A version of this post was originally published on March 12, 2012
The mythology of the crack cocaine epidemic misdirects the devastation of persistent social inequities to cautionary tales of crack houses, crack heads and crack babies. Yet the emergence of myth is a predictable response within a society that too often places the blame on those victimized by social marginalization. While there is no doubt that crack cocaine use has devastating effects on individuals, families and communities, the extent to which we attribute the conditions of poor and minority inner city communities to drug use is just too much.
Myth 1: Crack dens, houses
The vacant buildings that became spaces for unrestricted drug activity should be symbolic of poor public policy. The peak years of the epidemic (1985 and 1993) were preceded by a number of forces (i.e., redlining, post industrialism, white flight, planned shrinkage) that led to the decay of inner-city neighborhoods throughout the country. For example, the construction of the Cross Bronx Expressway from the late 1940’s to the early 1970’s destroyed neighborhoods throughout the South Bronx – an epicenter of the crack epidemic. Compounded by planned shrinkage – the withdrawal of city services (i.e., fire, police garbage collection) to blighted neighborhoods as a means of coping with dwindling tax revenues – these and other public policies led to the flight of the middle class, business closures, and numerous abandoned/burnt-out buildings some of which became the notorious “crack dens,” “crack houses” and “shooting galleries.”
Myth 2: Crack heads
Crack cocaine users are often thought to be black and Hispanic. But crack use is not limited to racial minority groups. While the percentage of racial minorities who use crack cocaine is greater than whites, the absolute number of whites who use crack is greater than the absolute number of racial minorities who use crack. According to the National Household Survey on Drug Abuse (NHSDA), in 1993 – one of the peak years of the epidemic – 0.3% of whites, 1.6% of blacks and 0.6% of Hispanics used crack cocaine. This translates into nearly half a million whites (573,531), less than half a million blacks (368, 032) and 111, 006 Hispanics who used crack that year. Moreover, where one lives has more to do with crack cocaine use than race. When residence in large metropolitan areas is taken into account there are no racial differences in crack cocaine use.
Myth 3: Crack is more addictive than powder
The idea for this blog post came from a discussion I had with a friend who said that “crack cocaine is 12 times more addictive than powder cocaine.” This myth and the final myths are important to dispel because they serve as justification for the disparity in the crack vs. powder cocaine Federal Sentencing Guidelines. To trigger the five-year mandatory minimum prison sentence, you have to be caught with 18 times more powder than crack cocaine. Prior to 2010, you had to be caught with 100 times more powder than crack cocaine (the imperative word is “caught” because racial minority neighborhoods are policed far more than white neighborhoods).
There are no differences in how crack and powder cocaine are metabolized in the body. Because crack cocaine is administered by smoking and powder cocaine by sniffing (e.g., intranasal), popular thinking is that crack is more likely to lead to abuse. Smoking increases the immediacy and intensity of the effect of cocaine. Thus, it is the desire to regain the high that leads to more frequent use. However, there is little population based evidence to show that crack cocaine users are more likely than powder cocaine users to become dependent. For example, analysis of recent data from NHSDA showed that 5.9% of individuals who have ever tried powder cocaine were current users. The percentage of those who ever tried crack cocaine who were current users was the same.
Myth 4: Crack cocaine use causes violence
The level of violence in a number of large metropolitan cities rose 25 percent during the peak years of the crack cocaine epidemic. But practically all of the violence stemmed from running an illegal enterprise and virtually none from crack cocaine use itself. By 2000, violence plummeted and has stayed down since. Moreover, a recent study found that after taking into account social factors (i.e., sex, race, gender, urbanicity), psychiatric disorders and the use of drugs other than cocaine, there are no differences in violence among crack and powder cocaine users.
Myth 5: Crack babies
The effects of crack exposure during pregnancy are the most incessant myths of the epidemic. The effects of prenatal crack exposure on a child’s brain development and behavior appears relatively small and if it occurs, it endures for only the first few years of life. Moreover, poverty overwhelmingly determines a child’s development. When the social conditions of crack exposed children (like living in poverty) are taken into account there are no differences in development with their non-exposed peers. Put into perspective with other drugs, prenatal exposure to crack cocaine is less severe than exposure to alcohol and is comparable to tobacco – and there are a lot more fetuses exposed to alcohol than crack cocaine but far less panic and hysteria.
There are a number of organizations that are actively working to change current drug policies in the United States. The Drug Policy Alliance takes a multifaceted approach, reforming marijuana laws, fighting the injustice associated with the drug war, reducing the harm of drug use, creating reality-based youth education programs, defending personal liberty and working to create policy that is economically smart. The Sentencing Project actively works to reform federal mandatory penalties for crack and powder cocaine offenses to make them more equitable and fair. Be sure to call your representatives and let them know how you feel about U.S. drug policies.
Of course, addiction to crack cocaine and other drugs have a very real effect on our communities. If you or someone you know are suffering from addiction, there are a number of treatment centers that can help.
by Azure B. Thompson, DrPH, MPH
Azure is a sociomedical scientist with more than a decade of experience in drug use research.