As we look further into the problem of addiction, we can see even more ways that inequality and social control play out. We notice that race and ethnicity impact both drug policy and incarceration. We review the legalization of marijuana. We examine the unequal nature of access to effective drug treatment programs.

8.5.1 Racialized Drug Policy and Incarceration

The history of our current drug laws is full of anti-immigrant and anti-Black sentiment. Our drug laws are connected to what sociologist Craig Reinarman calls drug scares. Drug scares occur when there is a public panic about a drug causing a wide array of preexisting social problems (Reinarman 1994:156). Often law enforcement officials or the media associate the usage of a particular drug with a particular racial or ethnic group. The usage of this substance by that group would be understood as causing a variety of social problems.

One historical drug scare involved opium dens (the equivalent of today’s bar or tavern, with opium the drug of choice rather than alcohol). This was a popular activity for the Chinese immigrants who began coming to the United States during the 1850s to help build the nation’s railroads and perform other jobs. White workers feared their growing numbers as a threat to their jobs. Racial prejudice against the Chinese increased. Politicians, labor unions, and other parties began to focus on the Chinese habit of smoking opium at opium dens. They warned that the Chinese were kidnapping little White children, taking them to the opium dens, and turning them into opium fiends.

This campaign had two effects. It increased prejudice against the Chinese. It also increased public concern about opium. This rising concern led San Francisco in 1875 to become the first city to ban opium dens. Other California cities did the same, and the state itself banned opium dens in 1881. Three decades later, the federal government banned the manufacture, sale, and use of opium (except for use with a physician’s prescription) when it passed the Harrison Narcotics Act in 1914.

Another historical drug scare happened after the Mexican Revolution of 1910. During this period, Mexicans moved to the United States in increased numbers. Some of these immigrants used marijuana. White people feared that Mexican people would take their jobs. Like what happened with opium and Chinese immigrants during the 1870s, people in power began to say that Mexicans who used marijuana would become violent. They would be more likely to rape and murder innocent White victims. This racially prejudiced claim increased concern about marijuana and helped lead to the federal Marijuana Tax Act of 1937 which banned its use.

Race was also at the core of drug policy that emerged from an increase in heroin use in urban centers in the 1960s. According to media accounts, the face of the heroin user at that time was “black, destitute and engaged in repetitive petty crimes to feed his or her habit” (Hart and Hart 2019:7). A popular solution to this racialized drug scare was to incarcerate Black users of heroin and offer methadone treatment to White users.

New York state was a forerunner in creating harsh drug laws to address heroin use in cities. The infamous Rockefeller drug laws of 1973 created mandatory minimum prison sentences of 15 years to life for possession of small amounts of heroin and other drugs (Hart & Hart 2019). 90 percent of those convicted under the Rockefeller drug laws were Black and Latinx, though they represent a smaller proportion of people who use drugs in the population (Drucker 2002).

The 1980s brought renewed concern about the perceived use of drugs by Black communities in urban areas. This time the focus was on a new type of cocaine called crack. Crack was a drug market innovation that slightly altered the recipe for cocaine making it more potent and easily smokable. In 1986 Congress passed the Anti-Drug Abuse Act, which established mandatory minimum sentences based on certain quantities of cocaine or crack. In this act, Congress included much tougher sentences for offenses involving crack than for those involving cocaine.

For example, there was a five-year minimum federal prison sentence for the distribution of 5 grams of crack while a cocaine offense would have to involve 500 grams to reach the five-year minimum sentence. Vagins and McCurdy (2006) explain: “Because of its relative low cost, crack cocaine was more accessible for poor Americans, many of whom are African Americans. Conversely, powder cocaine is much more expensive and tends to be used by more affluent white Americans” (p. i). The harsher penalties for drug offenses involving crack disproportionately impacted Black and Brown Americans and led to the mass incarceration problem we have today in the United States (Alexander 2010).

In general, the drug war has focused disproportionately on people of color and greatly increased their numbers who have gone to jail or prison. Even though illegal drug use is more common among Whites than among Black and Latinx communities, the arrest rate for drug offenses is ten times higher for Black people than the rate for Whites (Blow 2011). Partly because of the drug war, about one-third of young Black men have prison records. Politicians often say that one in three Black men will end up in jail. More recent research suggests that this rate is declining, but the rate of incarceration remains disproportionately high (Kessler 2015). Harsh drug laws and racism are intertwined such that, “The ‘war on drugs’ has become the primary social control mechanism legitimating the surveillance and punishment of African-American communities” (Sudbury 2013:xxii).

8.5.2 Legalization of Marijuana

Social movements, as well as individuals who sought to decriminalize and legalize marijuana, were often motivated by the United States’s long history of systemic racism and the war on drugs. To decriminalize something means that it is still against the law, but violations would be treated like traffic offenses. Since 2012 18 states and Washington, D.C. have legalized marijuana for adults over the age of 21. Legalizing marijuana has meant less arrests and jail-time. For example, in Oregon the number of marijuana arrests decreased by 96 percent from 2013–2016, the year marijuana was legalized for adult recreational use (DPA 2022).

The Drug Policy Alliance, a nonprofit organization that advocates for the decriminalization of drugs, examined rates of youth marijuana use. They found that since legalization of marijuana use in some states, youth use rates have remained stable and in some cases gone down. They have also found that legalization has not made roadways less safe due to driving under the influence (of marijuana). Finally, they show that states are using the money generated through taxes on legal marijuana for the social good (DPA 2018). In Oregon 40 percent of the marijuana tax revenue goes to the state school fund and 20 percent goes to alcohol and drug treatment.

However, health researchers remain concerned about the impacts of marijuana legalization on adolescent marijuana use. Increasing amounts of research reveal correlations between adolescent marijuana use and short and potentially long-term impairments on cognition, worse academic/vocational outcomes, and increased prevalence of psychotic, mood, and addictive disorders (Hammond et al. 2020). Though marijuana use rates among adolescents are higher in states that have legalized the substance, those rates were higher even before legalization (Choo 2014; Wall 2011; Ammerman 2005). Legalization itself did not cause higher usage rates.

Other negative impacts of marijuana use have risen in states where marijuana is legalized. Motor vehicle accidents and deaths where marijuana was involved have increased. Young children and pets accidentally overdose more often. Finally, emergency rooms see more patients and hospitalize them more often due to potent marijuana causing psychosis, depression, and anxiety (Committee on Substance Abuse & Committee on Substance Abuse Committee 2015, as cited in Hammond et al. 2020; Hall et al. 2018; Hopfer 2014; Sevigny 2018; Tefft et al. 2016; Wang 2017).

When considering whether marijuana should be legal, Hammond et al. (2020) point out that we must balance the negative impacts (discussed above) with the positive effect of decriminalization reducing youth juvenile justice involvement. Youth involvement in the juvenile justice system can have long-lasting negative impacts on the life outcomes of youth. For example, involvement in the juvenile justice system may disrupt education or cause long-lasting mental health problems. We must consider the reduction of these types of issues alongside the known negative impacts of youth marijuana use.

Another equity issue arises with the legalization of marijuana and the rise of a money-making industry. A drug-related felony on an individual’s record may be a barrier to gaining a license to sell marijuana through a dispensary. As we’ve discussed in this chapter due to systemic racism within drug policy enforcement, those with drug-related felonies on their record are disproportionately Black. This means that Black entrepreneurs may be disproportionately blocked from entering the marijuana industry. Several states and cities have implemented equity programs to address this issue. In California a prior drug felony cannot be the sole basis for denying a marijuana license. In Portland, Oregon a portion of marijuana sales tax revenue is spent on funding women-owned and minority-owned marijuana businesses (DPA).

8.5.3 Access to Drug Treatment: SES and Race in Oregon

Socioeconomic status and race impact access to drug treatment. Most elective drug treatment programs require some form of payment for services. Those without insurance and without the financial means to pay will be unable to receive treatment. Researchers have also found that racial discrimination has prevented entry for Black and Indigenous people of color into more desirable forms of drug treatment (Hansen 2015).

While some may actively seek drug treatment, others may be forcefully mandated to attend strong-arm or faith-based rehabilitation programs. Sociologist Teresa Gowan asserts that these types of mandated rehab programs are used by the state to manage the poor. Poor individuals with a drug violation may be mandated into forms of treatment that are designed to “transform basic behavioral dispositions and instill a new moral compass” (Gowan 2013).

At strong-arm rehab centers all DWI (driving while intoxicated) and many low-level drug offenders are encouraged to define themselves as addicts, even if they may not actually have a substance use disorder. They are also punished for a relapse and rewarded for a “cure”. Gowan found that cultural styles and tastes that were not middle class were brought into the so-called therapeutic habilitation process and considered to be in need of reform. Bringing up the role of poverty or racism in one’s life is thought to be immature and evidence of the addict ego (Gowan 2013).

Race and class also play a role in determining which type of opioid use disorder treatment one will receive. Hansen (2015) found that BIPOC were often only offered the option of the less desirable methadone treatment, which requires near-daily visits to a clinic and a demeaning and constricting practice of surveillance (Bourgois 2000). In contrast, White middle-class individuals were more likely to be given the opportunity to receive buprenorphine treatment for their opioid use disorder. This type of treatment is more private and requires significantly fewer medical interactions. Hansen (2015) sees this systemic discrimination as working to maintain the race and class privilege of white middle-class individuals.

Drug treatment in Oregon is particularly lacking. Oregon ranks 47th among the 50 U.S. states in access to treatment for substance use disorders. Treatment needs are significantly unmet In fact, only 8.5 percent of teens and adults in Oregon who needed treatment actually received it (NSDUH 2020). Hope is on the horizon, though. Measure 110, which decriminalizes possession of small amounts of illicit drugs, was passed in the 2020 election, This law increases state funding for drug treatment services. We’ll explore the decriminalization of drug possession in Oregon more in the next section.