Tuesday, December 26, 2017

Black Victims of Heroin, Opioid Crisis 'Whitewashed' Out of Picture, Report Finds
Wilbert Lee talks about recovering from a 35-year heroin addiction at A Safe Haven in North Lawndale where he now works the reception desk Dec. 21, 2017.

John Keilman John KeilmanContact Reporter
Chicago Tribune

Farrah Evans began using heroin on the West Side of Chicago 20 years ago, long before opioids became the stuff of suburban nightmares and presidential speeches.

At first it was nothing more than a party drug, one that was available on every corner in her neighborhood. But soon enough, it consumed her life.

“It was crazy,” she said. “I didn’t realize how heavy that monkey on my back was until I found myself out in the streets, homeless, having to hustle or do whatever I needed to do to get me some heroin.”

Evans, now 40 and in recovery, embodies a side of the opioid crisis some experts believe has been overlooked by the media and policymakers — African-Americans in urban neighborhoods.

The Chicago Urban League recently issued a paper titled “Whitewashed: The African-American Opioid Epidemic,” outlining the drug’s toll on that community: African-Americans make up 15 percent of the state’s population but account for 24 percent of opioid-related deaths.

At the same time, the researchers said, African-Americans are less likely to get help because Cook County, home to about 2 out of 3 black Illinoisans, has a relative scarcity of clinics providing buprenorphine — the medication many experts believe is among the most effective treatments.

Stephanie Schmitz Bechteler, a co-author of the report, said those grim facts have been missing from the public deliberation over heroin, which often focuses on white users in suburban and rural areas.

“On the one hand, the change in narrative has brought a broader awareness to the issue, but it has come at the expense of the comprehensive set of people who are affected by this,” she said.

Opium to painkillers

Illegal drugs have been a part of Chicago since the opium dens of the 19th century, and the heroin market in particular has long been robust. A 1925 Tribune report quoted a federal investigator as saying: “Chicago has been the source of supply for the entire country. All the big men in the dope industry — it’s nothing less — make their headquarters here.”

While newspapers were crammed with lurid stories of “dope fiends” and “jive pushers” in crumbling city neighborhoods, the suburbs were seen as relatively free of the drug’s curse. But that started to change in the 1990s, when the arrival of heroin pure enough to snort spawned a new breed of user: young, affluent and white.

The demographics shifted even more as a surge of powerful opioid painkillers led many more into addiction and overdose. Opioid deaths among whites, 70 percent of the nation’s total in 1999, grew to 82 percent by 2015, according to figures from the Kaiser Family Foundation.

Many who died were from wealthy suburbs and far-flung rural areas, places that had never before encountered such a plague. News coverage reflected that shift, but in a way that cast white users as sympathetic victims and black and Latino users as criminals, according to a media analysis published last year in the journal Culture, Medicine, and Psychiatry.

While the suburbs have reacted to spiraling opioid abuse with law enforcement policies that aim to guide users into treatment instead of jail, the Urban League researchers said the hard-nosed “War on Drugs” approach remains the rule in Chicago’s poor neighborhoods.

“From 2012 to 2016, the Chicago community areas with the highest rates of felony drug arrests were overwhelmingly the city’s racially concentrated areas of poverty; the neighborhoods with the lowest rates were primarily white and wealthy,” they wrote.

Geographic disparities

Data from the Chicago Department of Public Health found a similar geographic disparity in overdose deaths. In 2016, the neighborhoods with the greatest number of victims were on the South and West sides.

State Rep. La Shawn Ford, whose district covers part of the West Side, said treatment options for users there remain too scarce. If there are cutbacks to Medicaid, the government-funded insurance program for the poor, the problem will get worse, he said.

“We would see a major increase in overdoses if people are not able to stay on Medicaid,” he said.

The Urban League report found that as of 2015, the Chicago area had the lowest buprenorphine treatment capacity of any metro area in the Midwest. But city officials say they are doubling their funding for that service to $3 million, much of which is going to clinics on the South and West sides.

“Medication-assisted treatment capacity is expanding,” said Julia Morita, Chicago’s public health commissioner. “That has been a goal, but not a lot of providers can do it, so we’re really ramping up assistance right now.”

One center in the city’s network is PCC Wellness, which has many West Side residents among its clientele. Amanda Brooks, the clinic’s chief population health officer, said it treats 350 people and still has room to grow.

“There are a lot of resources out there,” she said. “Unfortunately, it’s just people being aware that they exist.”

Evans learned about PCC from a friend after several unsuccessful attempts at getting sober. She said she has been clean for 13 months, thanks to a combination of buprenorphine, therapy and other services.

She has tried to persuade others in her East Garfield Park neighborhood to follow her example, she said, but many are too scared to try something they know little about.

“They see the gym shoe boys” — drug dealers — “but not people who are trying to help,” she said.

Jamelia Hand, a health consultant who specializes in aiding African-American opioid users, said a long history of mistrust in the medical establishment complicates that effort.

Recalling a former client whose husband insisted she go to church rather than treatment, Hand said outreach efforts should include houses of worship as well as barbershops, salons and other important places in the black community, she said.

“Those are sacred meeting grounds,” she said. “That’s where life is discussed. That’s where we go for therapy, in some cases.”

Options needed

As the city tries to expand treatment, Gabriela Zapata-Alma, substance abuse director of the treatment center Thresholds, said she has begun working with Chicago police to divert some drug users to recovery clinics rather than jail.

That’s a practice that has become popular in the suburbs in recent years, but Zapata-Alma said she wants to take it a step further by embedding intake counselors in some police stations to do on-the-spot assessments.

“Any petty crime that has to do with substance use disorder, (arrestees) can be screened by licensed staff, and if they need treatment, can be sent there,” she said.

Wilbert Lee, 61, agreed that more avenues to treatment are needed. He found his way there after decades of heroin addiction that started when he was in high school on the South Side.

After earlier stints with methadone didn’t take, he enrolled six years ago in A Safe Haven, a residential center in North Lawndale for people suffering from addiction and homelessness. Unlike many programs in the city, it does not rely on medication, using abstinence-based methods to promote drug-free living.

Lee, who got clean and now works the front desk at A Safe Haven, said he still knows people who use, and though he tries, it’s hard to pry them away from the “madness” of addiction.

“When I see them, I tell them there’s help available if you want it,” he said. “But you’ve got to be ready in your heart to really change.”


Twitter @JohnKeilman

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