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A Matter Of Machismo: ‘It’s Not Cool To Call 911’
Lopez has close ties these days with health care providers, the police and EMT rescue squads. But that has changed dramatically from when he was using heroin. On the streets, he said, “it’s not cool to be calling 911” when a person sees someone overdose. “I could get shot, and I won’t call 911.”
It’s a machismo thing, said Lopez.
“To the men in the house, the word ‘help’ sounds, like, degrading, you know?” he said. Calling 911 “is like you’re getting exiled from your community.”
Santiago said not everyone feels that way. A few men called EMTs to help revive him. “I wouldn’t be here today if it wasn’t for them,” he said.
But Santiago and others say there’s growing fear among Latinos they know of asking anyone perceived as a government agent for help — especially if the person who needs the help is not a U.S. citizen.
“They fear if they get involved they’re going to get deported,” said Felito Diaz, 41.
Bermudez said Latina women have their own reasons to worry about calling 911 if a boyfriend or husband has stopped breathing.
“If they are in a relationship and trying to protect someone, they might hesitate as well,” said Bermudez, if the man would face arrest and possible jail time.
A Tight Social Network
Another reason some Latino drug users said they’ve been hit especially hard by this epidemic: A 2017 DEA report on drug trafficking noted that Mexican cartels control much of the illegal drug distribution in the United States, selling the drugs through a network of local gangs and small-scale dealers.
In the Northeast, Dominican drug dealers tend to predominate.
“The Latinos are the ones bringing in the drugs here,” said Rafael, a man who uses heroin and lives on the street in Boston, close to Casa Esperanza. “The Latinos are getting their hands in it, and they’re liking it.”
Kaiser Health News and NPR agreed not to use Rafael’s last name because he uses illegal drugs.
A resident walks into the Casa Esperanza’s men’s program in Roxbury. (Jesse Costa/WBUR)
Some Spanish-speaking drug users in the Boston area said they get discounts on the first, most potent cut. Social connection matters, they said.
“Of course, I would feel more comfortable selling to a Latino if I was a drug dealer than a Caucasian or any other, because I know how to relate and get that money off them,” said Lopez.
The social networks of drug use create another layer of challenges for some Latinos, said Dr. Chinazo Cunningham, who treats many patients from Puerto Rico. She primarily works at a clinic affiliated with the Montefiore Medical Center in the Bronx, in New York City.
“The family is such an important unit — it’s difficult, if there is substance use within the family, for people to stop using opioids,” Cunningham said.
The Burden Of Poverty
Though Latinos are hardly a uniform community, many face an additional risk factor for addiction: poverty. About 20 percent of the community live in poverty, compared with 9 percent of whites, according to the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)
In Massachusetts, four times as many Latinos live below the poverty line as do whites. The majority of Casa Esperanza clients were recently homeless. The wait time for one of the agency’s 37 individual or family housing units ranges from a year to a decade.
“If you’ve done all the work of getting somebody stabilized and then they leave and don’t have a stable place to go, you’re right back where you started,” said Casa Esperanza’s Stewart.
Cunningham said the Latino community has been dealing with opioid addiction for decades and it is one reason for the group’s relatively high incarceration rate. In Massachusetts, Latinos are sentenced to prison at nearly five times the rate of whites.
“It’s great that we’re now talking about it because the opioid epidemic is affecting other populations,” Cunningham said. “It’s a little bit bittersweet that this hasn’t been addressed years before. But it’s good that we’re talking about treatment rather than incarceration, and that this is a medical illness rather than a moral shortcoming.”
Nationally, says the CDC’s Anderson, there’s no sign that the surge of overdose deaths is abating in any population.
“We’ve already had two years of declining life expectancy in the U.S., and I think that when we see the 2017 data we’ll see a third year,” said Anderson. “That hasn’t happened since the great influenza pandemic in the early 1900s.”
The fatality counts for 2017 are expected out by the end of this year.
This story is part of a partnership that includes WBUR, NPR and Kaiser Health News.