The issue of substance use disorder (SUD) in Black communities is full of contradictions. On one hand, substance use among African Americans is no worse than the general population (roughly equal, in fact), and those who need treatment are actually more likely to get it than their non-Black peers.
But in contrast, African Americans are much more likely to discontinue treatment early, which decreases the likelihood of long-term recovery. And despite comprising just 12.5% of illicit drug users, fully one-third of those incarcerated for drugs are Black, demonstrating a clear disparity in society’s methods for dealing with substance use between Black and non-Black people.
That’s why treating addiction in Black communities isn’t just about solving a drug problem. It’s about changing the community dynamics, resolving inequities in how we address it, and breaking the generational cycle of addiction and the trauma that fuels it.
To have any chance at success, we must first overcome a history of mistrust within the Black community, instilled by previous healthcare atrocities, a legacy of broken promises and inconsistency in service. Solving the problem requires changing attitudes toward treatment and the future for Black communities.
As providers, we must be active, engaged and involved in the community. Here are seven boots-on-the-ground strategies I’ve put to work in my own community to create real, measurable change:
1. Be present.
I’ve made it my mission to be engaged with clients beyond our therapy sessions. I’m active in the community and they see me as an ally. On Sundays, I pick up bananas in bulk and deliver them to their homes, which gives me a chance to see the real family dynamics at work. I started attending one of my client’s sports games to cheer him on and provide support outside of our sessions. This had an amazing trickle-down effect — after about a year, his mother came to me crying at one of his games. She told me that she had just celebrated one year of being clean, after being inspired by my interest and commitment to her son’s success. That was a tremendously proud moment for me, and it proved the ripple effect is possible by making an impact on just one life.
2. Be consistent.
For a variety of reasons, the tenure of treatment providers tends to be short-lived in some communities. When therapists and counselors move jobs frequently, it perpetuates mistrust. Black families are especially reluctant to open up and divulge family secrets. When they do, and the individual moves on quickly, they feel burned, abandoned and are less likely to ask for help again. Providers must demonstrate consistency and commitment, and it starts with organizations hiring people with genuine compassion and care for their community. And we must set clear expectations, perhaps by asking therapists to make a two-year commitment to their role.
3. Involve partners.
Being involved in the community can’t happen in a vacuum. It requires engaging with partners to create a safer environment for our clients. One young man in my neighborhood has seen his brothers in and out of jail several times, using and selling drugs. In fact, he even saw this behavior every day on his walk to school. So, I went to the police for help, asking them to clear out the drug trade along that route. Now that pathway to the local school is clear, not exposing students to drugs.
4. Be representative.
Building trust is much easier when you know the culture, look like you belong and are reliable to your community. That’s why treatment providers must make a concerted effort to recruit and hire more people of color to work in ethnic communities. Having that commonality builds affinity and peace of mind and encourages clients to introduce you and vouch for you as a mentor among their peers.
5. Assess needs.
Don’t assume you know what’s going on in the community and what challenges they face. Addiction and mental health often exist in the shadows, especially in African American culture where there’s a lot of stigma and asking for help is considered a sign of weakness. Instead, gather empirical evidence of needs by conducting surveys within the neighborhood to ask people about their greatest concerns. This not only shows you actually care but also helps you figure out where to spend time and resources.
6. Leverage mentors.
Success stories are one of the best ways to demonstrate there’s a better alternative to drugs and encourage treatment. Through our alumni program, former clients in long-term recovery are encouraged to volunteer — it’s good for both them and the community. I recently stood alongside our alumni serving meals at the homeless shelter. They not only roll up their sleeves but are also there to provide encouragement, answer questions and serve as an example of what’s possible.
7. Provide education.
It’s essential that providers get involved with schools to not only teach kids about the risk of addiction but also work to break down the stigma and clear up taboos about treatment. Many kids in our neighborhood think dysfunctional living is normal, so we work hard to teach them that there is an alternative. In addition to school programs, we also host open houses at our treatment facilities and participate in other community events. The goal is to saturate the community with our presence so that any time there’s a problem, we’re top of mind.
It’s time we not only celebrate our accomplishments but also acknowledge the challenges impacting the Black community and hindering continued progress. As we remember the contributions of our peers and ancestors, let’s also work together to further elevate Black communities through real-time efforts to end the stigma and cycle of addiction.
Andy Ansola is a Group Facilitator at Recovery First Treatment Center, an American Addiction Centers facility.