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The Editorial Board: For doubters of institutional racism, drug treatment study offers proof

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Black and Hispanic patients are prescribed the opioid treatment Suboxone, a brand name version of buprenorphine, less often and for less time than white patients, according to a new data analysis.

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With just two words, a political writer once refuted the claim of critics who flatly insisted that governments never do anything of value: clean water. Regulations (at least when they’re followed) have made a transformative difference in both public health and longevity.

Now, based on new study reported in JAMA Psychiatry, a two-word response is available to those who refuse to acknowledge the fact of institutional racism: addiction treatment. By analyzing 15 years of prescription data, researchers have documented that white people suffering from drug addiction are more likely to be offered life-saving treatment options than Black or Hispanic people. What is more, they found, even when treatment is offered to minorities, its duration is shorter than it is for white people.

Even for those who understand that the disgrace of institutional racism is ongoing, it’s a bucket of colder water. Western New Yorkers have learned a lot about racial health disparities in the past few years, but without the disturbing specificity of this study.

Consider buprenorphine, a treatment that helps those in recovery to fight cravings. In studying some 867,000 occasions when a patient who was not already on buprenorphine began taking it, researches uncovered stark differences in its use. About 84.1% of the patients were white, while just 8.1% were Black and 6.3%. were Hispanic. The remaining 1.5% were of other races and ethnicities.

“We shouldn’t be surprised,” said Dr. Ayana Jordan, an associate professor of psychiatry at NYU. Grossman School of Medicine who studies race and addiction. Messaging about buprenorphine, also known by the brand name Suboxone, was overwhelmingly directed at white working patients, she said.

Black and Hispanic patients were also less likely to keep refilling their prescriptions. The reasons for that were outside the parameters of the study, but outside experts offered plausible theories that ranged from greater availability in white neighborhood to physician bias and even marketing strategies. That last point is a familiar factor, given the documented way in which tobacco companies have targeted Black neighborhoods.

A lot more digging is necessary and, as with all issues, the choices made by individuals are a factor. But bad decision-making – on either drug use or pursuing treatment – don’t come close to explaining the radically disproportionate numbers that this study identified in more than three-quarters of a million occurrences.

The study is valuable for reasons beyond documenting the existence of institutional racism: It sounds an alarm on unequal treatment availability for millions of Americans while underscoring the cost to society in loss of productivity, diminished tax base, the impact on family structure – especially on children – and the added public costs of police and court time.

We want to think that this is merely a tragic oversight by a system unaccustomed to considering how its practices can hurt the most vulnerable. We hope that’s the case, but it’s also indisputable that other practices have been implemented specifically for their disastrous impact on minorities. Among them was red-lining, a .practice in which government maps identified Black neighborhoods that were then identified as risky for investment. American cities continue to pay a high price for that racist policy and prominently among them is Buffalo.

Road-building has also isolated communities of color, including in East Buffalo, but also Rochester, Syracuse and New York City, where the Cross Bronx Expressway is practically synonymous with road construction that is indifferent to its social consequences.

It is unfortunately common to devalue the need to extend a hand to those in the grip of drug addiction. That approach is not only self-defeating, but for those who ever sneaked their first underage beer, also hypocritical. No one knows at 14 or 15 if that sip is a banana peel on which they will slip into a ravaged life.

We need to reach out to as many people who ask for that help as we can, and do it without regard to any other factor. And we need to understand that institutional racism is a monster that still lives among us, whether it hides in policing or retailing or property assessments or access to life-saving health care. We need to do better.

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Related to this story

FRIDAY, June 3, 2022 (HealthDay News) -- The COVID-19 pandemic was associated with immediate decreases in filled buprenorphine prescriptions by members of racial- and ethnic-minority groups but not White patients, according to a study published online June 1 in JAMA Network Open.

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