, Volume 12, Issue 2, pp 217–238 | Cite as

White opioids: Pharmaceutical race and the war on drugs that wasn’t

  • Julie Netherland
  • Helena HansenEmail author
Original Article


The US ‘War on Drugs’ has had a profound role in reinforcing racial hierarchies. Although Black Americans are no more likely than Whites to use illicit drugs, they are 6–10 times more likely to be incarcerated for drug offenses. Meanwhile, a very different system for responding to the drug use of Whites has emerged. This article uses the recent history of White opioids – the synthetic opiates such as OxyContin® that gained notoriety starting in the 1990s in connection with epidemic prescription medication abuse among White, suburban and rural Americans and Suboxone® that came on the market as an addiction treatment in the 2000s – to show how American drug policy is racialized, using the lesser known lens of decriminalized White drugs. Examining four ‘technologies of whiteness’ (neuroscience, pharmaceutical technology, legislative innovation and marketing), we trace a separate system for categorizing and disciplining drug use among Whites. This less examined ‘White drug war’ has carved out a less punitive, clinical realm for Whites where their drug use is decriminalized, treated primarily as a biomedical disease, and where their whiteness is preserved, leaving intact more punitive systems that govern the drug use of people of color.


addiction whiteness prescription opioids heroin 



The authors wish to acknowledge Sonia Mendoza, Laura Duncan, Alyson Kaplan, and Danae DiRocco for their help with media analysis for this paper, as well as the helpful comments of David Herzberg, Donna Murch and Jessie Daniels on an earlier draft of this paper, and the useful suggestions of three anonymous reviewers. This paper was supported by a U.S. National Institute of Drug Abuse K01 award (to Hansen), as well as a Robert Wood Johnson Health & Society Scholars Program Fellowship and a Robert Wood Johnson Health Policy Investigator Award (to Hansen).


  1. Adler, J. (2003) In the grip of a deeper pain. Newsweek, 20 October, p. 48.Google Scholar
  2. Alexander, M. (2010) The New Jim Crow: Mass Incarceration in the Age of Colorblindness. New York: The New Press.Google Scholar
  3. Allen, T.W. (1994) The Invention of the White Race. London: Verso.Google Scholar
  4. Beaulieu, A. (2001) Voxels in the brain: Neuroscience, informatics and changing notions of objectivity. Social Studies of Science 31(5): 635–680.CrossRefGoogle Scholar
  5. Bigg, M. (2007) Report says U.S. jails more blacks than whites for drugs. Reuters, 4 December,
  6. Bourgois, P. and Schonberg, J. (2009) Righteous Dopefiend. Berkeley, CA: University of California Press.Google Scholar
  7. Braun, L. (2014) Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics. Kindle Edition Minneapolis, MN: University of Minnesota Press.CrossRefGoogle Scholar
  8. Campbell, N. (2000) Using Women: Gender, Drug Policy, and Social Justice. Oxford: Psychology Press.Google Scholar
  9. Campbell, N. (2010) Toward a critical neuroscience of ‘addiction’. Biosocieties 5(1): 89–104.CrossRefGoogle Scholar
  10. Campbell, N. and Lovell, A. (2012) The history of the development of buprenorphine as an addiction therapeutic. Ann. N.Y. Acad. Sci. 1248(2012): 124–139.CrossRefGoogle Scholar
  11. Chou, I. and Narasimhan, K. (2005) Neurobiology of addiction. Nature Neuroscience 8(11): 1427.CrossRefGoogle Scholar
  12. Cicero, T. and Surratt, H. (2012) Effect of abuse-deterrent formulation of OxyContin. New England of Journal and Medicine 367(2): 187–189.CrossRefGoogle Scholar
  13. Centers for Disease Control (CDC) (2014) Prescription Drug Overdose in the United States: Fact Sheet,, accessed 15 December 2015.
  14. CESAR FAX (2012) Suboxone® sales estimated to reach $1.4 billion in 2012 – more than Viagara® or Adderall®. CESAR FAX, Center for Substance Abuse Research, University of Maryland, College Park, 10 December, Vol. 21, Issue 49.Google Scholar
  15. CNN (2003) Limbaugh admits addiction to pain medication,, accessed 15 December 2015.
  16. Clark, R., Samnaliev, M., Baxter, J. and Leung, G. (2011) The evidence doesn’t justify steps by state medicaid programs to restrict opioid addiction treatment with buprenorphine. Health Affairs 30(8): 1425–1433.CrossRefGoogle Scholar
  17. Congressional Record (1999) Hearing before the Subcommittee on Health and Environment of the Committee in Commerce, House of Representatives. Congressional Record – House (106th Congress 1st Session): 1–23.Google Scholar
  18. Congressional Record (2000) Drug Addiction Treatment Act of 2000. Congressional Record – Senate (106th Congress): S9111.Google Scholar
  19. Congressional Record (1999a) Drug Addiction Treatment Act of 1999. Congressional Record – Senate (106th Congress): S1089-S1093.Google Scholar
  20. Courtwright, D. (2001) Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press.Google Scholar
  21. Courtwright, D. (2001) In: V.P. Dole, M.E. Nyswander and M. Jeanne Kreek (eds.) Dark Paradise: Opiate Addiction in America Before 1940. Cambridge, MA: Harvard University Press.Google Scholar
  22. Dackis, C. and O’Brien, C. (2005) Neurobiology of addiction: Treatment and public policy ramifications. Nature neuroscience 8(11): 1431–1436.CrossRefGoogle Scholar
  23. Daniels, J. (1997) White Lies. New York: Routledge.Google Scholar
  24. Daniels, J. and Schulz, A.J. (2006) Whiteness and the construction of health disparities. In: L. Mullings and A.J. Schulz (eds.) Gender, Race, Class, and Health. San Francisco, CA: Jossey-Bass, pp. 89–127.Google Scholar
  25. Daniels, J. (2012) Intervention: Reality TV, whiteness and narratives of addiction. In: J. Netherland (ed.) Critical Perspectives on Addiction. London: Emerald Publishers, pp. 103–125.CrossRefGoogle Scholar
  26. Daniels, J. (2013) Whiteness and Health in Transnational Context: Toward a New Research Agenda. Paper for the American Sociological Association Annual Meeting. New York.Google Scholar
  27. Davis, M., Varga, D., Dickerson, D., Walsh, D., Le Grand, S.B. and Lagman, R. (2003) Normal-release and controlled-release oxycodone: Pharmacokinetics, pharmacodynamics, and controversy. Support Care Cancer 11(2): 84–92.Google Scholar
  28. Davis, D. (2007) Narrating the mute: Racializing and racism in a neoliberal moment. Souls: A Critical Journal of Black Politics, Culture & Society 9(4): 346–360.CrossRefGoogle Scholar
  29. DEA (undated) National Take Back Initiative,, accessed 18 February 2013.
  30. Dole, V.P. and Nyswander, M. (1966) Study of methadone as an adjunct in rehabilitation of heroin addicts. Illinois Medical Journal 130(4): 487–489.Google Scholar
  31. Dumit, J. (2004) Picturing Personhood: Brain Scans and Biomedical Identity. Princeton, NJ: Princeton University Press.Google Scholar
  32. Dyer, R. (1988) White. Screen 29(4): 44–65.CrossRefGoogle Scholar
  33. Eban, K. (2011) OxyContin: Purdue Pharma’s painful medicine. CNN Money, 9 November,
  34. Emmanuelli, J. and Desenclos, J.C. (2005) Harm reduction interventions, behaviours and associated health outcomes in France, 1996 –2003. Addiction 100(11): 1690–1700.CrossRefGoogle Scholar
  35. Epstein, S. (2007) Inclusion: The Politics of Difference in Medical Research. Chicago, IL: University of Chicago Press.CrossRefGoogle Scholar
  36. Feagin, J.R. (2010) The White Racial Frame: Centuries of Framing and Counter-Framing. New York: Routledge.Google Scholar
  37. Feagin, J.R. (2012) White Party, White Government: Race, Class, and U.S. Politics. New York: Routledge.Google Scholar
  38. Fine, M., Weis, L., Pruitt, L.P. and Burns, A. (1996) Off White: Readings on Race, Power and Society. New York: Routledge.Google Scholar
  39. Fletcher, P. (2011) Arrests mark U.S. prescription drug abuse crackdown. Reuters 28 October,
  40. Frankenberg, R. (1993) White Women, Race Matters: The Social Construction of Whiteness. Minneapolis, MN: University of Minnesota Press.Google Scholar
  41. Fullwiley, D. (2007) The molecularization of race: Institutionalizing human difference in pharmacogenetics practice. Science as Culture 16(1): 1–24.CrossRefGoogle Scholar
  42. Goode, E. (2013) Incarceration rates for blacks dropped, report shows. New York Times, 27 February,
  43. Haffajee, R., Jena, A. and Weiner, S. (2015) Mandatory use of prescription drug monitoring programs. JAMA 313(9): 891–892.CrossRefGoogle Scholar
  44. Hamid, A. et al (1997) The heroin epidemic in New York city: Current status and prognoses. Journal Psychoactive Drugs 29(4): 375–391.CrossRefGoogle Scholar
  45. Hansen, H.B. and Roberts, R.K. (2012) Two tiers of biomedicalization: Methadone, Buprenorphine, and the racial politics of addiction treatment. Advances in Medical Sociology 14: 79–102.CrossRefGoogle Scholar
  46. Hansen, H., Siegel, C., Bertollo, D., Case, B., DiRocco, D. and Galanter, M. (2013) Variation in use of buprenorphine and methadone treatment by racial, ethnic and income characteristics of residential social areas in New York city. Journal of Behavioral Health Services and Research 40(3): 367–377.CrossRefGoogle Scholar
  47. Hart, C. (2013) High Price – A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. New York: Harper Collins.Google Scholar
  48. Hausmann, L.R., Gao, S., Lee, E.S. and Kwoh, C.K. (2013) Racial disparities in the monitoring of patients on chronic opioid therapy. Pain 154(1): 46–52.CrossRefGoogle Scholar
  49. Herzberg, D. (2013) But the wife must have these to live a decent life: Sedatives, stimulants, and the other drug war of the 1970s. Paper Presented at Challenging Punishment; 3 October, Rutgers University, New Jersey.Google Scholar
  50. Hughey, M. (2010) The (Dis)similarities of white racial identities: The conceptual framework of ‘hegemonic whiteness’. Ethnic and Racial Studies 33(8): 1289–1309.CrossRefGoogle Scholar
  51. Jones, C.P. et al (2008) Using “socially assigned race” to probe white advantages in health status. Ethnicity & Disease 18(4): 496–504.Google Scholar
  52. Joyce, K. (2005) Appealing images. Social Studies of Science 35(3): 437–462.CrossRefGoogle Scholar
  53. Katz Rothman, B. (2001) The Book of Life. Boston, MA: Beacon Press.Google Scholar
  54. Lassiter, M. (2015) Impossible criminals: The suburban imperatives of America’s war on drugs. The Journal of American History 102(1): 126–140.CrossRefGoogle Scholar
  55. Leonardo, Z. (2009) Race, Whiteness and Education. New York: Routledge.Google Scholar
  56. Leshner, A. (1997) Addiction is a brain disease, and it matters. Science 278(5335): 47–49.CrossRefGoogle Scholar
  57. Linnemann, T. and Wall, T. (2013) ‘This is your face on meth’: The punitive spectacle of ‘white trash’ in the rural war on drugs. Theoretical Criminology 17(3): 315–334.Google Scholar
  58. Lipsitz, G. (2006 [1998]) The Possessive Investment in Whiteness. Revised Edition Philadelphia, PA: Temple University Press.Google Scholar
  59. Lopez, I.H. (2006) White By Law: The Legal Construction of Race. New York: NYU Press.Google Scholar
  60. Lovell, A. (2006) Addiction markets: The case of high dose buprenorphine in France. In: A. Petryna, A. Lakoff and A. Kleinman (eds.) Global Pharmaceuticals: Ethics, Markets and Practices. Durham, NC: Duke University Press.Google Scholar
  61. Low, S.M. (2009) Maintaining whiteness: The fear of others and niceness. Transforming Anthropology 17(2): 79–92.CrossRefGoogle Scholar
  62. Manchikanti, L. (2007) National drug control policy and prescription drug abuse: Facts and fallacies. Pain Physician 10(3): 399–424.Google Scholar
  63. McLellan, A.T., Lewis, D.C., O’Brien, C.P. and Kleber, H.D. (2000) Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA 284(13): 1689–1695.CrossRefGoogle Scholar
  64. Murakawa (2011) Toothless: The methamphetamine “epidemic,” “meth mouth,” and the racial construction of drug scares. Du Bois Review 8(1): 219–228.CrossRefGoogle Scholar
  65. Musto, D. (1999) The American Disease: Origins of Narcotic Control. New York: Oxford University Press.Google Scholar
  66. (2014) Mike’s Story. The National Alliance of Advocates for Buprenorphine Treatment., accessed 15 December 2015.
  67. Office of National Drug Control Policy (ONDCP) (2011) Minorities & drugs: Facts & figures. Office of National Drug Control Policy,, accessed 15 December 2015.
  68. Office of National Drug Control Policy (ONDCP) (2013) Fact Sheet: Prescription Drug Monitoring Programs. April 2011,, accessed 13 February 2013.
  69. Pollock, A. (2012) Medicating Race: Heart Disease and Durable Preoccupations with Difference. Durham, NC: Duke University Press.CrossRefGoogle Scholar
  70. Rich, J., Wakeman, S. and Richman, S. (2011) Medicine and the epidemic of incarceration in the U.S. New England Journal of Medicine 364(22): 2081–2083.CrossRefGoogle Scholar
  71. Roberts, D. (2011) Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-First Century. New York: New Press.Google Scholar
  72. Roediger, D. (2007) The Wages of Whiteness. 2nd edn. London: Verso.Google Scholar
  73. SAMHSA (2010) Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings Rockville, MD: Office of Applied Studies.Google Scholar
  74. SAMHSA (2015) Buprenorphine. Substance Abuse and Mental Health Services Administration,, accessed 15 December 2015.
  75. Santos, A. (2012) Trafficking and abuse trends for prescription drugsPresentation by Alan G. Santos, Associate Deputy and Assistant Administrator, DEA Office of Diversion Control, at the Pharmacy Diversion Awareness Conference; 2–3 June, Atlanta, GA.Google Scholar
  76. Schwartz, Y. (2012) Painkiller use breeds new face of heroin addiction. NBC News 19 June,
  77. Scotti, R. and Kronenberg, S. (2001) Symposium: U.S. drug laws: The new jim crow?: Foreword. Temple Political & Civil Rights Law Review 10: 303–310.Google Scholar
  78. Secure and Responsible Drug Disposal Act (2010) One Hundred Eleventh Congress of the United States of America.Google Scholar
  79. Seppala, M. (2010) Prescription Pain Killers: History, Pharmacology and Treatment. Center City, MN: Hazelden Publishing & Educational Services.Google Scholar
  80. Silverman, E. (2012) Reckitt’s Suboxone Strategy Is Really About Patients Or Profits? Forbes Magazine,, accessed 15 December 2015.
  81. Silverman, A. and Voas, J. (1994) Opiate for the Mrs. Pheonix. New Times News, 8 September.Google Scholar
  82. Singer, M. (2008) Drugging the Poor: Legal and Illegal Drug Industries and the Structuring of Social Inequality. Long Grove, IL: Waveland Press.Google Scholar
  83. Solinger, R. (2013) Wake Up Little Susie: Single Pregnancy and Race Before Roe v. Wade (Kindle Locations 5990–5991). Kindle Edition Taylor & Francis.Google Scholar
  84. Stanton, A., McLeod, C., Luckey, B., Kissin, W. and Sonnefeld, L.J. (2006) Expanding treatment of opioid dependence: Initial physician and patient experiences with the adoption of buprenorphine,, accessed 10 March 2010.
  85. Steiner, B.D. and Argothy, V. (2001) White addiction: Racial inequality, racial ideology, and the war on drugs. Temple Political & Civil Rights Law Review 10: 443–475.Google Scholar
  86. Tiger, R. (2012) Judging Addicts: Drug Courts and Coercion in the Criminal Justice System. New York: NYU Press.CrossRefGoogle Scholar
  87. Tough, P. (2001) The alchemy of OxyContin. New York Times, 29 July,
  88. Toombs, J.D. and Kral, L.A. (2005) Methadone treatment for pain states. Am Fam Physician 71(7): 1353–1358.Google Scholar
  89. Twine, F.W. and Gallagher, C. (2008) Introduction: The future of whiteness: A map of the “third wave”. Ethnic and Racial Studies 31(1): 4–24.CrossRefGoogle Scholar
  90. Ung, E. (2001a) For those who need painkiller, stigma hurts: A drug’s stigma hurts those in need. The Philadelphia Inquirer, 4 September, p. A01.Google Scholar
  91. Ung, E. (2001b) In neighborhoods, mourning the lives lost to a legal drug. The Philadelphia Inquirer, 31 July, p. A01.Google Scholar
  92. U.S. Census Bureau (2009) Law enforcement, courts, & prisons: Arrests,, accessed 18 February 2013.
  93. Van Zee, A. (2009) The promotion and marketing of OxyContin: Commercial triumph, public health tragedy. American Journal of Public Health 99(2): 221–227.CrossRefGoogle Scholar
  94. Volkow, N. and Li, T.K. (2005) The neuroscience of addiction. Nature Neuroscience 8(11): 1429–1430.CrossRefGoogle Scholar
  95. Volkow, N. (2014) America’s addiction to opioids: Heroin and prescription drug abuse. Testimony to Congress presented on 14 May,
  96. Vrecko, S. (2010) Birth of a brain disease: Science, the state and addiction neuropolitics. History of the Human Sciences 23(4): 52–67.CrossRefGoogle Scholar
  97. Wacquant, L. (2009) Punishing the Poor: The Neoliberal Government of Social Insecurity. Durham, NC: Duke University Press.CrossRefGoogle Scholar
  98. White, W. (1998) Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems/Lighthouse Institute.Google Scholar
  99. Wray, M. (2006) Not Quite White: White Trash and the Boundaries of Whiteness. Durham, NC: Duke University Press.CrossRefGoogle Scholar
  100. Zuberi, T. and Bonilla-Silva, E. (eds.) (2008) White Logic, White Methods: Racism and Methodology. Lanham, MD: Rowman & Littlefield.Google Scholar

Copyright information

© Macmillan Publishers Ltd 2016

Authors and Affiliations

  1. 1.Drug Policy AllianceNew YorkUSA
  2. 2.Departments of Anthropology and Psychiatry, New York UniversityNew YorkUSA
  3. 3.Nathan Kline Institute for Psychiatric ResearchOrangeburgUSA

Personalised recommendations