THE CLAIM: Black people in America use and distribute drugs the most.


Between 1982 and 1985, the number of crack cocaine users in America increased by an estimated 1.6 million people. But, the federal government never declared a public health emergency. Instead, addicts and those who overdosed were labeled criminals — casualties of a “War on Drugs.” In stark contrast, the opioid crisis (fueled by Oxycodone) that hit Suburban America officially became a national “public health emergency” in 2017. Ran through the U.S. Department of Health and Human Services (HHS), President Trump announced, “We cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction. [It’s] never been this way. We can be the generation that ends the opioid epidemic. We can do it.”

Both crack cocaine and opioids usage have impacted millions and qualify as substance abuse. But, the key to funding medical treatment, investing more in prevention rather than prisons, and — above all — gaining empathy for addicts, seems to depend on the type of person using.

Widespread addiction in Black, urban communities has historically been viewed as a crime, requiring heavy enforcement. People suffering from addiction in wealthier, white communities are considered victims of a country-wide public health crisis, needing medical care. According to the National Institute of Health, 3 million people in the US have experienced or currently suffer from Opioid Use Disorder (OUD). The majority of individuals misusing (prescribed) opioids are white. In 2020, Medicare coverage was expanded to include opioid treatment programs providing MAT, medication-assisted-treatment. The federal government’s focus has switched to improving the health of those in possession of harmful drugs rather than punishing them.

Under the Biden-Harris Administration, the opioid epidemic has also been referred to as a “behavioral health crisis.” Now, the drug dealers are licensed doctors or pharmacists who “over-prescribe.” The stereotype of Black “crack heads” and “crack babies” of one drug era has been replaced — slotted in for white, wealthier individuals simply considered patients needing federal support.

Andrea Palm, deputy secretary of the Department of Health and Human Services, has pointed out, “…to tackle the behavioral health crisis in this nation, we need to fully understand the issues surrounding mental health and substance use, and the impact they have on people and communities… the Biden-Harris Administration is committed to meeting people where they are with information, resources, and support.”

Addiction is a heavily studied disease. But, for illicit drug use, the annual health data collected can only be considered an estimated review or sketch of the total picture because it relies on participants willing to be surveyed. Overall, 70.3 million people (over the age of 12) have used illicit drugs in 2022. According to the National Survey on Drug Use and Health (NSDUH), rates of illicit drug use were the lowest among Asians. Black (26.7 percent) and white (25.8 percent) people have near exact rates of use. Also keep into account that Black people only represent less than 14 percent of the US population whereas white people make up about 59 percent.

Marijuana accounts for the majority of illicit drug use for all of those surveyed. When you project these numbers to US population demographics (via census data), it draws attention to recovery efforts. If rates of illicit drug use are nearly the same, why do Black people die more often from overdoses?

Black people and drug usage

Again, these numbers only reflect the percentage of those participating in the national survey. Individuals dealing with homelessness and those in prison are excluded from the NSDUH survey. Using drugs at a similar rate, but overdosing more often than other racial groups reflects how Black people experiencing addiction have less access to healthcare resources. To be fair, our data visual above only displays the rate of individuals who die from an overdose rather than the total percentage of overdoses.

The path to rehabilitation depends on a combination of factors: mental health treatment, medicine to overcome withdrawal (and side effects of use), stable social or family networks, and, of course, enough income to even fund adequate treatment in the first place.

At the start of the War on Drugs, the US prison population was under 200,000; it has since skyrocketed by more than 500 percent to roughly 2 million people. According to the Prison Policy Initiative, mass incarceration now costs the US an estimated $182 billion a year. More money has been spent on enforcement and incarceration than actual drug rehabilitation. $47 billion is spent annually to enforce current drug laws.

Technically, the War on Drugs is not over. First introduced in 1971 via President Nixon, the phrase was meant to summarize the government’s efforts to battle drug trafficking and its social impact. Many experts consider the policy a total failure and a matter of hype. Since being launched, the War on Drugs has cost the US over $1 trillion in drug enforcement. For more than 50 years, at least three generations of Black people have been impacted by severe sentencing laws. Even with similar usage trends, Black people are incarcerated for drug offenses at a rate 10 times greater than whites, with the majority of arrests being for possession. Until the Fair Sentencing Act of 2010, distributing 5 grams of crack led to the same punishment as someone who trafficked 500 grams of powder cocaine, it’s more expensive form favored by Wall Street and the Hollywood elite. As JAY-Z explained in his video collaboration with artist Molly Crabapple, “It’s the same drug. The only difference is how you take it.”

Despite the billions of dollars spent and speeches made under different administrations, incarceration has not decreased rates of drug abuse. In fact, an estimated 65 percent of prisoners meet the criteria for drug addiction, but only 11 percent actually receive treatment.

Our data visual below compares money devoted exclusively to drug treatment efforts (as part of the National Drug Control Strategy) in fiscal year 2022 to the estimated annual funding for public correctional facilities. Keep in mind, the numbers do not include costs for private prisons or federal prevention efforts not directly tied to rehabilitation.

Black people and drug usage

Even with a greater spotlight on “pill mill” doctors who have prescribed millions of dollars worth of opioid drugs, the frequency of arrests and sentencing is relatively low compared to dealers of illicit, cheaper drugs like crack or marijuana (in states where it remains illegal). Take for example, Dr. Richard Evans in Houston. He received a five-year sentence for money laundering, mail fraud, and dealing over one million pills through his pain management clinic, bringing in an estimated $2.4 million.

A study by William & Mary Law School reviewed 25 of the some of the worst opioid pill mill doctors to be sentenced and in more than half the cases, judges imposed sentences below Federal Sentencing Guidelines. Researchers noted the hypocrisy in drug trafficking punishment, stating how “many pill mill doctors are in their 60s and 70s and judges appear to be tailoring their sentencing decisions to ensure that older doctors will not spend the rest of their lives in prison. Additionally, prosecutors face an uphill battle in proving the drug quantity against white-collar doctors (rather than street dealers) who can claim that some of their prescriptions were legitimate.”

Racial bias and wealth gaps have greatly impacted how addicts are treated and who gets helped in America. If the crack cocaine epidemic was categorized as a national health emergency during its height, instead of an opportunity to criminalize Black people for over half a century, the War on Drugs might have finally hit an expiration date.