis, and lastly, heroin, which comprised a mere 6 percent of convicted offenders.

The vast majority of crack and cocaine offenders (88 percent) were found to be Black. By comparison, only 13 percent were white, according to the Bureau of Justice Statistics. This brings up a racial disparity issue.

“When you look overall at drug use trends in the country, you see that people of color and whites use drugs at similar rates—so then, why is it that we see such a larger proportion of African Americans in particular arrested for drugs compared to whites?” asks Nazgol Ghandnoosh, senior research analyst at The Sentencing Project.

And why are crack- and cocaine-related offenders so much more prevalent in the prison system than heroin-related offenders?

Meet the Expert: Dr. Nazgol Ghandnoosh of The Sentencing Project

Dr. Nazgol Ghandnoosh is a senior research analyst at The Sentencing Project, a nonprofit organization based in Washington, DC that engages in research and advocacy for criminal justice reform.

Dr. Ghandnoosh conducts and synthesizes research on criminal justice policies and writes about racial disparities in the justice system, public opinion about punishment, and the scope of reform efforts. She co-wrote “Treating an Illness, Ending a War,” a report detailing the US’s past drug crises and how the government has handled them.

Dr. Ghandnoosh holds an undergraduate degree from the University of Pennsylvania and a doctorate in sociology from the University of California, Los Angeles.

A Problem With Old Roots

The answer to these questions dates back to the 1980s when mandatory minimum sentencing for cocaine and crack was first introduced.

“The crack crisis overlapped with a period of time when crime rates were rising in the country and they began to reach really quite high levels,” Dr. Ghandnoosh said.

Crack-users were painted as violent criminals, creating a link between the increased crime rates and crack-use in the minds of people. And because crack, specifically, was associated with the African American community, many have come to see this as a direct attack against the minority group.

“The kinds of imagery that were presented [during the crack crisis] would often include a police officer about to arrest somebody, or it would include a very decrepit home, and when middle-class white Americans see that kind of depiction of an issue, it makes it harder for them to see themselves in that position and think about what kind of policy response the problem warrants when they think of themselves as completely outside of the problem,” Dr. Ghandnoosh said.

During this time, policymakers were able to introduce harsher penalties for drug possession. At the time, a 100-to-1 crack-cocaine conviction disparity was set, meaning you needed to be caught with 100 times as much cocaine as crack in order to trigger a five-year mandatory minimum sentence.

“The most common response from policymakers was not ‘Let’s think about how to get to the root of this with a public health approach’—it was lawmaking out of anger about the harm that people were seen as causing themselves and their communities.”

Dr. Ghandnoosh also noted an analysis by the Columbia Journalism Review, which highlights the dramatic contrast between the media’s portrayal of the crack crisis in the 1980s versus today’s depiction of the opioid crisis.

The theme of punitive punishment for crack offenses has remained instilled in our criminal justice system. By the time the 1990s and 2000s rolled around and opioids became the new dominant concern, the response was more sympathetic. Some attribute this partially to the fact that roughly 80 percent of opioid overdose victims are white.

“I think all of that helps people white Americans, in particular, to relate to the problem more and be more supportive of a more compassionate response,” Dr. Ghandnoosh added.

How Racial Disparity in Drug Punishments is Perpetuated

But why do we continue to see such a racial disparity in our prison system decades later? There are more than a few factors at play, but a lot of it has to do with law enforcement, which has been highlighted by the Black Lives Matter movement, with activists calling for higher accountability standards for police officers.

“Policing is one of the most important entry-points into the criminal justice system,” Dr. Ghandnoosh said. “So to the extent that there’s a growing movement that recognizes that we don’t need police to respond to so many of the problems that we have in our society, that helps to close the very wide door we have right now into the criminal justice system.”

The stop-and-frisk policies of some urban police departments, made famous during Michael R. Bloomberg’s time as mayor of New York City between 2002 and 2013, have led to a disproportionate number of Black and Hispanic individuals, who had not committed any crime, being targeted.

Many of these policies have been scaled back largely due to public backlash, but racial profiling happens with or without stop-and-frisk policies.

“When a white driver is pulled over because of a concern about their driving, they’re less likely to be searched for drugs, whereas a Black driver is more likely to be searched,” Dr. Ghandnoosh added.

Yes, the police are the door to the criminal justice system, but they are just one of the multiple factors.

“When you look at what criminal justice research has found, there is disparity at every stage of the process,” Dr. Ghandnoosh said. “Usually at every stage, it’s a small amount, but it accumulates as you go down the system.”

White Americans are also more likely to be able to have space in their homes where they can use drugs, making them less likely to be apprehended by police.

“People of color are slightly more likely to use it publicly because people of color are disproportionately, especially in urban areas, living in tighter residential quarters and they don’t have as much space as white Americans do to do drugs indoors.”

A third factor that has consistently contributed to the disparity is drug-free zone laws, in which states designate areas like schools and public parks where individuals caught selling drugs face higher penalties than outside of these zones.

The idea aims to protect children by discouraging the selling of drugs in areas that they spend the most time. However, these zones often overlapped with urban areas, where people of color are most likely to inhabit, fueling disparity.

The Racial Disparity in Access to Substance Abuse Treatment

There is even racial disparity when it comes to getting access to healthcare and completion of substance abuse programs.

“An important part of that when we think about the drug war is access to treatment for substance use disorder,” Dr. Ghandnoosh said. “The fact that Black Americans are less likely to have health insurance than white Americans and that they have less wealth than white Americans, that has made it so that even during the opioid crisis now when we see more of a public health approach to substance use disorder, we also see continuing obstacles for Black Americans to be able to access those better approaches.”

According to a study from 2013, racial and ethnic minorities with addiction disorders are particularly at risk for poor outcomes, when it comes to the completion of publicly funded substance abuse treatment. For African Americans, this is largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability.

This is because minorities living in poverty may be more likely to receive treatment in an environment with high social distress, weak social support, and few economic opportunities, the study says.

“We also see continued prejudice among medical professionals in their reluctance to prescribe medication-assisted therapy to Black patients compared to white patients,” Dr. Ghandnoosh said.

Black patients are about half as likely to be prescribed opioid medicines in the emergency department than white patients, according to a 2016 study. This is because “non-white race is one of the largest predictors of provider mistrust.”

Signs of Hope for the Future

Throughout the 2000s, there have been changes that have begun to reduce disparity. Thanks to reforms at both state and federal levels there has been a reduction of the number of people imprisoned for a drug offense of 29 percent between the peak year of 2007 and 2017.

The Fair Sentencing Act of 2010 reduced the infamous 100-to-1 crack to cocaine sentencing disparity to 18-to-1—a significant reduction, but still far from equal. More recently, the First Step Act that was passed under President Trump made that reform apply retroactively to people already in the federal prison system.

“The number of people of color in prison has declined more than the number of people that are white that are in prison,” Dr. Ghandnoosh added. “So there has been a reduction in racial disparities among people in prison. And this is especially true among women, where there’s been a dramatic reduction in the number of Black women in prison compared to white women.”

“Also, some places like New York City, have scaled back stop-and-frisk policies—in terms of some prosecutors are beginning to think more carefully about how often they bring harsher charges against people of color compared to whites,” Dr. Ghandnoosh added.

While these changes are significant milestones on the road to racial parity in the criminal justice system, there is still much more work to do.

“There’s still such a long way to go when you look at the significant racial disparities that continue that we still need to chip away at even though there has been some progress.”

Nina Chamlou

Nina Chamlou


Nina Chamlou is an avid writer and multimedia content creator from Portland, OR. She writes about aviation, travel, business, technology, healthcare, and education. You can find her floating around the Pacific Northwest in diners and coffee shops, studying the locale from behind her MacBook.