Suburban and rural drug abuse not reported locally


While middle-class suburbanites feel smug over their low homicide rates compared to urban areas, the drug-related deaths and devastated lives on their own streets are hidden behind closed doors.

In December 2001, researchers at Brandeis University published a study examining the distribution of illicit drug abuse across class boundaries.

"The Visibility of Illicit Drugs: Implications for Community-Based Drug Control Strategies," published in the American Journal of Public Health, examined more than 2100 neighborhoods, collecting data from more than 42,000 respondents.

The results indicated that while "the most disadvantaged neighborhoods have the most visible drug problems," drug use "is nearly equally distributed across all communities." The authors argued, "Thus, efforts to address drug-related problems in poorer areas need to take into account the broader drug market served by these neighborhoods."

The relative invisibility of illicit drug abuse among the middle class has made it a silent but deadly killer. While news media focus on violent deaths on our urban streets, they ignore the rising death toll among middle class drug abusers.

That death toll doesn't show up on the police blotter: they are recorded by emergency room staff as drug overdoses. Unlike crime records, which are public information, the deaths and near-deaths by drug overdose are protected by doctor-patient confidentiality.

No one would argue that releasing the identities of these casualties of the drug trade is appropriate. However, failing to attend to these numbers in aggregate while simultaneously focusing exclusively on violent crime in our urban centers does no one any favors.

New York Times Op-Ed contributor Mike Males, a senior researcher at the Center on Juvenile and Criminal Justice, took note of skyrocketing deaths from drug overdoses among the middle class in an essay published earlier this year (Jan. 3, 2007). He wrote:

"According to the Centers for Disease Control and Prevention, the number of Americans dying from the abuse of illegal drugs has leaped by 400 percent in the last two decades, reaching a record 28,000 in 2004. The F.B.I. reported that drug arrests reached an all-time high of 1.8 million in 2005. The Drug Abuse Warning Network, a federal agency that compiles statistics on hospital emergency cases caused by illicit drug abuse, says that number rose to 940,000 in 2004 - a huge increase over the last quarter century."

Few, however, are aware of this devastating trend, primarily because the casualties are "simply the 'wrong' group," Males says.

He continues, "As David Musto, a psychiatry professor at Yale and historian of drug abuse, points out, wars on drugs have traditionally depended on "linkage between a drug and a feared or rejected group within society." Today, however, the fastest-growing population of drug abusers is white, middle-aged Americans. This is a powerful mainstream constituency, and unlike with teenagers or urban minorities, it is hard for the government or the news media to present these drug users as a grave threat to the nation."

The homicide rate nationwide (as well as in New York and Rochester) has declined substantially during the same time period. The national high of 10.2 homicides per 100,000 was recorded in 1980. In 2006, that had fallen to 5.7, a reduction of nearly half. New York's high of 12.7 also occurred in 1980. In 2006 that had fallen to 4.8, a decline of almost TWO-THIRDS.

During that time we have seen a 400 percent increase in drug-related deaths nationwide. The fastest growing group of drug-related deaths are not youth, but middle-aged adults.

Males continues: " Among Americans in their 40s and 50s, deaths from illicit-drug overdoses have risen by 800 percent since 1980, including 300 percent in the last decade. In 2004, American hospital emergency rooms treated 400,000 patients between the ages 35 and 64 for abusing heroin, cocaine, methamphetamine, marijuana, hallucinogens and 'club drugs' like ecstasy."

Nor are rural areas immune to the scourge of drug addiction. In fact, rural areas have nearly the same rates of drug abuse and addiction as urban areas. The absolute numbers are lower, but that's because there are fewer people living in rural areas (that's what makes them rural!). See, for example, this study of substance abuse in rural and small town America conducted by Karen van Gundy of the University of New Hampshire. Van Gundy found that differences between rural and urban drug use were statistically non-significant.

See one of her tables below:




While middle-class suburbanites feel smug over their low homicide rates compared to urban areas, the drug-related deaths and devastated lives on their own streets are hidden behind closed doors.

Those names and pictures will never be splashed across the pages of our newspapers nor paraded before television cameras. No one will be interviewing the spouses and children and brothers and sisters and friends. They will not be subjected to public ridicule over bad personal choices. No one will be cursing them for the burden those choices have placed on our health care system, for which everyone pays either through insurance rates or through taxes.

Has the Rochester area escaped this trend? Possibly. But not likely. There is no way the drug trade in Rochester could be profitable relying solely on traffic among the urban poor.

The only way we will know for certain is if people -- particularly our media -- start asking the right questions of the right sources.




Posted: Thu - April 10, 2008 at 03:17 PM          

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