2022 Articles

A cultural and political difference: comparing the racial and social framing of population crack cocaine use between the United States and France

Goulian, Andrew; Jauffret-Roustide, Marie; Dambélé, Sayon; Singh, Rajvir; Fullilove, Robert E.

Crack cocaine refers to a derivative of powder cocaine. Nonetheless, the usage of the term “crack cocaine” is loaded with unfortunate connotations of stigma and discrimination. When comparing the framing of crack cocaine use between the United States (U.S.) and France, the respective cultural and sociopolitical settings need to be accounted for.
In the U.S., crack cocaine refers to a smokable variety of cocaine which is considered to be more affordable and accessible than powder cocaine [1]. In the 1980s and 90 s, the U.S. response to crack cocaine was driven by media depictions of an urban, public health crisis primarily affecting black communities in American cities. This media depiction drove U.S. drug policy and shaped both political debate and public attitude towards crack cocaine [1, 2]. The subsequent influx of drug education messages, public service announcements, and curriculums that were created in response to crack cocaine were pervaded by the public and political fear that crack cocaine was destroying a generation of young Americans [3]. The U.S. government response at this time focused on managing the perceived crack cocaine epidemic by criminalizing rather than providing treatment facilities or healthcare services for people who use crack cocaine. In fact, the 1988 National Household Survey on Drug Abuse showed that the sharpest rise in cocaine and crack cocaine use since the inception of the survey in the early 1970s, rapidly outpaced the availability of treatment programs and efforts to expand treatment facilities in metropolitan areas such as New York City [4].
The French approach to crack cocaine shares commonalities and differences with the U.S. In France, crack cocaine is mostly smoked but more recently is also being injected intravenously and the spike of increased crack cocaine use in France did not occur until the 2000s [5, 6]. French political and media attention towards crack cocaine has also recently increased due to the presence of visible, open drug use in Paris framing the topic as a public order, health, and social problem. This attention stems from crack cocaine in France having increasing associations with socially and economically vulnerable populations when compared to powder cocaine use patterns [6]. Unlike the U.S., the aggregation of racial data is prohibited in France. And as a result, the French understanding of the current rise in crack cocaine use does not clearly analyze the issue along racial lines but rather considers low socioeconomic populations to be drivers of the recent increase in crack cocaine use [5]. Since the late 1970s, in addition to a repressive drug policy approach, France has implemented a strong, publicly funded drug treatment system with harm reduction services to better address the health needs of people who use drugs [7]. Accordingly, France is systematically more equipped to serve the healthcare needs of people who problematically use crack cocaine compared to the U.S. [5, 6].