Drug choice, not race, fuels disparities, experts say
In 2002, 27 people died of heroin overdoses in Wisconsin. A decade later, the toll skyrocketed to 187 deaths.
Heroin has quickly become the most visible drug on the radar for those who work with addicts and in the state's criminal-justice system. Experts say it is the emergence of this drug that partially accounts for the racial disparities in Wisconsin's drug courts.
“When I look at the racial numbers from 2009 to today, the proportion of African-Americans has gone down as the proportion of heroin addicts has gone up,” said Milwaukee County Circuit Judge Ellen Brostrom, who runs that county's drug court.
According to a recent study by Washington University in St. Louis, 90 percent of heroin users are white, and most are young and live in the suburbs. By contrast, hospital studies show that African-Americans are much more likely than whites to abuse cocaine. And one University of Wisconsin-Madison expert said heroin addicts tend to commit less violent crimes than those on cocaine; many drug courts exclude violent offenders from participating.
The result: Some drug courts, such as the one in Dane County, are now full of white heroin users.
Journey Mental Health, a Madison-based nonprofit that provides treatment for Dane County's drug court, reports that in 2008, 20 participants abused cocaine and 37 abused heroin. But by 2013, those numbers changed dramatically: four cocaine users and 92 heroin users.
The Washington University study found the path to heroin addiction usually starts with prescription painkillers. Once people are hooked, they sometimes turn to heroin for a similar high at a fraction of the cost, the study's author, Dr. Theodore Cicero, has said.
His study found that the demographics have shifted “from an inner-city minority-centered problem to one… involving primarily white men and women in their late 20s living outside of large urban areas.”
Dr. Randall Brown, an associate professor at UW-Madison and director of the Center for Addictive Disorders, said how the two drugs work on the brain could help explain the disparities because they correlate with the types of crime a user is likely to commit.
Cocaine causes changes in the brain that regulate impulses, leading to violent and aggressive behaviors — just the type of crime that can disqualify someone from drug court. Heroin usually results in more “inquisitive” crime, said Brown, such as robbing a bank or selling drugs, crimes that do not disqualify a person from receiving treatment.
The Dane County drug court recently underwent a reorganization to focus on more high-risk offenders, which could lead to increased participation by African-Americans and other minorities.
But Dane County Circuit Judge Juan Colas, who now runs the drug court, said those efforts might be eclipsed by the wave of heroin addicts now flooding the criminal justice system.
“The proportion between cocaine and heroin has flipped … so now we've made these changes in drug courts, and at the same time drug profiles of addicts have changed,” Colas said. “It could be these things have cancelled each other out.”
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