Race, Stigma, and Addiction

Abstract

Racialized attitudes toward addiction have shaped medical and institutional responses in the United States since the nineteenth century. This racialization has been made salient by the recent rise in opioid abuse and dependence among whites, which has precipitated unprecedented efforts at caring for individuals with opioid use disorder. Such a response was not mounted in an attempt to treat Native American communities, which have similar rates of opioid overdose mortality as whites, nor was it mobilized in response to past and current drug epidemics in African American communities. Treatment and policy innovations have primarily targeted white communities, under the assumption that medicalization of addiction treatment will reduce stigma in treatment. In this chapter, the authors argue that stratified medicalization furthers racial inequalities in addiction treatment while also failing to reduce treatment stigma even among white Americans. Racialization of opioid use disorder has led to disparate policy and clinical responses, and it has led to criminalization of addiction among nonwhites and medicalization of addiction among whites, thereby deeply influencing and differentiating the experiences of stigma among these groups.