The Rev. Mike Starks witnessed the destruction of crack cocaine, but not from the sidelines — he was a self-described gangster and drug addict before he became a minister.
The Akron community activist recalls authorities responding to the epidemic, which is said to have lasted from 1984 to the early 1990s, with the all-out War on Drugs. Lawmakers enacted mandatory prison sentences for dealers. Stories in the media blamed addicts for their choices and told of gang-ravaged inner cities.
Starks was caught up in the middle of the war. Drugs ruled his life, and he spent several stints in prison in the 1980s and ’90s.
He said the public and politicians have reacted very differently to the ongoing opiate epidemic.
Today, news outlets tell of parents who’ve lost children to overdoses, addicts overcoming drug dependency and politicians pushing compassion for substance abusers. The talks have peppered campaign trails and even inspired President Barack Obama to label addiction a public health crisis rather than a moral failing.
So what changed?
Starks and local experts agree public opinion shifted because today’s epidemic of addiction to heroin and prescription drugs affects every facet of society — regardless of race, region or social class.
Starks, who’s been sober since 2002, said the public has become more compassionate because opiates have a longer reach than crack ever had.
“You can’t centralize addiction to the ghetto anymore,” he said. “It’s not an urban problem; it’s an America problem, even a world problem.”
Institutional racism
According to a 2006 study by Harvard University, poor black people were at the epicenter of crack-related crime and addiction. Homicide rates for young black men doubled, and spikes were recorded for the black population’s rates of fetal deaths and weapons arrests.
There’s little evidence of parallel spikes in the white population at the time, the report found. As a result, policies targeting drug dealers affected black populations much more than whites.
Liz Piatt, chair of Hiram College’s sociology department, said it was a case of institutional racism.
“I think the interesting thing about institutional racism is that when people think of racism, they think of individual acts. They say, ‘I’m not racist,’ ” she said. “In this case, it’s not people who are racist; it’s the system and policies that are experienced more by one subset of the population.”
With today’s epidemic, Piatt said whites are much more affected by opiate-related crime and addiction. Authorities have said repeatedly in recent years that opiate addiction does not discriminate.
Greater compassion is a natural result, Piatt said.
There’s so much empathy that prosecutors are viewing those who die of overdoses as crime victims, slapping people with charges of involuntary manslaughter for giving victims the drugs that killed them. Before, prosecutors focused on punishing dealers for trafficking illegal drugs and damaging society as a whole, rather than for causing individual deaths.
“We never saw that before,” Piatt said.
Empathy for addicts
Sally Longstreth, clinical director for Oriana House drug treatment centers, said the severity of heroin’s withdrawal symptoms and overdose risk compared to crack also plays a part.
She said crack addicts experience severe psychological cravings, but the sickness from withdrawal is less severe.
Withdrawal is much more severe for heroin addicts. Family and friends watching a loved one suffering might prompt a change of heart for some, Longstreth said.
Dr. Alan Shein, medical director for Summa Health System’s Addiction Medicine Services, said the sheer number of people dying from opiate overdoses might also be leading to more compassion.
Of the 213 people in Summit County who died in 2015 of drug overdoses, 153 overdosed on heroin or the more deadly fentanyl, the medical examiner’s office reported. In 2014, about 100 died of overdoses on all opiates, including heroin, fentanyl and prescription painkillers.
The county tracked all overdoses as one set of data in the 1980s and ’90s, so no specific comparisons could be drawn for the two epidemics locally. However, national numbers suggest total overdose rates rose exponentially since the crack epidemic, in part because of opiates’ lethality.
“We didn’t see nearly the deaths with crack that we see now with heroin,” Shein said.
Shein said the severity of heroin withdrawal is contributing to the deaths. Heroin addicts are overwhelmed with desire to use the drug — no matter the risk — so they can avoid excruciating withdrawal symptoms.
“Cocaine withdrawal was nothing like the heroin withdrawal,” said Shein, who’s been working in the field of recovery since 1987. “Today, it becomes the most important thing in a person’s life to avoid going through withdrawal.”
Crack addicts died from health complications brought on by their addictions, he said. With heroin, the drug itself is lethal.
‘Legitimate’ addiction
Robert Peralta, an associate professor of sociology at the University of Akron, said greater empathy might be happening because many of today’s opiate addicts got their start more “legitimately” by abusing prescription pills rather than experimenting with illegal drugs.
Doctors in the 1990s began prescribing greater amounts of opiates to treat pain, which officials say led to more people becoming addicts. Many pill addicts then turned to heroin because it’s more accessible and causes a similar high.
The shift to heroin was exacerbated by crackdowns on medical “pill mills” that over-prescribed painkillers. When it became harder for pill addicts to get their fix from doctors, many of them turned to heroin to ease their cravings.
“Maybe that’s part of the reason there was such negative social backlash with crack cocaine,” he said. “The addiction back then didn’t stem from a legitimate source.”
Peralta said he was astounded by how the media has altered its coverage of addiction in recent years.
“I’m struck,” he said. “To see compassion in the media and people talking about treatment, intervention and prevention is really important.”
Everyone vs. opiates
Like Hiram’s Piatt, Peralta stressed that race plays an important part in discussing the shift in compassion.
“White people are seeing people like themselves using these drugs,” he said, “and that hits closer to home for many of them.”
But for Ophelia Averitt, former president of the Akron branch of the NAACP, there’s more to the issue than race.
“Crack didn’t start with colors of any kind. It was more of a location issue,” she said. “This epidemic we have now — nothing can match it.”
She said it’s hard for people to empathize with victims if they don’t know someone affected.
“When things come into our neighborhoods,” she said, “we start to pay attention.”
Averitt said it was to be expected that more would pay attention as the opiate epidemic swept the nation.
“This is affecting everyone,” she said. “We all need to be part of the efforts to stop heroin.”
The Rev. Starks, the former addict who now ministers to those at risk of leading lives of crime, agreed.
“We’re all part of the human race. We’re all God’s children,” he said. “Until we get that, we’re headed to one heck of a tailspin.”
Nick Glunt can be reached at 330-996-3565 or nglunt@thebeaconjournal.com. Follow him on Twitter @NickGluntABJ.