A new study has found that interventions designed to increase connections to non-drug-using family and friends, the faith community, education and employment are the best ways to reduce substance abuse among African-Americans and other minorities in low-income, resource-poor communities.
The study focused on locations within the Arkansas Mississippi Delta, a region characterized by strained race relations, a stagnant economy, high unemployment, low incomes, and high emigration, and where the population is predominantly African Americans living in poverty.
“African Americans within such contexts often face multiple obstacles to accessing formal drug treatment services, including access to care and lack of culturally appropriate treatment programs,” said lead researcher Dr. Ann Cheney, an assistant professor in the department of social medicine and population health in the Center for Healthy Communities in the University of California Riverside School of Medicine.
“Despite these obstacles, many initiate and maintain recovery without accessing formal treatment. They do so by leveraging resources or what we refer to as ‘recovery capital’ — employment, education, faith community — by strategically connecting to and obtaining support from non-drug-using family and friends.”
The study, which analyzed substance-use life history interviews carried out from 2010 to 2012, illustrates that social networks and the resources embedded within them are critical to reduce substance use among minorities in resource-poor communities, the researcher says.
“Recovery without treatment, also called natural recovery, is common and perhaps even more prevalent among ethnic and racial minorities than among Whites,” Cheney explained. “Cocaine use varies along racial lines and social class and is increasingly a problem among African Americans in rural Arkansas.”
The study included 51 African American cocaine users between the ages of 18 and 61, represented by men and women about equally, who reported no formal drug use treatment or counseling in the past 30 days. Each provided information that included his or her perception of substance abuse in the community, cocaine use history, attempts to cut down or stop cocaine use, and treatment experiences.
The researchers found that nearly three-quarters of the participants (72 percent) reported at least one attempt to reduce or quit cocaine use, motivated by:
- Social role expectations, such as desires to be better parents or caregivers and responsible people, prevent harming their children, become more present in their children’s lives, prevent hurting loved ones;
- Fatigue — participants were tired of the drug lifestyle and its effects on their physical and mental health;
- Criminal justice involvement (incarceration forced participants to quit cocaine use);
- Access to recovery capital — most participants accessed substance use treatment programs or self-help groups at some point in their lives;
- Abstinence-supporting networks that helped participants reduce cocaine use or achieve temporary recovery outside of rehab;
- Pro-social lives and activities, such as participation in church or leisure-time activities; and
- Religion and spirituality, where faith helped participants reduce or quit cocaine use.
“Our analysis showed that recovery without treatment largely coincided with lifestyle changes and shifting social relationships,” Cheney said.
“African Americans, especially those in rural areas, often face personal, cultural, and structural barriers to accessing formal treatment programs. This makes reducing or quitting cocaine use without formal treatment a more feasible alternative and encourages reliance on existing networks of support.
“Interventions that are culturally appropriate and feasible within their resource-poor communities are needed,” she continued. “While accessing resources in faith communities is normative among African Americans in the South, other minority or underserved populations may hold different values and find valued resources within other social spaces.”
According to Cheney, the best approach would be for interventions to increase users’ access to resources that would allow them to live more conventional lifestyles — such as employment and stable housing — and meaningful lives spent with non-drug using friends or in faith or supportive communities.
“This approach is ideal in resource-poor communities — as long as interventions are tailored to local contexts and cultures,” she said.
Cheney continues her focus on the role of social networks in substance use outcomes and recovery among minority populations. Next, she will examine the role of social networks in substance use risk among Latinos in southern California’s Inland Empire.
The study was published in the journal Substance Use and Misuse.