Andre Johnson of Detroit Recovery Project discusses solving substance abuse

by CASSIDY SPARKS

Andre Johnson is the president and CEO of the Detroit Recovery Project Inc., a multi-service agency that provides a wide spectrum of support services to the city’s recovery community.

The Detroit native has 23 years of professional experience implementing programs to tackle substance abuse. Since its inception in 2005, the Detroit Recovery Project has devoted more than $15 million to its mission to helping addicts become drug-free.

Rolling out spoke with Johnson about his commitment to the community and the work he does daily.

What is the mission and vision of the Detroit Recovery Project?

The Detroit Recovery Project is a private nonprofit corporation dedicated to supporting recovery, which strengthens, rebuilds and empowers individuals, families and communities who are experiencing co-occurring mental illness and substance use disorders. This is accomplished by ensuring access to integrated networks of effective and culturally competent holistic health services.

In your leadership role, what is your commitment to the community? 

My commitment to the recovery community in Detroit is to be an advocate for individuals [who] are affected by substance use disorders in addition to ensuring resources are available in the community to support long-term recovery.

What would you say about the target group you serve?

The target group of men and women we serve are individuals [who] have suffered not only from the “throes of addiction,” but [also] have suffered physically, spiritually, mentally and emotionally. Many individuals have lost hope and often have a feeling of either “helplessness or hopelessness.”

Why should someone want to support your nonprofit financially or in other ways? 

Supporting an organization like the Detroit Recovery Project is a good investment in our community. The financial returns …benefit the Detroit community greatly. Who wouldn’t want to invest in a safe drug-free community?

The more individuals we are able to assist and serve, results in family reunification and crime reduction as well as other by-products of drug usage. For example, individuals’ health improves, reducing HIV and hepatitis from spreading [as well as preventing] other co-morbid health and mental health disorders from developing and exacerbating from substance use, ultimately improving the quality of life in Detroit.

How important is technology to the day-to-day operations of the organization? 

Technology is important for several reasons. … Electronic file access helps to keep real-time data on individuals as well as increase client retention and develop qualitative and financial reports.

CASSIDY SPARKS

I AM A BLOGGER, JOURNALIST AND MEDIA ENTHUSIAST. I AM PASSIONATE ABOUT COVERING ENTERTAINMENT, FASHION AND BEAUTY. KEEP UP WITH ME AT CASSINTHECITY.COM

https://rollingout.com/2019/11/07/andre-johnson-of-detroit-recovery-project-discusses-tackling-substance-abuse/

Every race, gender and culture must be welcome in treatment

February 23, 2018

Nicole Stempak

Mark Sanders, LCSW, CADC, is focused on patients’ recovery after they leave treatment facilities. For the last five years, he’s been helping to build recovery cultures. The idea is simple: Train people established in recovery to offer support in the very community where the clients are returning.

The movement requires providers and professionals to have an understanding of the neighborhoods and communities where clients live and work. “We want to know what resources exist within that community to support recovery,” Sanders says.

All too often, memories can trigger patients who may not have thought about using while in treatment. People, places and things can trigger cravings once they return home. It’s a problem Sanders has seen repeatedly during his 35 years as a certified addictions counselor. A consultant in behavioral health, he also has taught for more than 30 years at the university level and has authored five books. Sanders is co-founder of Serenity Academy of Chicago, the only recovery high school in Illinois, and past president of the board of the Illinois Chapter of NAADAC.

His most recent project has been the development of the Online Museum of African Americans Addiction, Treatment and Recovery, a resource geared toward frontline workers who want to work more effectively with African American clients. Addiction Professional recently caught up with Sanders to talk about treatment and recovery in the African American community.

AP: Can you describe the prevalence of addiction among African American communities?

Sanders: If we were to pay attention to media accounts, we might believe that addiction is more prevalent in the African American community.  And yet, when you look at SAMHSA’s annual statistics on drug use by race and by gender, African Americans consistently rank third or fourth on the list in terms of actual use. For middle class African Americans and those in the higher socioeconomic brackets, we can expect to see a recovery rate as high as their white counterparts in the same socioeconomic brackets. The more recovery capital you have, the greater your chances of recovery. The challenge is where race and poverty comes together.

The greater challenge is they are more likely to be arrested for possession of substances and thus more likely to wind up in the criminal justice system. There’s evidence that receiving a felony has longer-term consequences than actual addiction. You can always recover. That drug-related felony arrest will follow you for a long time.

AP: What are some of the reasons behind addiction and disparity among African Americans?

Sanders: At the core of addiction among African Americans is some type of trauma, which is consistent with other groups. Among those who are economically disadvantaged or economically poor, trauma can also be connected to joblessness. What executive directors at for-profit treatment centers need to know is they may work with African Americans in corporate America, who might be dealing with trauma but also organizational stress, racism in the workplace, etc.

AP: How do you see that stress and trauma affecting African Americans’ mental health, recovery and treatment abilities?

Sanders: African Americans have experienced oppression for several hundred years in America beginning with slavery, Jim Crow laws, discrimination and high disparity in detention centers. One of the reasons they’re not No. 1 in terms of drug use is the protective factor. There are many factors that actually protect African Americans from mental illness and substance abuse, and it includes things like spirituality, the sense of ‘we’-ness, extended family orientation where you have a great deal of community support, the ability to utilize humor and dance and movement to help mitigate stress.

AP: Is there a danger in providers being colorblind?

Sanders: Everywhere we go as human beings, we bring our experiences with us. African American clients will then bring with them to treatments their experiences of being African American, and then you view the world through their lens. Some African Americans say, ‘If you don’t see color, you don’t see me because my race, my culture, my ethnicity has a way of shaping who I am. So therefore, if you say you don’t see color, literally, I don’t feel like you see me.’

The other thing is, if we don’t see color, we also may not have the opportunity to examine our own biases. We’re not really thinking about that if we don’t see color. Lately in the diversity literature, they’ve been talking about microaggressions, intentional and unintentional slights. It’s insulting people without even knowing we’re insulting them. We have to pay attention to these things so we don’t injure someone inadvertently.

AP: If providers don’t acknowledge race, are they ignoring experiences or situations?

Sanders: By not seeing race, there might be some other things programs may not see. If you’re an African American and you walk into a treatment facility, the first thing you may find yourself instinctively doing is looking at the artwork, similar to the way you would if you were in someone else’s house or a museum. And the first thing you might ask is, ‘Do I see images of myself in the artwork?’ Because sometimes the pictures on the wall at the treatment center can send a signal of who is welcome and who’s not welcome in that space.

I’m a patient engagement specialist, so one program invited me to come in and help engage their clients more effectively. They said 80% of their clients were missing their second outpatient session. I sat in their waiting room for two days to see the agency from the perspective of new clients coming in. I started going through the magazines in the waiting room. They had magazines like O, Good Housekeeping and Martha Stewart Living, but they served Latino and Hispanic gang members. There was nothing in those magazines that reflected who they were as people—and those types of things can send a signal about who’s welcome and who’s not welcome.

AP: What advice do you have for providers?

Sanders: Look at areas such as hiring. Does your staff makeup reflect the clients that you work with? We used to say addiction is an equal opportunity employer. Peter Bell [of Hazelden Betty Ford] said addiction is best treated when the cultural background in which it emerged is taken into consideration, meaning that treatment providers have to be willing to understand and learn something about the culture. I would say if a treatment center works with African Americans, Latinos, Hispanic or Asian clients, then they should learn some things about the communities they are serving. 

When we’re providing clinical services, there’s something the clients bring to the table: their experiences and perceptions. Treatment providers are also bringing their experiences and their perceptions. So, not only do you need to understand the clients you’re working with, treatment providers also need to understand our own biases, our own assumptions, our own stereotypes. If we begin to understand those things, we can begin to see how our own experiences might impact the clients we serve. 

AP: What is one thing our readers needs to know about this issue?

Sanders: It’s really critical that even if you work in a program for what we call acute care treatment—short-term treatment—for so many people, addiction is a chronic and progressive illness. With addiction and treatment, we see you for 28 days, whereupon you have what we call ‘a graduation.’ We often have zero to two contacts with you upon discharge, whereas in cancer treatment, they may follow up with you for five years. At a minimum, we need to monitor people longer.

Addiction Professional https://psychcongress.com/article/special-populations/every-race-gender-and-culture-must-be-welcome-treatment

Nicole Stempak is a freelance writer based in Ohio.

"RAP MUSIC IS THE CNN OF THE GHETTO"

The above quote "rap music is the CNN of the ghetto" is credited to Chuck D, lead rapper of the Rock in Roll Hall of Fame group Public Enemy. While Chuck D said the quote in 1989, it came to me as I was watching an episode today of The Evolution of Hip Hop, Season 3 Episode 4 (Netflix). The episode focuses on the history of Hip Hop in the South and highlighted the lyrics of a song by Kilo Ali of Atlanta, Georgia, during the height of the cocaine epidemic and mass incarceration of African Americans. The song is entitled Cocaine (America Has a Problem, 1990) and is a cautionary tale about the impact of crack cocaine on African American Communities. Some of the Lyrics are below.

Cocaine says she loves you, but she really don't. She say she'll always be there, but she really won't. She'll make you buy an Uzi, say go kill your brother or you're gonna lose me.

Click below to hear the entire song.

Click here to listen to other songs that serve as cautionary tales on the impact of drugs on African American communities for a half century. These artist should be hailed as prevention specialists 

America's War on Drugs Has Treated People Unequally Since Its Beginning

BY JOHN H. HALPERN AND DAVID BLISTEIN 

AUGUST 12, 2019

Billie Holiday

Judy Garland

When Prohibition ended in 1933, drug enforcers finally had a new agency they could call their own, the Federal Bureau of Narcotics. This launched the career of its first commissioner, Harry Anslinger, the person most synonymous with the phrase “war on drugs”—in fact, the first person to use it—and likely the first person, outside of any royal family, to be referred to as a “czar.”

Between 1930 and 1962, Anslinger established the standards that continue to serve as basic tools of the trade for America’s drug enforcement, such as dramatic drug busts, harsh penalties and questionable data. There remains serious disagreement in scholarly as well as political circles about how successful Anslinger really was in reducing drug sales and use in America, though he achieved several significant legislative victories, including the Uniform State Narcotic Drug Act, which fostered collaboration between federal agents and police in different states (each of which had its own specific laws).

But, as difficult as passing drug laws is, enforcing them effectively, consistently and fairly has proven to be virtually impossible.

Anslinger unapologetically divided the world into us and them, good and bad, right and wrong—and always black and white. While Anslinger’s 30-year war on drugs undoubtedly saved the lives of some individuals, his racial prejudices tarnished his reputation in ways that, even allowing for 20/20 hindsight, can’t be dismissed. The most blatant example was his disparate treatment of two of the nation’s most famous celebrities in the 1950s: Judy Garland and Billie Holiday. Click here to continue reading the article.

SHE FREED 17 PRISONERS FACING LIFE, WITH THE HELP OF KIM KARDASHIAN

By Nick Fouriezos

It’s the number that Brittany Barnett will never forget: 1374671. Seven digits assigned to her mother after she was arrested on a felony charge of assault and bail jumping related to her crack cocaine addiction.

The experience hit home as Barnett later changed career tracks, leaving accounting behind to study law at Southern Methodist University in Texas, a state that incarcerates more people than any other in the country. But since then, the former corporate lawyer has done more than she could have imagined for the plight of prisoners like her mom.

This spring, Barnett helped secure the release of 17 federal prisoners in 90 days under the newly passed First Step Act — a feat that drew national headlines because it was partially funded by Kim Kardashian West. It was the culmination of what she started in summer 2017 with the Buried Alive Project, a nonprofit working to eliminate life-without-parole sentences. “Life without parole is the second-most-severe penalty permitted by law in America, and we’re imposing this sentence on people with drug offenses. It’s mind-blowing to me,” Barnett says. “Reform, to me, is a fix. What we need is a fundamental shift to transform the system.”

Barnett has just finished a training event on compassionate release — where sick, elderly or disabled prisoners are set free early — for lawyers at the Washington, D.C., offices of lobbying giant Akin Gump when the Texas native lets her roots show. With a slight drawl, the 35-year-old spells out “B-O-G-A-T-A,” the 1,200-person town she grew up in, where the Rivercrest Rebels played high school football under a Confederate battle flag. “I can honestly say that growing up, I didn’t experience much racism,” she says. Instead, it showed up in less obvious ways, such as a childhood friend who got a life sentence for drugs when he was 23 years old. “We thought, Jeez, this is just East Texas. What I didn’t know is that he wasn’t an anomaly.”

The sweet tea and trap music lover’s goal today is to dredge up pro bono lawyers who are willing to work with some of the 1,600 people in the federal justice system who are serving life for drugs. Just getting that number was difficult enough: The Department of Justice wasn’t keen to share the information, Barnett says, and so her Buried Alive Project team had to piece together the records themselves. “If you don’t have a good counsel, it turns what is a difficult fight into one that is impossible. So the work she is doing is so important, just to ensure we have a fair and just system,” says David Safavian, deputy director of the Center for Criminal Justice Reform at the American Conservative Union.

The First Step Act is expected to lead to the release of more than 2,200 prisoners locked up for nonviolent drug crimes. But for many critics, it didn’t go far enough. While it eliminated so-called “stacked” sentences for future defendants, it didn’t reverse them retroactively for those currently in the system, meaning some people are serving up to 55 years for what may be only a five-year sentence today, Safavian says. To try to combat some of those challenges, Barnett recently launched the Third Strike Campaign, telling the stories of 13 prisoners who weren’t released under the First Step Act. “You have people spending life sentences today under yesterday’s laws,” Barnett says.

IT IS VERY IMPORTANT FOR LITTLE BLACK GIRLS IN BOGATA, TEXAS, AND OTHER RURAL AREAS, TO SEE THAT BLACK WOMEN ARE DOING THIS WORK.

BRITTANY BARNETT

The story of how Barnett and West joined forces begins with a critical race theory class that Barnett took at SMU — a class that she had to beg to be let into, because it was overbooked. “That was the only time I ever have” made an exception, says David Lacy, who was teaching the course. Barnett, studying to be a lawyer at the time, began investigating the human faces of a war on drugs that required 100 times as much powder cocaine as crack cocaine to invoke equal mandatory minimum sentences — a distinction mostly made along racial lines. “There were people talking about it 10 years ago, but it didn’t have nearly the momentum it has right now,” Lacy says.

It was in those studies that she met Sharanda Jones, the first woman serving life whom she would later help free through clemency in 2015, under the Obama administration. Soon after, she took on the case of Alice Johnson, a convicted drug trafficker and friend of Jones, whose moving video (below) reached West. The celebrity entrepreneur visited the White House in the summer of 2018 to discuss prison reform with President Donald Trump, and, a week later, the great-grandmother was granted clemency and released.

Still, West’s involvement didn’t come without controversy. As West helped fund a three-month sprint by Barnett and her business partner, MiAngel Cody, to release as many prisoners as possible earlier this year, criminal justice advocates complained about the attention she was getting — headlines implying West was becoming a lawyer and freeing these people herself, distracting from the years of work done by less-famous people on the ground. Amid those complaints, Barnett posted on Facebook that West had “linked arms with us to support us when foundations turned us down,” and that at the end of the day, “TWO Black women lawyers freed 17 people from LIFE W/O PAROLE sentences.”

Looking back at that moment, Barnett says she posted because she wanted to defend West against criticism. “People know that Kim’s not going to court and arguing in front of a judge,” she says. She understands that some people took that as her wanting credit, which she denies, before adding: “I stand on the fact that it is very important for little Black girls in Bogata, Texas, and other rural areas, to see that Black women are doing this work.” Even with many challenges ahead, Barnett has hope for one simple reason: The human narratives behind unjust sentences are starting to be told. “Being able to put a heartbeat to the number,” she says — a number just like her mother’s. Nick Fouriezos, Reporter 

https://www.ozy.com/politics-and-power/she-freed-17-prisoners-facing-life-with-the-help-of-kim-kardashian/95841

Death of An Icon

We received the news today of the death of Dr. Carl Bell a distinguished psychiatrist from the South Side of Chicago. Congressman Danny K. Davis said, "Carl Bell is the greatest psychiatrist in the world." Others called Dr. Bell, "an African American Sigmund Freud." Bells early work focused on violence prevention in African American Communities. He achieved notoriety for his work on mental health and addictions protection factors for African Americans and his research on the impact of trauma on child development. Bell published over 400 scholarly articles. His most recent work focused on preventing Fetal Alcohol syndrome in African American Children.

 Click here to view his articles on prevention of fetal alcohol syndrome. (http://www.museumofafricanamericanaddictionsrecovery.org/dr-carl-bell)

He will be greatly missed! We are fortunate that he mentored scores of psychiatrists to continue his great work

AFRICAN AMERICAN FATHERS AS SUBSTANCE USE DISORDERS PREVENTION AND INTERVENTION

Today is Fathers Day. I am moved to right this post on the importance of African American Fathers in the lives of their children in general and specifically as prevention of early heavy substance use and early intervention. I have spent the past 5 years counseling African American adolescents and emerging adults with Substance Use Disorders. Nearly 100% percent of the young men I work with have early onset heavy marijuana use (before age 16). Nearly 100% of them have a poor to no relationship with their father. Is this coincidental?

In the book, I Don't Want To Talk About It, author Terrence Real indicates that the absence of fathers in son’s lives can play a major role in the son developing "Male Depression." The early symptom of male depression includes: anger; rage; and heavy substance use. The substances are used to medicate the anger and rage. The young men I work with could easily meet the criteria for male depression.

What about the importance of fathers in the life of African American Daughters? In the book, What Ever Happened To Daddy's Little Girl?: The Impact Of Fatherlessness On Black Women, author Jonetta Rose Barras describes the impact of fatherless on daughters. According to Barras, young daughters often go through "the search." each time the doorbell or phone rings she wonders and is hoping that it is her father reaching out. As she grows older there may be a period of promiscuity. According to Barras, the promiscuity is not so much about sex, it’s about magical thinking. "If my father discovers how desirable I am, maybe he will come back into my life." This period is often followed by dating older partners as an unconscious desire to be near her father. Unfortunately, relationships with older partners could be the teen girls’ premature entry into adulthood, including: early sex, teen pregnancy and drug use. It is also well documented that the absence of fathers also increases the risk of incest and/or childhood sexual abuse for young daughters. Many teen girls may start to use drugs early to cope with the emotional pain of the absence of her father and the consequences of that absence as discussed in this paragraph.

Addictions counselor reading this post should put efforts into involving fathers in the addictions treatment of teens seeking recovery and make sure the impact of fatherlessness, where it exists, is discussed in treatment.

The End Result of the War on Drugs

The end result of the war on drugs of the 1980's is that African American males became the most incarcerated population on the planet Earth. In the post below Addictions Historian William White, MA describes the impact of racism and panic on communities of color and offers recommendations on how to deal with such panic in the future.

RACISM, MORAL PANICS, AND DRUG WAR CASUALTIES: AN UPDATE

June 6, 2019

Bill White

Surging cocaine use and new patterns of cocaine use in the 1980s and early 1990s in the United States sparked media and political frenzies. At the center of what sociologists have christened a moral panic was the iconic image of “crack babies” and “crack kids”—infants and children branded a “biological underclass” whose parents were portrayed as “irretrievably depraved.” Such images spurred a wave of laws and policies that in turn fueled dramatic expansions of the U.S. criminal justice and child welfare systems. Those most dramatically affected by these expansions were poor communities of color who witnessed unprecedented numbers of their young men imprisoned and their young women and children placed under the control of state child protection authorities. In the aftermath, countless individuals faced restrictions on access to housing, education and training, employment, food stamps, and basic voting rights. But most importantly, a population of mislabeled children reaped the consequence of low expectations, mothers faced social shame and loss of their children (sometimes from nothing more than false drug tests), and families were damaged in a pattern not unlike that which occurred in the era of the Indian boarding schools.

New “cocaine experts” rode the crest of this moral panic, warning from every media venue that an “epidemic” of cocaine-exposed infants was creating a “lost generation” devastated by the havoc prenatal cocaine exposure was inflicting on their development. There was just one problem: those claimed effects and those dire predictions related to prenatal cocaine exposure, based on studies now viewed as “junk science,” were simply wrong. Well-designed studies challenged and then discredited all of the prevailing wisdom on prenatal cocaine exposure. When the inflammatory rhetoric of “crack babies” and “crack kids” peaked, virtually every mainstream media outlet spewed this flawed junk science in front page articles and television specials. Later retractions of those flawed findings rarely reached cultural visibility. (The latest mea culpa is an opinion piece from the Editorial Board of The New York Times entitled Slandering the Unborn.) This era illustrates how racism, bad science, moral crusaders, and desire for institutional expansion can collide to inflict untold damage on multiple parties.

I wish to raise two issues related to this era of history. The first is the question of the ethical and moral responsibility of multiple parties to make amends to the individuals, families, and communities harmed by these actions. If industries have a responsibility for harm that results from their products or services (such as the liability of the tobacco and pharmaceutical industries for their role in nicotine and opioid addiction), then two questions follow: 1) What is the responsibility of those who were at the core of what is now realized to be an extremely harmful disinformation campaign, and 2) What are the responsibilities of those persons and institutions who supported and profited from the laws and policies linked to a perceived cocaine epidemic? In both cases, the question is whether reparations are due to the individuals, families and communities who bore the brunt of those laws and policies. When do scientists, politicians, moral crusaders, educators, criminal justice and child welfare leaders, and health care professionals (including addiction treatment professionals) publicly declare their role in such harm and state what actions they are taking to make amends for such injuries?

The second issue is how frontline addiction professionals and recovery support specialists can avoid complicity when such moral panics rise within the culture. I would offer the following suggestions.

1.    Recognize the existence of moral panics related to new drug trends and maintain a healthy skepticism of all alarmist information being promoted during such periods–even when it seems to come from credible sources. Information emanating from the earliest stages of moral panics is notoriously unreliable. The objective voice that will stand the test of time is the one least likely to be heard at the height of a moral panic.

2.    The fact that a piece of information has been published in a scientific or professional journal does not in itself mean that this information has been scientifically validated. Early reports may not hold up to more methodologically rigorous studies. The way of science is that all knowledge is on probation pending further investigation and new discoveries.

3.    When you find you have been an accomplice in the dissemination of misinformation, do everything you can to correct what you have disseminated and correct it within the specific venues in which it was originally presented. Remember, those you originally communicated with may be continuing to act on the misinformation you provided; harm may be continuing to unfold. Consider this correction process a highly ethical form of professional amends.

4.    When alarmist voices are fanning the flames of cultural hysteria (often in pursuit of their own personal or institutional interests), bring your professional calmness to bear on this situation by tempering calls to impulsive action with more reasoned approaches to problem assessment and problem resolution. Always ask, “Are there any unintended consequences that could flow from what is being proposed?” A long tradition of harm in the name of help exists within the histories of addiction treatment and recovery support. One of the major goals of our professional careers should be to avoid to the greatest extent possible participating in this tradition.

5.    Moral panics have a way of turning people into objects that need to be extruded from the life of the community. In this climate, awful things can be perpetrated in the name of the most noble of values. Protest any emerging labels that turn people into things. As my friend Don Coyhis often reminds us: Words are important. If you want to care for something, you call it a “flower”; if you want to kill something, you call it a “weed”.

Opioid Addiction Drug Going Mostly To Whites, Even As Black Death Rate Rises

PUBLIC HEALTH

May 8, 20191:46 PM ET

Heard on All Things Considered

MARTHA BEBINGER

Buprenorphine, better known by the brand name Suboxone, helps people with opioid addiction stay in recovery. But it is prescribed far more often to white drug users than to blacks.

Craig F. Walker/Boston Globe via Getty Images

White drug users addicted to heroin, fentanyl and other opioids have had near exclusive access to buprenorphine, a drug that curbs the craving for opioids and reduces the chance of a fatal overdose. That's according to a study out Wednesday from the University of Michigan. It appears in JAMA Psychiatry.

Researchers reviewed two national surveys of physician-reported prescriptions. Between 2012 and 2015, as overdose deaths surged in many states, so did the number of visits during which a doctor or nurse practitioner prescribed buprenorphine, often referred to by its brand name, Suboxone. The researchers assessed 13.4 million medical encounters involving the drug but found no increase in prescriptions written for African Americans and other minorities.

"White populations are almost 35 times as likely to have a buprenorphine-related visit than black Americans," says Dr. Pooja Lagisetty, an assistant professor of medicine at the University of Michigan Medical School and the study's corresponding author.

The dominant use of buprenorphine to treat whites occurred at the same time opioid overdose deaths were rising faster for blacks than for whites.

"This epidemic over the last few years has been framed by many as largely a white epidemic, but we know now that's not true," Lagisetty says.

What is true, Lagisetty added, is that most of the white patients either paid cash (40%) or relied on private insurance (35%) to fund their buprenorphine treatment. The fact that just 25% of the visits were paid for through Medicaid and Medicare "does highlight that many of these visits could be very costly for persons of low income," Lagisetty says.

Doctors and nurse practitioners can demand cash payments because there's a shortage of clinicians who can prescribe buprenorphine, according to Dr. Andrew Kolodny, co-director of Opioid Policy Research at Brandeis University. Only about 5% of physicians have taken the special training required to prescribe buprenorphine.

"The few that are doing it are really able to name their price, and that's what we're seeing here and that's the reason why individuals with more resources — who are more likely to be white — are more likely to access treatment with buprenorphine," says Kolodny, who was not involved in the study.

Kolodny wants the federal government to eliminate the required special training for buprenorphine and a related cap on the number of patients a doctor can manage on the drug.

Fentanyl-Linked Deaths: The U.S. Opioid Epidemic's Third Wave Begins

What Explains The Rising Overdose Rate Among Latinos?

Some physicians who have studied racial disparities in addiction treatment say the root causes go back to 2000, when buprenorphine was approved. At that time, proponents argued that buprenorphine was needed to help treat suburban youth, says Dr. Helena Hansen at New York University. Those young patients didn't see themselves as addicted to heroin in the same way as hard-core urban heroin users who went to methadone clinics for treatment, she says.

"Buprenorphine was introduced as private office treatment, for a private market, with the means to pay," says Hansen, an associate professor of psychiatry and anthropology. "So the unequal dissemination of buprenorphine for opioid dependence is not accidental."

Hansen added that the fix must include universal access to treatment in a primary care setting, an end to the criminalization of opioid dependence (which puts more blacks in prison for drug use than whites), and more federal funding to expand access to buprenorphine for all patients.

Several leaders in the fight to reduce opioid overdose deaths say the study results are disturbing.

"It really demands for us to be looking at equitable treatment for addiction for African Americans as we do for white Americans," says Michael Botticelli, director of the Grayken Center for Addiction at Boston Medical Center and the former director of the Office of National Drug Control Policy.

Botticelli identified some key issues that may be contributing to the racial treatment gap that deserve further investigation. For example, he wants to know whether Medicaid reimbursement rates are simply too low to entice more doctors to work with low-income patients, or there are too few inner-city doctors prescribing buprenorphine, or African Americans themselves are somehow reluctant to seek this form of treatment.

Dr. Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health, called the findings surprising and disturbing. Surprising because the disparity is so large, and disturbing because her agency has prioritized educating doctors about the value of prescribing buprenorphine.

Volkow also expressed disappointment that federal parity laws, which are supposed to guarantee equal access to all types of medications, don't seem to be working for buprenorphine. "We need to ensure that we have capacity to provide these treatments," Volkow says. "Because if you say you have to pay for them, but there are no services that can provide the treatments, then the issue of paying for them is secondary."

Volkow has noted that fewer than half of Americans with an opioid use disorder have access to buprenorphine or the two other medications used to treat opioid addiction: methadone and naltrexone. Volkow said she is glad that the use of buprenorphine is on the rise, but the U.S. needs to understand why this lifesaving treatment isn't benefiting all patients who need it.

This story is part of a reporting partnership that includes WBUR, NPR and Kaiser Health News.

Tiger Woods Wins His 15th Major Championship Today! Implication for African American Males and Other Clients Seeking Addictions Recovery

Tiger Woods became a professional champion at age 20 and won 3 of the 4 major golf tournaments that year. Jack Nicholas who holds the record for winning the most major golf championships (18) called Tiger the greater golfer ever and predicted that Tiger would shatter his record. By age 36, Woods won 14 major championships then the "messenger of misery visited him." During the next 11 years Tiger went from one crisis to the next and did not win another major championship until today. There were multiple marital affairs, divorce, public shame and bad press, sex addiction treatment, the death of his father (who introduced Tiger to golf at age three), and one injury after another for 11 years. There are many lessons here which have implications for African American males and other clients seeking recovery. 

1.    African American males are often inspired by the success of other African American males. As Tiger Woods won the tournament today I cried tears of joy. It felt like I had just won the Masters. Soon after his victory I received a call from 5 African American male friends. One simply stated, "Did you see that?! Did you see that?!" Another stated, "I don't even watch golf. I turned away from watching the NBA playoffs to watch the brother win!" African American males seeking recovery need to be connected with African American males in long term recovery who are doing well in recovery. This can be a source of inspiration.

 2.    Tiger Woods win today is a testament to his own recovery story. Following multiple sexual affairs he entered sex addiction treatment. His ups and downs offers proof that recovery is not a straight line, there are many ups and downs and good things will happen if you hang in there. 

3.    Throughout this entire journey he demonstrated resilience which is a necessary ingredient for recovery and a protective factor against developing a substance use disorder in the first place.

Recovery Community Organizations in Medically Underserved Communities of Color

by Joe Powell

A Recovery Community Organization (RCO) is an independent, non-profit organization led by persons in recovery, their family members, friends and allies. RCOs provide a combination of long-term peer-based recovery supports, community education, grassroots mobilization and advocacy to support recovery. The sole mission of an RCO is to mobilize resources within and outside of a community to increase the prevalence and quality of long-term recovery within a community (Valentine, White and Taylor, 2007).

 In 1998 SAMSHA funded 20 RCOs throughout the United States to advocate and educate communities about the long-term effects of recovery. It was in the same year that the Association of Persons Affected by Addiction (APAA) was founded by people from various backgrounds and experiences. We had one simple purpose and that was to spread recovery in Dallas Texas. Now 21 years later, we know through experience that the RCO model is ideal for African American communities impacted by addiction and co-occurring mental health challenges. Recovery flourishes in a community that is connected to a network of strength-based services; and that network thrives because of the experiential knowledge and lived experience of the people in recovery and allies.

While many African Americans receive services in traditional addiction treatment programs many of these programs offer acute care solutions to a chronic and progressive illness. Simply, they focus on the problem and the person’s weakness rather than their strengths and supports. Many of these programs are located outside of the black community and offer little to no continued cultural hope or recovery support upon discharge. It became clear that services were needed within the community to support recovery. APAA moved to Martin Luther King Jr. Blvd in the heart of a black community in Dallas. The first thing our RCO did was Map the entire community for recovery capital and champions. In the community there were churches, barbershops, police stations, grocery stores, community groups, 12 step meetings etc. We pulled the entire community together, bringing addiction out of the closet and we mobilized the community to support recovery. We viewed the entire community as the recovery center. We noted that there were many liquor stores in the community and no programs to support recovery. We started training and hiring recovery coaches within the community to support long term recovery. Treatment centers often lose funding and shut down. We have found that offering a peer-based solution in the black community is a great solution.

Federal, State, County and the city council is now involved in our recovery efforts. Our funding is now provided by various community groups who see the benefits of anchoring recovery in the community. While there is much work to do, we have a thriving recovering community in Dallas. We coordinated the 2016 National Recovery Celebration and look forward to hosting the 2019 Big Texas Rally for Recovery. 

About the Author

Joe Powell is the President and CEO of APAA a leading peer driven, peer led, and peer ran recovery community organization. He is recipient of the Vernon Johnson Award for advocacy. 

400 Years of Perseverance, Resilience and Success

This post is meant to offer hope to African American seeking recovery. The first kidnapped Africans were brought to America as Slaves in 1619(city of Jamestown, Virginia). This year marks the 400th year anniversary of Africans living in America (1619-2019). There are two ways this story can be told. One, from the perspective of the 10 PM News in any city in American which routinely and stereotypically depicts African Americans as lazy, dishonest, criminal, oversexed, immoral, addiction prone individuals, who have contributed little to the success of this country. Then there is the truth! Objectively, historians 100 years from now looking back on our first 400 year history in America and conclude, "What an amazing people!  During their first 254 years in America they were brutalized in Chattel slavery (1619-1863). This was followed by 146 years of lynchings, victims of burnings (especially churches and Black owned businesses), beatings (read the story of Emit Till), bombings (read the story of the four little girls, Birmingham, Alabama and Black Wall Street), medical Maltreatment (read the story of the Tuskegee Experiment), Jim Crow Laws, discrimination, racism, redlining, voter suppression, job discrimination, last hired/first fired, police brutality, police shootings and Mass incarceration. Yet, they rose to produce some of the most successful people in world history." When Tennis Arthur Ashe was diagnosed with HIV he said, "I handled being black in America. I'll handle this too." For African Americans reading this post who are seeking addictions recovery, know that recovery is within your reach in that you come from a people who persevere and succeed. Scroll down to view a partial list of African American Achievers.  

Mae Jamison, MD

Astronaut and Medical Doctor

Jackie Robinson

Integrated Major League Baseball

The only Player who's Number is retired by the entire league

First Prominent Recovering Alcoholic

Leader of The Black Temperance Movement.

Misty Copeland

Number one Ballerina in The World

Madam C.J. Walker

First Female Self-made Millionaire in America

One of The Best Surgeons in The U.S.

Separated Conjoined Twins.

Simone Biles

Greatest Gymnast of all time.

Reginald Lewis

First African American Billionaire 

Oprah Winfrey

Most Successful Talk Show Host in History

W.E.B Dubois

First African American to earn a PHD from Harvard

Michael Jordan

Basketball Great

Muhammad Ali

Greatest of All Time

Laila Ali

Greatest of All Time

Michael Jackson

Greatest Entertainer of All Time

Reverend Dr. Martin Luther King JR.

Leader of the Civil Right Movement

Nobel Peace Prize Winner

Aretha Franklin

Queen of Soul

Voted Best Singer of The 20th Century By Rolling Stone Magazine

George Washington Carver

Scientist, Inventor, Chemist, Botanist

Serena William

Greatest Tennis Star of All Time

Thurgood Marshall

Supreme Court Justice

Katherine Johnson

Mathematician

Her calculations played a key role in the first U.S. Successful Flight to Outer Space

Denzel Washington

Oscar Winning Actor

Guion Buford

Astronaut, Pilot, Scientist

African American History Month: An Interview with Mark Sanders, LCSW, CADC, Creator of the Online Museum of African American Addictions, Treatment and Recovery

Mark Sanders launched the Online Museum of African American Addictions, Treatment and Recovery in 2016 to share research that he's gathered over the course of his career on effective approaches to substance use disorder prevention, treatment and recovery in the African American community. The Online Museum also celebrates the many ways that both African Americans and non-African Americans have worked to promote treatment and recovery within African American communities and beyond. 

In the interview that follows, Mark tells what inspired him to start the Online Museum and describes the many resources it offers.   

What inspired you to create the Online Museum of African American Addictions, Treatment, and Recovery? 

Mark Sanders: 

“My reason for creating two-fold: First, it was personal, in that all of the people who I love have had the disease of addiction. Both of my grandfathers died from alcohol use disorders. Second, it all goes back to 1986, the year that crack cocaine replaced marijuana as the major street drug. In May 1986, my dad died of a crack-cocaine-induced heart attack. One month later, the morning after signing with the Boston Celtics as the number one player in the NBA, college basketball star Len Bias died of a cocaine overdose. As the Museum intro notes, Congress intensified the war on drugs at that time, leading to a vast increase in incarceration rates of people with substance use disorders, most of them African American men. 

Also in 1986, I graduated from grad school and took a job as a social worker with General Motors in Chicago. My job was to determine length of stay for GM employees identified with substance use disorders. Many of these individuals were African American men who were sent to treatment facilities that had limited experience in treating African Americans. This marked the beginning of my gathering research on effective substance use treatment for African Americans. I started to speak on the topic at conferences and professional meetings, and in 1993, I wrote my first book, Treating African American Substance Users.

Throughout those years I frequently spoke with my mentor Bill White, who in my mind is the top historian in the treatment and recovery services field. We would talk regularly about the history of addiction in America in general and more specifically, within the African American population. 

Bill has written more than 400 articles on recovery, which are posted on his website, Selected Papers of William L. White, to make them more accessible to people outside the realm of research. Bill’s site had a great influence on the launch of the Online Museum. 

Bill and I had written a series of articles on the African American experience, with my wife, Tanya, who is also a social worker. One of the articles, Addiction in the African American Community, relates the recovery stories of Frederick Douglass and Malcolm X, and what we could learn from them. A second article, When I Get Low, I Get High, examines how addiction is portrayed in African American music. Another article explores the portrayal of addiction in literature and movies. With these articles, I realized that I could create a site similar to Bill’s, with a goal to make sure that the story of African American addiction, treatment, and recovery is told from multiple perspectives. The Online Museum launched in June 2016.  

How do you select content for the Online Museum?  

“Sometimes, I do a strategic search for things such as examples of Alcoholics Anonymous in African-American communities, or African Americans and the temperance movement. Often, the content finds me. I look for inspirational quotes or stories to highlight the successes of other groups—for example, March 8, National Women’s Day, or National Hispanic and Latino heritage month. 

Martin Luther King Day, I found a 20-minute YouTube video of Dr. King talking to young people about hope, one of his most inspirational talks: What is Your Life’s Blueprint.With that, I began to think about the importance of instilling hope among young African Americans as a prevention tool.

We are lucky to have a lot of great contributors. Dr. Carl Bellhas a page on the Online Museum—right now his focus is on fetal alcohol syndrome. Fred Dyerhas a page on working with emerging adults. Bill White has also given us permission to repost from his blog. 

The Online Museum includes a blogwith posts by a variety of writers. I always have my eyes and ears open for content. A recent post was inspired by the comments to an online trivia contest that asked: “What well-known comic is from Peoria, IL.” The answer, Richard Pryor, raised a question about why we should celebrate Pryor, given his problems with drugs and alcohol. What many people don’t know about Pryor is that he suffered terrible childhood abuse, and that led to a blog post, Don’t Judge a Man Until You Have Walked A Mile in His Moccasins: Defending Richard Pryor, about the relationship between adverse childhood experiences and later substance use.  

One of the most popular blog posts, based on number of page views, is An Open Letter to The Hip Hop Community (Rappers): Your Lyrics Can Increase the Risk of Relapse.”

 Describe some ways that the Online Museum content has been used since you launched the site. 

“In 2018, the Online Museum was viewed by people in all 50 states in 88 countries. So far, in 2019, we’ve had visitors from 36 states in and 18 countries. 

When we first developed the Online Museum, we went to the ATTC directory of addiction counselor training programs across the United States. We sent information on the site to all of those programs. 

Some institutions or addictions studies programs are using the Online Museum in their curricula. The Online Museum is also featured in a webinar that I presented for NAADAC, titled “Counseling African Americans with Substance Use Disorders.”

Treatment counselors use the Gone Too Soon! to share stories of how alcohol and drug use has shortened the lives of many athletes and celebrities.  

How can addiction treatment and recovery services professionals use the site during Black History Month and all year long? 

“I encourage people to peruse the site and make a commitment to learning something new about the African American community. Treatment professionals can read the scholarly articles specific to treatment and recovery issues, and try to implement some of the ideas presented. The content on the site may be especially valuable to young white professionals who are new to the field and working with African American or other populations for the first time. The Online Museum content can also be an excellent resource for older professionals who are mentoring someone just starting out. 

The Story of the Month section of the site aims to help reduce stigma and bust stereotypes about African Americans—each story demonstrates that African Americans can and do recover. This page can be a useful tool for counselors and inspiration for people seeking recovery. 

The Addiction Hall of Fame is also designed to challenge stereotypes and celebrate all that African Americans have done to help promote addiction treatment and recovery. We recently announced the 2019 inductees, and their profiles are featured on the site.”

It is my hope that people who are interested in the subject of addictions history, treatment and recovery among African American in the present and the future can utilize the museum as a source of information. The biggest hope is that people interested in the subject 50 years from now will grab the baton and continue the work.” 

About Mark Sanders: 

Mark Sanders, LCSW, CADC, is an international speaker, trainer, and consultant in the behavioral health field whose work has reached thousands throughout the United States, Europe, Canada, Caribbean and British Islands. 

Mark is the author of five books, which focus on behavioral health. Recent writings include Slipping through the Cracks: Intervention Strategies for Clients Multiple Addictions and Disorders, Recovery Management: and Relationship Detox: Helping Clients Develop Healthy Relationships in Recovery. He has had two stories published in the New York Times best-selling books series, Chicken Soup for the Soul. Mark has been a certified addictions counselor for 34 years. He has received numerous awards including a Life Time Achievement Award from the Illinois Addiction Counselor Certification Board and the Barbara Bacon Award for outstanding contributions to the Social Work profession as a Loyola University of Chicago Alumni. 

Mark is co-founder of Serenity Academy of Chicago, the only recovery high school in Illinois. He is past president of the board of the Illinois Chapter of NAADAC. He has had a 30 year career as a university educator having taught at the University of Chicago, Illinois State University, Illinois School of Professional Psychology, and Loyola University of Chicago, School of Social Work.

Article prepared by Maureen Fitzgerald, Great Lakes ATTC and ATTC Network Coordinating Office.

New Years and Other Holiday Celebrations for African Americans Seeking Recovery

Harriet Tubman Madame C. J. Walker Muhammad Ali

The new year is upon us. For persons seeking recovery New Years is one of the days in which relapse is most common. In America, just about every holiday is celebrated with the use of alcohol and/or other drugs. In a previous post I suggested that African Americans in recovery or seeking recovery create their own drug free celebrations which could elevate self-esteem, increase cultural pride, teach history and help them stay sober during holidays. Below are some suggested celebrations on the birthday of prominent African Americans.

Madam C. J. Walker Day (December 23) - Madam C. J. Walker was the first American woman self-made millionaire, building a hair care products empire for African American Woman. Perhaps December 23rd is the day to begin plans for a business you've always wanted to start.

Muhammad Ali Day (January 8) - The greatest boxer of all time gave up his heavy weight title to stand for principles he believed in. Perhaps on this day you could stand up for an important principle or cause you believe in.

Dr Martin Luther King, Jr. Day (January 15) - On this day you could view tapes of Dr King’s speeches, Read his quotes or books to internalize his courage in the midst of adversity.

Harriet Tubman Day - As she was born into slavery there is no official day for her birth day. Pick a day! Celebrate her courage and the enormous love she had for enslaved Africans enabling her to make 19 trips from the south to the North freeing hundreds of Africans as a leader of the underground railroad.

New Years Day - How about a day of gratitude for another day or year of recovery surrounded by others in recovery!

Your Birth Day - Instead of sipping champagne, or smoking a blunt, how about throwing a party on your birthday for your parents for the gift of life!

Holidays which can be created are endless, including: Barack Obama Day; Michelle Obama Day; Paul Robeson Day; Ida B. Wells Day; Louis Armstrong Day; Ella Fitzgerald Day; Jackie Robinson Day, Whitney Young Day, etc., etc., etc.,

Happy New Year!

RAP MUSIC/Hip Hop AS THERAPY: Lessons For Addictions Counselors

Studies indicate that journaling can be just as effective as therapy in helping people change. If this is true, then rap music is the ultimate journaling! When rapper Snoop Dogg burst on the scene much of his music focused on "Chronic" (weed smoking), "Gin and Juice" (alcohol drinking), "hookers and hoes" (derogatory lyrics about women) and "murder was the case" (gun violence). At the time of this writing, his life and lyrics have changed dramatically. He now coaches a youth football league and many of the youth whom he has coached have earned division I football scholarships and several play football in the NFL. He recently published a cookbook entitled, From Crook to Cook. He recently released a 22 song gospel album.

Rapper Jay Z transformed himself from drug dealer to multi-millionaire entrepreneur. This transformation is even reflected in his wardrobe, from sagging pants to pulled up pants and suits. Rap is autobiographical journaling. On the Black Album he explains the connecting between his early drug dealing, womanizing and his father leaving the family. He stated:

"Now all the teachers couldn't reach me and my momma couldn't beat me hard enough to match the pain of my pops not seeing me, so, with that disdain in my membrane, got on my pimp game fuck the world my defense came. Then Dahaven introduced to the game, Spanish Jose introduced me to caine (Cocaine), I'm a hustler now,"

Years ago he wrote a song entitled, "Song Cry" about a woman that left him after he cheated on her. While he was sad he couldn't cry. Here are the lyrics.

"I couldn't see em falling down my eyes so I've got to let this song cry."

He kept writing and who would ever though he would begin his 444 album (released 16 years later) with these words, "Cry Jay Z Cry." This was in response to his nearly losing his wife Beyonce due to infidelity and his desire to transform his life to save his marriage and family. Years removed from drug dealing on the 444 Album he rapped of charity and legally building generational wealth.

In the beginning of his career, Oscar and Grammy winning rapper Eminem described himself as the "white Tupac Shakur." Their commonalities included, music genre, poverty, drug addicted mothers and absent fathers whom they hated. Like many youth I have counseled Eminem used marijuana, alcohol and other drugs to cope. He kept rapping (journaling) and his Relapse and Recovery Albums (released in 2009 and 2010) were transformational. He is now in long term addictions recovery.

Addictions counselors reading this post should be aware of the role creativity can play in recovery and be willing to incorporate a variety of mediums in their work with clients including art, music, movement, dance, poetry and journaling.

RECOVERY CELEBRATION AND ADVOCACY IN GHANA AFRICA

by Bill White, MA

The rise of an international recovery advocacy movement is, country by country, expanding the physical, psychological, social, and political space in which long-term personal and family recovery can flourish. Earlier posts have highlighted such efforts in Canada, the UK, the Islamic Republic of Iran, Australia, Japan, the Philippines, and East Africa. Today, we explore recovery advocacy in the Republic of Ghana in West Africa.

The Republic of Ghana, a nation of more than 25 million people and more than 40 languages, is located on West Africa’s Gulf of Guinea. Like countries around the world, Ghana has experienced significant alcohol and other drug problems. Rising from these problems has been a new generation of recovery activists addressing the needs of people seeking and in recovery from addiction. Leading this effort organizationally has been Recovery Africa, Inc., founded in 2014 after years of groundwork and support from the Hopeful Way Foundation and the sustained collaboration of people in recovery and professionals in the U.S. and Ghana. The Mission of Recovery Africa is to assist Ghana and other African countries in developing organizations that effectively address addiction to alcohol and other drugs across the arenas of prevention, treatment, and recovery support.

Recovery Africa has supported the development of a residential treatment center (The House of St. Francis), a medical detox facility, four Oxford Houses (including one for women), and the expansion of recovery support groups, including AA and NA groups and approaches that draw more directly on African traditions. Recovery Africa has also helped create the Recovery Ghana Consortium, provided addiction-related training to medical and service professionals, and sponsored educational exchange visits to Ghana by students in recovery from other countries. Efforts are underway to encourage development of employee assistance programs within Ghana’s growing commercial sector by linking businesses and recovery community organizations. All of these efforts have garnered support from the Government of Ghana. Support from the U.S. has been provided through relationships with Oxford House Inc., Faces and Voices of Recovery, Dot and John Mooney Foundation, and Healing Transitions as well as through visits by prominent U.S. recovery advocates.

Recovery Africa sponsors an annual recovery walk each year to celebrate recovery, stir hope among those still suffering from addiction, reduce stigma, and offer living proof that recovery is real! All proceeds from the walk support Recovery Africa’s continued efforts in peer-to-peer recovery support, recovery-focused public education, and recovery advocacy. Ghana’s first recovery walk was held in 2015, and more than 350 people participated in the 2018 walk held this past September in Accra with the theme United Against Stigma of SUDs (Substance Use Disorders). Included in the Recovery Walk were representatives from the Ghana Prison Service, Narcotics Control Board, Korle Bu Teaching Hospital, National Commission for Civic Education, other Ghanaian non-profit organizations, and rehab centers that provide treatment and recovery services for the local recovery community as well as local schools, youth groups, and churches. Also participating was Recovery Africa’s primary partner Hopeful Way Foundation and a number of representatives from the American recovery advocacy movement. Videos of the 2018 Recovery March can be viewed by clicking HERE.

If you would like to make a personal contribution to Recovery Africa to support the recovery advocacy work in Ghana, you may do so by clicking HERE. Even the smallest of donations will help expand needed recovery support resources.

The images below convey the spirit of that event and some of the messages conveyed to those observing the walk or seen through quite extensive media coverage of the event.

Acknowledgement: Thanks to Recovery Africa, Inc. Board Member Kristen Harper for providing photos from the 2018 Recovery Walk and to Dan O’Laughlin for sharing information on Recovery Africa and the Hopeful Way Foundation.

Implementing Cultural Competence in a Trauma Informed Setting for African-American Emerging Adults with Co-occurring Disorders

by Fred Dyer, PhD, CADC

The aforementioned title of this post reminds those of us who are working with African American Emerging Adults with Co-occurring Disorders, and/or those who desire to, that due to the early exposure of Adverse Childhood Experiences (ACE'S) and their impact psychiactrically, behaviorally and developmentally, when working with African Emerging adults it is necessary to be able to respond to the trauma in their lives in a culturally competent/sensitive manner.

 Laura Brown{2008} reminds us of the importance of cultural competence  in trauma informed care by stating that "Healthcare delivery of services for emerging adults  cannot be all inclusive without embracing, the need  for cultural competence/sensitivity, and even the best practices lack efficacy when culture is not incorporated as a trauma-informed solution. Additionally failure to bring cultural competence to the table can lead to missteps in genuinely helping African American emerging Adult trauma survivors or worse can result in deepening the wounds of trauma, creating secondary and tertiary traumas that are more painful than the original because they are appraised by victims and survivors as unnecessary wounds.

 As with other important topics time nor space affords the appropriate amount of time to discuss. However any discussion/treatment of trauma must and should include: Historical trauma and culturally competent/ sensitive practice parameters for healing historical trauma.

The following are a few principles for implementing culturally competent/sensitive trauma informed -care with African- American emerging adults with co-occurring disorders. 1. connect clients with resources they trust including types of professionals and traditional healers, 2. help clients to restore a sense of safety, 3. connect clients with elders who lived thru traumatic events and who managed trauma, discrimination, and setbacks, 4. remember it is important to ask clients "what the event means to them. It is clear that addressing cultural competency and utilizing cultural sensitivity in a trauma -informed setting with African - American emerging adults with co-occurring disorders is no longer an exception, but rather an expectation.

Let’s Create Our Own Holidays As African Americans in Recovery

Today is Columbus Day. Each year the Nation takes a day to celebrate a man who did horrible things. Christopher Columbus called the people he met in the "New World" Indians, because he was lost and thought he was in India. He never set foot on U.S. Soil. He landed in the Caribbean Islands and raped, robbed, pillaged and destroyed.

 How about celebrating Frederick Douglass Day as the first prominent American recovering alcoholic and leader of the Black Temperance Movement or Malcolm X Day? Malcolm had a religious conversion in prison and went from pimp, thief and addict to a leader of millions. While these two men are famous there are other lesser known hero's that are worthy of celebration such as Mother Hale, an African American women who mothered hundreds of children whose parents could not care for them due to cocaine addiction, heroin addiction or Aids. Hale's contribution includes a legacy of service which is so important to recovery.

Most celebrations in the country involve drinking and/or drug use including holidays, birthdays, anniversaries, weddings and graduations. Even funerals! African Americans in recovery can create celebrations of our own to reinforce recovery.

Salute to Black Grandparents: the Guardians of Children of Substance Using Parents

The African proverb, "it takes a village to raise a child" is exemplified by African American Grandparents when their own adult children are unable to take care of their children due to addiction, incarceration (often related to addiction) or mental illness.

Studies indicated that when raised by grandparents, grandchildren often report feeling loved. In addition, African American Grandparents often introduce their grandchildren to family rituals (family dinners), cultural rituals, history, constant and predictable routines, the adult protective shield, spirituality and God. All of these have proven to be substance abuse prevention protective factors.

Grandparents raising their grandchildren often lose their own personal freedom and the opportunity to enjoy the golden years. Many are economically poor and raise grandchildren who have often experienced neglect, abandonment and maltreatment due to parental addiction, mental illness, incarceration or a combination. This can be quite stressful. Some grandparents are raising their adult children and grandchildren simultaneously.

We owe black grandparents! I owe black grandparents. My grandparents became my caretaker the year addiction and incarceration impacted both sides of my family. I was bitter because I was not living with my parents and took my bitterness out on my grandparents (youth often demonstrated their frustration where they feel safest and most loved). This was my junior year of high school. The angrier I acted, the more loving my grandmother became. She was a saint, a praying grandmother! That year I failed 2 classes and my 2.0 grade point average dropped to 1.5. I demanded, in a harsh tone, that my grandfather give me money to pay for summer school. He said to me, "I'm not giving you anything! If you want to destroy your life, I'm not going to pay for it!" My grandmother overheard the conversation and with tears in her eyes said, "Give him the money. I love him" I understand the research that says that children raised by their grandparents often report feeling loved. That event was the catalyst which propelled my life forward.

I try to honor my grandmother by being successful as I can be. Each time I go to the barbershop I give the barber an extra $15 to anonymously pay for the haircuts of grandsons raised by grandmothers. What are some little things you can do to support grandparents raising their grandchildren?

Don'T Judge a Man Until You Have Walked a Mile in His Moccasins: Defending Richard Pryor

This morning I took a short trivia quiz online about the life of standup comedian Richard Pryor and read the comments about Richard Pryor by others who took the quiz. Most of these comments were negative. Examples:

"I don't like Richard Pryor."

"He swore too much."

"He was Vulgar."

"He was a drug addict. That's why he wasn't great."

As a child and adolescent I grew up in a family where there was drug addiction, alcoholism, domestic violence and corporal punishment. One of the few things that gave me relief back then, along with hope and laughter were Richard Pryor albums introduced to me by my father (thanks Dad!).

As I read comments about Pryor, the famous Native American Proverb came to mind, "You should never judge a man until you have walked a mile in his moccasins." Below is the comment I submitted.

"At the turn of the century Rolling Stone Magazine selected Richard Pryor as the greatest stand-up comic of all time. Richard grew up in a brothel and was sexually abused as a child. There is a strong link between childhood sexual abuse and addiction. Early in Pryor's comedy career a prominent comedian tried to convince Richard to "Stop swearing" and "Be completely clean" with his comedy routine. According to Pryor, "When I followed that advice I had a nervous breakdown on stage. I decided I needed to be true to myself. My comedy reflects the fact that I grew up with, thieves, hustlers, pimps and prostitutes."

It is important for us as addictions and recovery professionals to accept clients for where they are, i.e. stage of change, as people, (you are not what you have done) and their pathway/style of recovery.