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Systemic Racism & Addiction: How Are They Connected?

“I had always felt an underlying tone of dismissal when accessing the healthcare system. I felt belittled, degraded, and misunderstood enough times to almost convince me that I was not ‘good enough’ to access it. As a result, because I felt this treatment was racially motivated, I was unable to find a practitioner whom I could trust for medical help.”

Would you believe this statement came from an aboriginal Canadian in modern-day (supposedly inclusive) Canada? University of Northern British Columbia social work student Lynda Brunen’s words are a testament to systemic racism in its current form. Brunen isn’t the stereotypical alcoholic or drug-dependent indigenous person, yet she is subject to racial discrimination. So imagine the plight of the native who has substance abuse problems.

People struggling with alcohol or drug addiction are already stigmatized as a result of their disease, but more so if they belong to a minority group in North America. Racism here has its roots in history. One would think that in the 21st century, issues of race would have been long gone—at least in the United States. Members of the two largest demographic groups (black and white Americans) believe that society is fairer now, and that equality has been achieved. But the reality is different.

A 2017 survey by Yale University psychologists presented in the Proceedings of the National Academy of Sciences (PNAS) revealed that for every $100 in income earned by an average white family in the USA, an average black family earns $57.30 [1]. College-educated black workers earn about 20% less than their white counterparts. Survey participants were surprised by this disparity.

How is it that both groups overestimate economic equality between themselves? Partly because Americans, especially higher-income whites, have minimal exposure to those unlike them. They remain economically and racially segregated.

Redlining’s role in present-day disparities

To better understand the huge economic inequality among racial groups in the US, it is necessary to look back at the country’s history. One contributing factor was the practice of redlining [2]. After the civil war, federal government agencies drew maps dividing cities into desirable and undesirable areas for investment. Banks and insurance companies used these maps to deny loans and other services based purely on race. This practice blocked communities, specifically black ones, from accessing private and public investment, leading to legal segregation. Consequences of this practice are still affecting minorities to this day.

Cases in point: 

  • Alex Cequea, a New York Times writer, reported that in the late 1980s, an investigation into the Atlanta real estate market showed that banks were more willing to lend to low-income white families than to middle- or upper-income African American families.
  • In 2017, a study showed redlining is still affecting home values in major cities like Chicago.
  • A 2017 research by Mazumder, Aaronson, and Hartley confirmed the role of government policy in shaping racial disparities in America in terms of housing, credit, and wealth accumulation access [3]. Mazumder et al believe that the government’s creation of divisive maps influenced the development or decline of urban neighborhoods and contributed to these disparities.
  • Princeton economic historian Leah Boustan, commenting on that research, confirmed that the borders mattered, referring to them as ‘pathbreaking’. The borders were based on the belief that the presence of blacks and other minorities would lower property values and influence future events in these areas. “Though maps alone didn’t create segregated and unequal cities today,” she explains, “the role they played was pivotal.”

The ‘other whites’ suffered too

Coleman Hughes, a columnist on race issues for Quillette magazine, reveals another dimension to redlining. Apparently, the current housing-related injustice being experienced by ethnic minorities also happened to white minorities. He said that before World War II, white ethnic groups like the Italians and the Irish also couldn’t get mortgage loans. They were viewed as ‘out groups’ distinct from white Protestants. So they were also discriminated against. They were included after the war, though.

The Federal Housing Administration (FHA) linked banks, so the average person could get a mortgage loan more easily. This was the period when it was easy to build wealth, yet black Americans were bypassed from the post-war period until the Civil Rights movement. Today, the huge wealth gap is 10 to 1, such that the average white household has 10 times as much wealth as the average black household.

The reparation debate

Unfortunately, redlining cannot be undone. Some, like Ta-Nehisi Coates, a journalist specializing in political issues on African Americans and white supremacy, have suggested reparations instead. In 2014, Coates published ‘The Case for Reparations’ in The Atlantic magazine, where he urged Americans to re-examine the role of slavery, Jim Crow [4], and redlining in creating the wealth gap between blacks and whites.

But Hughes, of African American and Puerto Rican descent, disagrees with Coates. On June 19, 2019, Hughes argued against (the reparation) campaign before a US House Judiciary subcommittee: “Reparation payments to descendants of slaves would insult black Americans, making it harder to build the political alliances required to solve their current issues, such as underachievement. Reparation is a misnomer because it implies that cash transfers would repair (the damage).”

Coates wasn’t the first to recommend reparations. In 1964, former US President Lyndon B. Johnson created the Great Society—domestic programs aimed to eliminate poverty and racial injustice. Part of this was his War on Poverty, which gave billions of dollars’ worth of cash transfers to the black community. US participation in the Vietnam war, however, drained funds allocated to this initiative. It also coincided with the escalation of violent crime and the emergence of single-parent homes (not a problem in the black community before 1960).

How entrenched values perpetuate inequality

Behavioural patterns in black American culture differ from their white and Asian American counterparts. With blacks, there’s a social disincentive on doing well in school. Black kids are accused of ‘acting white’ if they do well in school. Testimonies from prominent black community members like the Obamas and JAY-Z—plus ethnographic studies—have confirmed this widespread ‘phenomenon’.

In contrast, Asian Americans don’t have this taboo on scholarly achievement. A Brookings Institution survey found that Asian American students do twice as much homework per night as their white counterparts, and white kids spend much more time on homework than black kids. This is another cultural phenomenon. “How will reparations fix this?” Hughes asks.

How does systemic racism differ from other forms?

Systemic racism (aka institutional racism) manifests itself in social and political establishments. It is demonstrated in imbalances related to criminal justice, employment, housing, healthcare, political power, income, wealth, and education.

Stokely Carmichael and Charles Hamilton, who conceived the term ‘institutional racism’ in 1967, wrote that individual racism is overt and therefore identifiable [5]. Institutional racism is subtle and thus, less noticeable. Systemic racism stems from established and respected groups in society, so it is condemned less than individual racism.

Systemic racism infects society’s structure, as it’s about daily decisions made by those who don’t think of themselves as racist. The system is designed in such a way that no single person or entity is responsible for it, yet it generates racist outcomes. That’s why it’s difficult to detect. When the white majority occupy most decision-making positions, however, this affects people of colour.

Canadian examples of systemic racism include the 1885 Head Tax and the 1923 Exclusion Act against the Chinese, the Indian Act, the Indian Residential School System, and the 1897 Female Refugee Act, which criminalized ‘immoral’ acts by unmarried pregnant or publicly drunk women [6].

Unintentional bigotry

A big part of systemic racism is implicit bias—prejudices in society that people aren’t aware they have. Examples of systemic racist statements:

Women are emotional. Jews are stingy. Muslims are terrorists. A study revealed that white-sounding names on resumes get twice as many interviews as identical resumes with black-sounding names. This implicit bias is one reason the black unemployment rate is twice that of white unemployment among college graduates today.

How has systemic racism affected drug laws?

Recent reports claim that US drug policy is racist, but researchers have been saying this for decades. Neuroscience and addiction writer Maia Szalavitz, herself a former cocaine and heroin addict, says American drug laws need reassessment because of their origin and how they affect drug users: “They’re not based on science, but on prevailing social attitudes, which were colonialist… and now, institutionally racist.”

According to Race Forward, home to the Government Alliance on Race and Equity (GARE)—a national network aiming to achieve racial equity— “over 40% of drug arrests are not for selling drugs but for possession of marijuana. White and black Americans use marijuana equally, but blacks are 3.7 times more likely to be arrested for it. Even if they don’t get convicted of a crime, that arrest can stay on their record and affect their chances at good jobs, housing, and bank loans for the rest of their lives.”

As for crack cocaine, although approximately two-thirds of users were white or Hispanic, a large percentage of people convicted of possession were black (1994 statistics). Of the defendants, 84.5% convicted of possession were black, 10.3% white and 5.2% Hispanic.

Severe, unequal drug possession laws, combined with racially motivated conviction rates, created massive racial inequality in the American criminal justice system [7]. Professor Daniel D’Amico of Loyola University, New Orleans, says this gets ignored because it doesn’t affect the majority. Less than 1 in 100 Americans were jailed in 2013. But for young black males, this number was closer to 1 in 4, as 1 in every 11 African Americans was in prison. They have higher chances of going to jail than of getting married or going to college.

Of the 1.6 million inmates in US prisons in 2010…

  • Black = 14% of the total population, but 36% incarcerated
  • Latino = 16% total, 24% incarcerated
  • White = 64% total, 31% incarcerated

Attempts at regulation change

Former President Barack Obama visited a federal prison in 2015 to call attention to this [8]. As a result, the law was changed to reduce disparity in 2010, but it affected only new cases. After 40 years of extreme sentencing policies, the US Sentencing Commission approved a retroactive drug sentence reduction, which resulted in the release of 6,000 prisoners given unjustly long sentences but who had already served substantial time [9].

Also, policies targeting minority populations in large cities (aka ‘stop and frisk’) and arrest quotas have declined because of lawsuits [10]. When the former NYC mayor stopped litigating ‘stop and frisk’ cases, the number of minorities detained under the practice decreased dramatically [11].

Despite these changes, institutional racism is still widespread in law enforcement and the criminal justice system, which uses racial profiling and police brutality. The biggest gap is on how capital punishment is disproportionately applied to minorities, especially blacks [12].

D’Amico believes that though the reasons for this inequality are “complicated and multicausal,” part of the blame lies in the ways authorities write and enforce and prosecute laws. He explains that in many cases, it’s not overt racism by individuals, but economics that’s the culprit: “The unequal enforcement of the criminal justice system happens because its political and bureaucratic structure creates perverse incentives.”

Drug prohibition laws were meant to be colour-blind, but the wealthy are treated differently in the drug trade. D’Amico says, “Different groups consume different drugs at different rates. Groups are politically represented in different quantities. So they’re arrested and incarcerated at different rates. Politicians and bureaucrats respond to incentives in this area. How could minorities hope to use the political process to fix inequality when they are systematically overincarcerated and disenfranchised?” He says new, radical approaches are necessary to bring about social change. And more study is needed to determine other causes of inequality.

Drug policy and racial minorities

Ethan Nadelmann, founder and executive director, Drug Policy Alliance, commented on the injustice of racial disparities, the disproportionality of arrests (especially drug-related), and the persecution of young black and brown men. As the leader of an alliance that advocates for drug policies grounded in science, compassion, health, and human rights, Nadelmann says, “Laws enforced equally is not sufficient. The distinction between which drugs should be legal and illegal had nothing to do with the dangers of these drugs… and almost everything to do with who used these.”

Szalavitz agrees. She doesn’t see the logic behind why marijuana use is more punishable than tobacco use, given the dangers of tobacco. She says, “Colonial legacy is responsible for current drug laws. Anti-marijuana laws are disproportionately enforced on people of colour.”

Nadelmann explains the history of how current laws came about:

  • “When the principal users of drugs in America in the 1870s and 1880s were middle-class white women in the south—taking opium and laudanum for menopause or as painkillers— nobody thought to criminalize them. But when the Chinese railroad and mine workers arrived with their opium, the authorities were concerned about the Chinese addicting white women with the substance. Thus began the first criminal laws in California and Nevada prohibiting opiates from China.”
  • “The first anti-cocaine laws were directed at blacks working in the docks in the south. The fear was, what would black men do to white women after they consume that white powder?”
  • “The first anti-marijuana laws in the mid and southwest were directed at Mexican migrants.”
  • Alcohol prohibition was a conflict between the ‘white-white Americans’ from north and west Europe and the ‘not-so-white Americans’ from south and east Europe. African American church leaders supported alcohol prohibition, but when the 18th amendment to the US Constitution was approved, the law was subsequently enforced on African Americans.”

Racial hierarchies and dog whistles

Heather McGhee, former president of Demos—a non-profit progressive US think tank that champions solutions for racial equity—defines racism as “the belief in a hierarchy of human value, that some people are worth more than others.” She warns: “As long as we believe in this, some of us will always end up on the bottom. Some progressives think that if we solve problems of economic inequality, racial disparities and racism will go away. But the solution to economic inequality is to tackle racism.”

Law professor Ian Haney López of the University of California Berkley and author of Dog Whistle Politics, says that constant race talk divides Americans. “This leads us to fight against, and distrust each other and to resent government—and in turn, to give control over government to the very rich.” He explains the concept of dog whistles, commonly used by conservatives. A dog whistle is coded language used by politicians to incite strong emotional responses in their target audience. Codes related to people of colour include illegal alien, freeloaders, inner-city crime. Codes related to white, non-Hispanic Americans include the silent majority, the heartland, hardworking taxpayers, real Americans.

López credits Lee Atwater, former President Ronald Reagan’s strategist, for the proliferation of dog whistles. López says Atwater was “able to convince many Americans to side with the preferences of the (upper) 1% by making fear of people of colour tied to our very idea of government.”

White opioid addiction versus black crack addiction

According to assistant professor Helena Hansen of New York University’s Department of Psychiatry, America’s drug war has played a profound role in reinforcing racial hierarchies. Although both black and white Americans use illicit drugs, blacks are 6 to 10 times more likely to be incarcerated for drug offenses.

Hansen’s examination of ‘white opioid’ history shows a different response to prescription drug abuse by white people, in which addiction is treated as a biomedical disease. Whereas drug use by people of colour is still run by punitive systems. This disparity has an advantage, though, in that it creates an opportunity to change drug policy to make harm reduction strategies available to everyone—even those previously discriminated against.

When US President Trump appointed former New Jersey Governor Christopher Christie to lead the opioid abuse control task force in 2017, Christie approached the job with compassion toward drug users, calling for decriminalization of opioid abuse. As policymakers (like Trump and Christie with addicted family members) are themselves affected by the epidemic, this has led them to lobby for a health-based approach over criminal justice. This shows how politicians’ personal relationships can influence policy.

The opioid epidemic has led to 52,000 drug overdose deaths in 2015 (white Americans included). Pundits say that because the white populace has been affected, white lawmakers— who make up a disproportionate percentage of the government—are more likely to support compassionate drug policies now than past ones like the crack cocaine epidemic of the 1980s and 1990s, which affected a large number of black drug users.

Aboriginal Canadians and the healthcare system

Racism in Canada also has its roots in history. One sector where past injustice and historical trauma have carried over to the present is in medical care. Aboriginal people with substance use disorders face barriers in accessing the mainstream healthcare system [13]. Because of their addiction, they experience both societal stigmatization and racism. Many of them deal with emotional and physical pain with drug or alcohol use. Aboriginal women, including those in Newfoundland and Edmonton, deal with additional discrimination based on gender and class. Aboriginal youth suffer from sexual abuse, homelessness, hopelessness, and mental illness.

To address these, the Assembly of First Nations added mental health issues and suicide in its health policy. As for addictions, the Chiefs of Ontario developed a Regional Prescription Drug Abuse Strategy. Similar initiatives have been launched throughout Canada.

What can we do?

Cequea recommends the following:

  • Strive to achieve racial equity and equal opportunity. Distribution of benefits and burdens shouldn’t be determined by race.
  • Demand higher standards from society. Hold to account, not just individual-level discrimination, but overall social outcomes.
  • Be mindful of our own implicit biases.
  • Lobby to change the criminal justice system.
  • Use demand reduction to prevent harmful drug use. Measured by a reduction in abstinence, this is distinct from harm reduction.
  • Call for an end to predatory lending.
  • Protect voting rights.
  • Make public school funding independent from property taxes, to give all districts equal access to resources.
  • Take a distinctions-based, collaborative approach that recognizes the unique needs of indigenous communities (First Nations, Inuit, Métis, Alaska natives, and other American Indians) regarding substance use issues. Policy or procedure changes must directly address their realities.

Brunen concludes, “We cannot undo history, but we can commit to creating a brighter future by recognizing through research what works and what doesn’t.” Research isn’t enough, though. Progress comes with a united collective. Information, rhetoric, and theory are only effective when society accepts these and leaders implement recommended changes.


[1] Kraus M, Rucker J, and Richeson J. “Americans misperceive racial economic equality”. Census data from Current Population Survey. PNAS. 2017.
[2] Badger, Emily. “How Redlining’s Racist Effects Lasted for Decades”. New York Times. 2017.
[3] Aaronson D, Hartley, D, and Mazumder, B. “The Effects of the 1930s Holc ‘Redlining’ Maps”. Federal Reserve Bank of Chicago Working Paper No. WP-2017-12. 2017.
[4] Jim Crow laws were rules of racial segregation in the southern United States enacted from the late 19th century until 1965.
[5] Carmichael, Stokely and Hamilton, Charles V. “Black Power: The Politics of Liberation (1967)”. New York: Vintage. 1992.
[6] From Calgary Anti-Racism Education
[7] Kurtzleben, Danielle. “Data Show Racial Disparity in Crack Sentencing”. US News & World Report. 2015.
[8] Horsley, Scott. “Obama Visits Federal Prison, A First For A Sitting President: It’s All Politics”. 2015.
[9] “US to release 6,000 federal inmates as part of prison reform”. 2015.
[10] “The NYPD’s black-box problem”. New York Daily News. 2013.
[11] Southall, Ashley. “Decline in Stop-and-Frisk Tactic Drives Drop in Police Actions in New York, Study Says”. The New York Times. 2015.
 [12] Arrigo, BA. Encyclopedia of Criminal Justice Ethics. SAGE Publications. 2014.
[13] Browne AJ, Fiske J, Thomas G. “First Nations women’s encounters with mainstream health care services and systems”. BC Centre of Excellence for Women’s Health. 1999.
Currie et al. “Racial discrimination experienced by Aboriginal university students in Canada”. Canadian Journal of Psychiatry, 57(10): 617-25. 2012.

Photo credit: zeevvees. This picture has a Creative Commons attribution license.