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: How Racial Capitalism Changed the Color of Opioids in America (U California Press, 2023) 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.

Claire Clark is a medical educator, historian of medicine, and associate professor in the University of Kentucky’s College of Medicine.

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