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KAREN HACKER, MD, Director, Allegheny County Health Department


In the 1990s when crack cocaine use—and the attendant violence perpetrated by rival dealers—skyrocketed in Pittsburgh’s Black communities, the official government response was new laws, more police and longer jail sentences for possession of crack than powder.

Similarly, heroin use in the Black community was always a law enforcement problem. Now that opioid use has exploded throughout the nation’s White population, it is a public health problem.

Though that change in attitude was largely glossed over during the recent two-day “The Face of the person with an Addiction” symposium at Duquesne University (Oct. 26-27), sponsored by the School of Nursing, it was not unnoticed.

“I agree,” said Dr. Karen Hacker, director of the Allegheny County Health Department. “I was around during the crack epidemic, I did long-term studies on the children of addicted mothers—and no, it did not get the same health focus.

“That being said, there were nowhere near the numbers of deaths we are seeing now—there’s no denying this is an epidemic. And while the increase in addiction has been driven largely by White males, we are now, in the last two years, seeing an uptick in Black and Hispanic populations.”

Dr. Hacker opened the seminar with a presentation on the extent of the opioid epidemic in Allegheny County, with state and national data. Perhaps the most telling statistics she provided concerned overdose fatalities—they have tripled in Allegheny County over the last few years from an average of just over 200 to 650 in 2016, and statewide overdose fatalities now outpace automobile accidents as the number one cause of death.

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