There are barriers to treatment when it comes to substance use and marginalized communities, and high rates of incarceration adds to the issue.
Misconceptions around high rates of substance use within the Black community — particularly illegal substances such as cocaine, heroin, or methamphetamine (meth) — continue to prevail.
There’s an ongoing epidemic when it comes to substance use and overdoses, but a majority of opioid-related deaths occur amongst white people, according to research done by KFF (previously Kaiser Family Foundation.)
It’s true that there may be stigma and barriers specific to the Black community when it comes to mental health — such as the distrust of the health system due to medical racism.
But Black people aren’t any more likely to live with substance use disorder than any other demographic. Adding to these barriers are the disproportionate rates of incarceration among Black people.
There are ways to address this issue, starting with providing access to mental health services in historically marginalized communities. Policy changes and community initiatives that involve increasing awareness and providing support programs in underserved communities are also key to making change.
Non-violent, drug-related charges make up a majority of the offenses for people who are presently incarcerated.
A recent report by the Sentencing Project estimates that Black people are incarcerated in state prisons at five times the rate of white people for the same crimes.
The report found that the greatest disparity was among drug-related offenses.
It stated that while Black and white people use and sell drugs at the same rate, Black people are four times more likely to be arrested for drug offenses and almost three times more likely to be arrested for drug possession.
These rates don’t only apply to men, either. The Prison Policy Initiative estimates that drug-related arrests have increased for women by nearly 216% since the early 1990s.
While Black women are incarcerated at higher rates than white women, this number has seen a decline over the past 20 years.
These rates have often been used to continue the cycle of racial profiling and over-policing of Black neighborhoods, but these practices could also be the cause of these disparities.
Mass incarceration denotes the exponential increase in arrests and imprisonments of people within the United States.
This uptick has a stark disparity when it comes to Black people, with the Black demographic making up about 14% of the U.S. population, but nearly 40% of the prison population.
Because mass incarceration has been an issue since the 1980s, creating solutions may feel daunting, but it’s possible to move the needle in a positive direction.
While we can’t completely prevent all incarceration or substance use in one swift motion, some community-led initiatives aim to provide support and increase safety regardless of the state a person is in with their substance use.
Restorative justice practices
One way to lessen arrests is to shift to practices in communities that allow for disputes to be handled without law enforcement. This can look different depending on your community and its needs.
Some grassroots and advocacy-based organizations push for restorative justice practices that include a push for tough conversations amongst peers and handling conflict within the involved community.
For example, some models of this practice look like safety planning and people physically showing up when someone is in danger, rather than calling the police.
This provides the ideal outcome because the person in danger is kept safe while also keeping other people within the community out of prison.
Some areas use harm reduction practices in an effort to keep community members safe.
Because these organizations and collectives recognize that people use substances for several reasons, they aim to make using these substances safer to prevent further harm until the person is able to abstain or reduce use on their own time.
This can look like communication about issues such as bad batches of substances or programs like needle exchanges.
In addition to providing resources for people who are aiming to quit or lessen how much they use, this creates an opportunity for people who are navigating their substance use to do so with less risk.
Other routes of action are focused on policy and law reform.
State-by-state, some of these policies are changing, and we’re seeing cities and states have conversations about police protocol, training, and the need to incorporate mental health professionals in their processes rather than resorting to force.
But because they’re called law enforcement, many advocacy and nonprofit organizations are zeroing in on the policies themselves.
Some of these laws and police protocols have been used as a way to unfairly profile Black people, such as New York’s stop-and-frisk policy, which has since been found unconstitutional.
Others may not have had racial intent, but have done the most disservice to Black families, such as the enforcement of no-knock warrants — the action that led to the death of Breonna Taylor in 2020.
A major shift could include altering the laws surrounding the substances themselves. Throughout the country, cannabis is being decriminalized and legalized.
But many of the areas removing the laws surrounding these substances still arrest numbers of Black people on these charges, according to the American Civil Liberties Union (ACLU).
Other substances, such as heroin, still carry heavy charges for obtaining or using. Instead of a person who’s using substances automatically being judged and punished, an option to mitigate substance use could be to address the use at its root.
People use substances for varying reasons, and often it’s to meet a need that otherwise goes unaddressed.
In a report on the opioid crisis and the Black population, the Substance Abuse and Mental Health Services Administration (SAMHSA) states: “…opioids are a way of coping in the absence of healing when a community has been traumatized by decades of violence, poverty, and neglect.”
Providing access to mental health services and support in underrepresented communities could help meet this need and improve outcomes.
There are traditional methods of treating substance use such as rehabilitation, medication, and therapy. But these options aren’t always accessible in the Black community or affordable.
There has been ongoing criticism of 12-step programs such as Alcoholics or Narcotics Anonymous due to the overtly religious nature and the framing that addiction is a moral issue.
Psychotherapy, or talk therapy, can also pose barriers, especially if you:
- live in a rural area away from offices
- have unreliable internet for virtual visits
- are without insurance
- don’t have the steady income to pay for recurrent appointments or medication
But there are ways to find help and support even when you can’t afford it.
If you’re interested in connecting with a mental health professional but you’re unsure where to start, consider checking out Psych Central’s hub on finding mental health support.
Addressing substance use and the connected incarceration within the Black community has to be done from multiple angles.
There have to be continued discussions about mental health with the goal of reducing the stigma surrounding it. In addition, making mental health services more accessible for everyone is crucial.
It’s also important to change the policies and laws that result in unfair incarceration of People of Color, as well as address the ways that mass incarceration not only affects those behind bars but their families and communities.
Some resources for substance use and general mental health support include: