A bottle of OxyContin in a Hollywood, Florida drugstore.
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explainer / justice

While Government Cracked Down On Illegal Drugs, Big Pharma Hooked Millions On Opioids

The racist roots of the opioid crisis.
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For more than a century, American drug policy has operated from the presumption that addiction is a problem native to, and emanating from, poor and nonwhite communities. That presumption helped sustain a mutually reinforcing cultural and regulatory split: on the one hand, a punitive “war” that dismissed addiction as a problem of crime, and on the other, a lightly regulated pharmaceutical industry that reaped billions on the sale of psychoactive drugs to white and respectable “patients.”

This binary architecture dividing “drugs” from “medicines” originated in the Progressive Era, when the demographics of drug use underwent a noticeable shift from white middle-class women to poor immigrant men. The social and political response hardened as addiction appeared to slide down the socioeconomic ladder and turned a medical phenomenon into a criminal one.

That shift was laid bare in the two marquee drug laws of the era. Based on a consumer protection model, the Pure Food and Drug Act of 1906 required honest labeling of drugs in the chaotic legal market and established the Food and Drug Administration (FDA) to enforce it. Eight years later, the Harrison Narcotics Tax Act restricted the use of narcotics to the medical realm but quickly evolved into a system of punitive prohibition, and in 1930 a dedicated police agency — the Federal Bureau of Narcotics (FBN) — was created to further stamp out drug use and “vice” among minorities and the criminal element.
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