Is the Prescription Opioid Epidemic a White Problem?

Hansen, Helena; Netherland, Julie

doi:10.2105/ajph.2016.303483

Cited by 166 publications

(94 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This selective stigmatization evokes the racialization of crack cocaine, racially disparate federal prosecutions for crack (versus powder) cocaine, and disproportionately harsh federal sentencing of blacks that continue to have reverberating impacts in the present day [169,170]. The racialization of OUDs has resulted in a treatment and prevention approach among blacks that is characterized by overcriminalization and reliance on heavily regulated delivery of opioid agonist treatment segregated from traditional healthcare systems (i.e., daily dosing at community methadone clinics), whereas treatment and prevention among whites has become increasingly medicalized and addressed through office-based care [171,172]. In recent years, the burden of the opioid overdose crisis has disproportionately increased among blacks compared with whites [2].…”

Section: Considerations For Health Disparity Populationsmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

View full text Add to dashboard Cite

• The current United States opioid overdose crisis is a complex, multifaceted, public health emergency that urgently requires the implementation of evidence-based primary, secondary, and tertiary preventive interventions. We develop a typology of the stigma related to opioid use, showing how multiple dimensions of stigma continue to fundamentally hinder the response to the crisis. • Public stigma is driven by stereotypes about people with opioid use disorders, such as their perceived dangerousness or perceived moral failings, which translate into negative attitudes toward people with opioid use disorders. • Enacted stigma describes the behavioral manifestations of public stigma, including discrimination and social distancing. Public and enacted stigma, in turn, lead to delivery of suboptimal care and undermine access to treatment and harm reduction services. • Public stigma and enacted stigma can become structural stigma when they become encoded in cultural norms, laws, and institutional policies. Collectively, these forms of stigma run at cross purposes to-and reduce public support for-public health-oriented policies to address the opioid overdose crisis.

show abstract

Section: Considerations For Health Disparity Populationsmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Like clinicians, upon passing legislation that legalized office-based buprenorphine, the DATA 2000 bill, Congressional lawmakers responded to testimony that office-based buprenorphine is more suitable for “suburban youth” (implicitly white patients) than methadone. They have also affirmed that the setting of general medicine clinics is more appropriate for private patients that presumably do not need the social services and mental health interventions provided in the public sector, nor the social control that is provided in highly regimented methadone programs (Hansen & Netherland, 2016). …”

Section: Introductionmentioning

confidence: 99%

“…Treatment rate disparities have been fuelled by buprenorphine marketing that has focused on the private sector, regulations and certification requirements that impede its implementation in the public sector (Hansen & Netherland, 2016), and by clinicians’ perception that office-based buprenorphine treatment is most appropriate for employed, “stable” patients, (Casadonte, Kolodner, Horton, & McMurphy, 2004; Larance et al, 2014). Like clinicians, upon passing legislation that legalized office-based buprenorphine, the DATA 2000 bill, Congressional lawmakers responded to testimony that office-based buprenorphine is more suitable for “suburban youth” (implicitly white patients) than methadone.…”

Section: Introductionmentioning

confidence: 99%

At the Expense of a Life: Race, Class, and the Meaning of Buprenorphine in Pharmaceuticalized “Care”

Hatcher

Mendoza

Hansen

2017

Substance Use & Misuse

Self Cite

View full text Add to dashboard Cite

Background/Objective Office-based buprenorphine maintenance has been legalized and promoted as a treatment approach that not only expands access to care, but also reduces the stigma of addiction treatment by placing it in a mainstream clinical setting. At the same time, there are differences in buprenorphine treatment utilization by race, ethnicity, and socioeconomic status. Methods This article draws on qualitative data from interviews with 77 diverse patients receiving buprenorphine in a primary care clinic and two outpatient substance dependence clinics to examine differences in patients’ experiences of stigma in relation their need for psychosocial supports and services. Results Management of stigma and perception of social needs varied significantly by ethnicity, race and SES, with white educated patients best able to capitalize on the medical focus and confidentiality of office-based buprenorphine, given that they have other sources of support outside of the clinic, and Black or Latino/a low income patients experiencing office-based buprenorphine treatment as isolating. Conclusion Drawing on Agamben’s theory of “bare life,” and on the theory of intersectionality, the article argues that without attention to the multiple oppressions and survival needs of addiction patients who are further stigmatized by race and class, buprenorphine treatment can become a form of clinical abandonment.

show abstract

“…It could be inferred from the findings reported by Case and Deaton (2015) that whites, relative to blacks, suffered more from poor labor market opportunities due to the great recession. However, Hansen and Netherland (2016) make a compelling argument that-rather than whites suffering from more anxiety and disappointment than blacks-whites had greater access to opioids through superior medical insurance coverage and a greater propensity to interface with physicians who were inclined to prescribe opioids.…”

Section: Robustnessmentioning

confidence: 99%

Race, Unemployment, and Mental Health in the USA: What Can We Infer About the Psychological Cost of the Great Recession Across Racial Groups?

et al. 2018

View full text Add to dashboard Cite

Social scientists from a range of disciplines have provided evidence of a connection between unemployment and mental health. However, researchers recognize that poor mental health can lead to joblessness, highlighting the challenge of generating an accurate estimate of the impact of unemployment on mental health. In addition, virtually all of these studies use either self-reported measures of mental health or broad measures of emotional well-being such as self-esteem or constructs of general emotional health which are less than ideal. A shortcoming in the literature is that scholars have yet to examine whether race effects the extent of the effect of unemployment on psychological distress. Unemployment might have a smaller impact on blacks, because they have a higher degree of resilience due to encountering a greater and more intense array of life challenges, or a larger impact because of the fear of the consequences of unemployment due to structural discrimination and fewer buffers such as wealth. This paper uses measures of mental health based on the DSM-IV and ICD-10 diagnostic manuals to offer estimates of the link between unemployment and psychological distress for whites and blacks. We directly consider the prior mental health background of individuals to address the problem of reverse causality bias that mars virtually all existing estimates of the link between mental health and unemployment. This also allows us to offer convincing evidence on the relative effect of unemployment on mental health across racial groups. The analysis uses data from the National Comorbidity Survey-Replication. We construct two subsamples, one composed of those with no previous identified bouts of poor mental health (resilient) and a second group containing individuals with a history of psychological distress (vulnerable). Resilient persons, relative to those with a history of suffering from psychological distress, should be less likely to suffer a bout of poor mental health leading to unemployment. In addition, the influence of other covariates is likely different for resilient versus vulnerable individuals. Thus, our contention is that estimates generated using the resilient subsample will be less prone to suffer from reverse causality bias, measurement error, and specification bias. Hence, these estimates will provide the most accurate gauge of the mental costs of unemployment across racial groups. Our findings reveal that among resilient persons the pernicious effect of short-term unemployment on psychological distress is significantly greater for blacks. Our findings, based on data from the recession that began in 2001, allow us to infer that the Great Recession had a more intense adverse mental health effect on members of the black community. Our results imply that policymakers should consider both the monetary and psychological costs of unemployment, as well as their racial implications, when formulating policy to address the effects of economic downturns.

show abstract

Is the Prescription Opioid Epidemic a White Problem?

Cited by 166 publications

References 3 publications

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

At the Expense of a Life: Race, Class, and the Meaning of Buprenorphine in Pharmaceuticalized “Care”

Race, Unemployment, and Mental Health in the USA: What Can We Infer About the Psychological Cost of the Great Recession Across Racial Groups?

Contact Info

Product

Resources

About