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University of California Press

About the Book

The first critical analysis of how Whiteness drove the opioid crisis.
 
In the past two decades, media images of the surprisingly white “new face” of the US opioid crisis abounded. But why was the crisis so white? Some argued that skyrocketing overdoses were “deaths of despair” signaling deeper socioeconomic anguish in white communities. Whiteout makes the counterintuitive case that the opioid crisis was the product of white racial privilege as well as despair.
 
Anchored by interviews, data, and riveting firsthand narratives from three leading experts—an addiction psychiatrist, a policy advocate, and a drug historian—Whiteout reveals how a century of structural racism in drug policy, and in profit-oriented medical industries led to mass white overdose deaths. The authors implicate racially segregated health care systems, the racial assumptions of addiction scientists, and relaxed regulation of pharmaceutical marketing to white consumers. Whiteout is an unflinching account of how racial capitalism is toxic for all Americans.

About the Author

Helena Hansen is an addiction psychiatrist and anthropologist and Professor of Psychiatry and Anthropology at the University of California, Los Angeles.
 
Jules Netherland is a sociologist and policy advocate and Managing Director of the Department of Research and Academic Engagement at the Drug Policy Alliance.
 
David Herzberg is a historian and Professor of History at the State University of New York at Buffalo.

Table of Contents

Contents

List of Illustrations 
Acknowledgments 
Time Line 


PART ONE. TECHNOLOGIES OF WHITENESS IN THE CLINIC, THE STATEHOUSE, AND THE ARCHIVE

1. Pharmakon of Racial Poisons and Cures 
    (as told by Helena Hansen, psychiatrist-anthropologist)
2. How to See Whiteness 
    (as told by all three authors)
3. Good Samaritans in the War on Drugs That Wasn’t 
    (as told by Jules Netherland, policy analyst)
4. “Mother’s Little Helpers”: White Narcotics in the Medicine Cabinet 
    (as told by David Herzberg, historian)

PART TWO. THREE OPIODS: RACIAL BIOGRAPHIES 

5. OxyContin’s Racial Precision 
6. Buprenorphine’s Silent White Revolution 
7. The Housewife’s Return to Heroin (and Forays into
    Fentanyl) 
8. From Racial Capitalism to Biosocial Justice 

Glossary 
Notes 
Bibliography 
Index 

Reviews

"Psychiatrist and anthropologist Hansen, policy advocate and sociologist Netherland, and historian Herzberg richly scrutinise drug use and race along multiple axes that include medicine, public policy, and history to emerge with a powerful portrait of precisely how the social construct of race and systemic racism have both created and blinded us to the unequal treatment of Black and white drug users. Through anthropology, personal histories, and nuanced data analysis this troika engages in textured, deeply researched, scholarship."
Lancet

"Black people on drugs get police, prison, and methadone; white folks get therapy, sympathy, and buprenorphine. Meanwhile, the biggest dealers, pharmaceutical companies, get fines and wrist slaps, but continue to profit by creating addicts and then selling drugs promising a cure. Why? The answers are all here in Whiteout, by far the boldest, most important, most illuminating book ever written on the opioid epidemic. The authors trace the crisis to racial capitalism, the source of a world where white lives matter and Black, Brown, and Indigenous lives don’t; where white deaths are tragic and Black, Brown, and Indigenous deaths routine. They show that legalization is not enough. We must desegregate and decommodify drugs and treatment. And if we are to truly save lives, racial capitalism has to die."—Robin D. G. Kelley, author of Freedom Dreams: The Black Radical Imagination

"Whiteout brilliantly exposes how drug policy, biocapital, and addiction science have historically segregated narcotics by race, shielding white drug users from the stigma and policing targeted at Black and Brown communities. With diverse disciplinary expertise and personal stories, Hansen, Netherland, and Herzberg compellingly show that only by grappling with this medicalized whitewashing can we fully understand both the racist war on drugs and the opioid crisis—and collectively end their widespread devastation."—Dorothy Roberts, University of Pennsylvania, author of Killing the Black Body 

"Whiteout is the most clear-eyed and comprehensive study of America’s overdose crisis to date. The authors' electric scholarship reveals how Whiteness determines the boundaries of categories we often think of as being derived scientifically and rationally. When it comes to drugs, America seems to suffer from a peculiar sort of historical amnesia. Whiteout shows us what we forget, what we choose to remember, and what's kept hidden."⏤Zachary Siegel, writer and drug policy journalist for Harper’s Magazine, the New York Times Magazine, and the New Republic

"A fascinating, well-written, and important look at how racism shapes drug policy and what to do about it."⏤Maia Szalavitz, author of Undoing Drugs: How Harm Reduction Is Changing the Future of Drugs and Addiction and contributing Opinion writer for the New York Times

"Hansen, Netherland, and Herzberg's Whiteout is a dramatic and much-needed challenge to our outdated ways of understanding addiction. They bravely place our drug policies in the context of the devastating and universal apartheid within which we all suffer. This book will change you and change us!"—Mindy Thompson Fullilove, author of Main Street: How a City's Heart Connects Us All

"Whiteout compellingly recruits sociopolitical development and persistent etiological mythologies such as blaming the victim, biological dimorphism, and malingering to buttress the authors’ claim that systemic racial disdain fuels the heavily punitive measures deployed against African American opiate dependence, casting it as a moral failure. The authors' insights, leavened with cultural sensitivity, contrast this approach with the empathic medical model adopted for whites and help illuminate for us the ethical path forward."—Harriet A. Washington, author of Infectious Madness and Medical Apartheid

Awards

  • New Millenium Book Award 2023 2023, Society for Medical Anthropology
  • Rachel Carson Prize 2024 2024, Society for the Social Studies of Science