Sunday, March 13, 2022

the last book I ever read (Jessie Singer's There Are No Accidents, excerpt seven)

from There Are No Accidents: The Deadly Rise of Injury and Disaster―Who Profits and Who Pays the Price by Jessie Singer:

In 2010, white people were dying of accidental drug overdoses at nearly twice the rate of Black people, in large part because OxyContin prescriptions still dominated the overdose epidemic. The epidemic was significant enough to shift the statistics of the entire history of accidental death in America—in 2002, white people began to be killed by accident, all accidents total, at a higher rate than Black people for the first time in recorded history because of the way white overdose deaths shifted the numbers. It was not the pile of bodies that made the public see the opioid epidemic as an epidemic, but that suddenly the bodies were white.

Today, that gap is shrinking. White opioid overdoses are leveling off, and Black overdoses are rising sharply. In 2019, accidental drug overdoses returned to their old pattern, with Black people dying at a rising rate, and at the same rate as white people, for the first time since 2002, because with OxyContin finally regulated, most accidental overdoses now come from illegal, not prescriptions, opioids. But stigma has not changed as an arbiter of accidents. Doctors prescribe buprenorphine, which lowers the risk and rate of accidental overdose by managing the urge for the drug, almost exclusively to white people. Researchers investigated some 13 million doctor visits between 2012 and 2015 and found a surge of physicians prescribing the medication to white people and no change in the number of prescriptions for Black people. Even while Black overdoses are rising faster than white ones, doctors are thirty-five times more likely to prescribe buprenorphine to white people.

Buprenorphine is better than methadone because it doesn’t require daily visits to a clinic—but that only helps if you’re white enough to get a prescription. For Black people without a prescription, there is the risk of the accidental overdose or the daily burden of the methadone clinic. As a result, white opioid use has begun to taper, while the crisis for Black people rises at a disproportionate rate.

In accidents, stigmas stack up, and race trumps them all.

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