Fred Dyer.png

Dr. Fred Dyer-Emerging Adults

We are happy to announce that Dr. Fred Dyer, a national expert on clinical practice with Emerging adults will author this exhibit on African American Emerging Adults with Substance Use Disorders. Emerging Adults are between the Ages of 18 to 25. Their development and clinical needs are different from adolescents and most report not feeling completely adult. Dr Dyer's content will range from blog posts, articles, thoughtful quotes and clinical tips. Scroll below to read his posts. Dr. Dyer can be reached at 773 322-8425 or dyertrains@aol.com

Developing Resilience in African American Emerging Adults Who Are At Risk for Substance Use Disorders: A Focus On Meaning and Purpose

 Given the multiple risk factors for heavy substance use which impacts many African America Emerging Adults, ranging from easy access to drugs, poorly performing schools, father hunger, the presence of gangs within communities,early criminal justice involvement and discrimination, how  can those of us who are committed to working with this population assist them in living  a drug free life? The answer is to help African American Emerging adults at risk for a substance use disorder develop resilience. There are many definitions of resilience.  Garbarino (1999) says that resilience is more than outside success, more than graduating from high school, staying out of jail, or holding a job. It also means developing a positive sense of self, a capacity for intimacy, and a feeling that life is meaningful. According to Walsh (2016) resilience can be defined as the capacity to rebound from adversity, strengthened and more resourceful. It is an active process of endurance, and growth in response to crises and challenges.

 There is a Japanese belief that everyone has the DNA, the trait and the cells to be resilient, and that resiliency must be practiced, developed and controlled (Bell and Suggs, 1998). Wolin and Wolin (1996) lists 12 characteristics of resilience. From their list the one which I believe encapsulates the remaining 11 is having a goal to live for which gives life meaning and purpose. Helping African Emerging Adults identify Meaning/purpose is a protective factor from developing a substance use disorder. Even with the presence of risk factors including poverty, discrimination, family alcohol and drug use etc., purpose can help them to thrive in the midst of risk. To help African American emerging adult clients tap into purpose I ask them a range of questions. How did you survive that? How have you been able to endure so much? What are your previous life challenges preparing you to do with the rest of your life? Does the challenges you have faced help create a mission for you? What is your life purpose? What are some steps you are willing to take today towards that purpose?

 Resources

 Bell, C., Suggs, H., (1998). Using Sports to Strengthen Resilience in Children: Training Heart. Child and Adolescent Psychiatric Clinics of North America. Volume 7, Issue 4, October 1998, Pages 859-865

 Garbarino, J., (1999). Lost Boys: Why our Sons Turn Violent and How We Can Save Them. Anchor Books. New York, NY.

 Walsh, F., (2016). Strengthening Family Resilience. Guilford Press. New York, NY.

 Wolin, S., Wolin, S., (1996). The Resilient Self: How Survivors of Troubled Families Rise Above Adversity. Random House. New York, NY.

Risk Factors for Substance Using African American Emerging Adults: Early Use of a Substance in Adolescence                                                            Leads to Abuse of the Substance in Emerging Adulthood

Often times substance use among African American Emerging is not considered within the context or background of adolescent development, and or peer group affiliations. The risk factor of adolescent substance use and expectancies which can impact on African American emerging adult use must be considered in prevention, treatment, family engagement as well as relapse prevention strategies. Consistent evidence suggests that those who use a given substance during adolescence are more likely to use and have problems with the use of the same substance as young adults. This is supported  by research on alcohol use{Floy, Lynam, Leukefield, and Clayton, 2004}.In a study  examining early adolescent substance use in relation to subsequent young adult substance use disorders, Gil et al. 2004} found that young adult  substance users began  using substances in early adolescence. Adolescents with alcohol -using peers  may be more  likely to belong to an early drinking trajectory into young adulthood, which in turn can lead to increased dependence. The important part here for those who have a passion and commitment to working effectively with African American Substance using Emerging Adults is to remember that before they entered into the journey of emerging adulthood many may not have completed the ongoing struggles of adolescence.

RACE, POVERTY AND OTHER RISK FACTORS FOR EMERGING ADULT SUBSTANCE USE DISORDERS

One could spend hours upon hours listing and debating risk factors for substance use among African American Emerging Adults. For the purposes of this blog the writer will cite just a few. The first risk factor for substance use is Race/ethnicity. A number of studies support an association between race/ethnicity and young adult substance use outcomes. One of the most commonly observed associations is an increased risk of alcohol use or problem use among White young adults {Arria et al., 2008: Gil et al., 2004. In addition to finding increased risk for Caucasians, Gil, Wagner, and Tubman[2004 also found increased risk of experiencing a variety of substance  use disorders in young adults for other race/ethnicity groups, particularly if they transition from abstaining in early adolescence  to regular use in young adulthood.

Another risk factor for substance use among African American emerging adults is poverty. Interesting poverty is sometimes {non-intentionally} left out of the conversation, when in this writers mind poverty should always be discussed. Regardless of the terms used. Whether it’s SES, or the Working poor, or abject poverty, poverty is a risk factor for alcohol and drug use, for violence and for mental health problems. The work of Bell and Jenkins, 1992 reminds us of the significance of poverty when discussing adolescent violence. Poverty interferes with an individual’s self concept and self esteem.  Family substance use history is also a risk factor for use as well. There is substantial  evidence that individuals  who are children of alcoholics are at an increased  risk  of heavy alcohol use, binge  drinking{Chassin et al.,2002,2004} or having an alcohol use disorder during their young adult years{Alati et al., 2005: King & Chassin, 2007} Siblings of young adults may also play a role  influencing young adult alcohol use behaviors. Research has found that alcohol use in young adulthood {mean age 25} was predicted by an older siblings use when they were in emerging adulthood. This was found to be true when the siblings were close in age.

Understanding Risk and Protective Factors for African American Substance Using Emerging Adults. {A Series}

In the understanding and developing of treatment planning , and for relapse prevention, it is imperative that those working with this population have some basic , but important tools/information in their tool box. At the outset it is necessary to remember the essential work of Urie Brofenbrenner who in the 70's introduced us to looking at and examining  behavior thru a systems lens, and which social workers had long since practiced. The African American emerging adult must navigate themselves through a macrosystem, an exosystem, a mesosystem, and a microsystem, and it is important to keep in mind that each system can and does impact on them and influences their risk for using, treatment compliance, as well as retention. This series will look at prevention Science as it relates to African American Emerging Adults, as well as the risk and protective  factors African American substance using emerging adults. 

There is a question which some may ask, and the question is a fair one. Which is, why review or focus on risk and protective factors for African  American Adults? The answer is that, not only is Emerging Adulthood an important developmental characteristic {which is considered the ages of 18-26} but it is also an important development characterized by peak  prevalence of substance  use problems, and problems related to use, which can set the stage for later  adult development. Lastly the Four top causes of death for Emerging adults are 1. Accidents, 2. Homicides, 3. Poisons/suicides, and 4. Substance Use. Consider the causes of death, then consider the lost of all that potential.  

The Importance of Identity Issues for African American Emerging Adults

In an article  by Jeffrey Arnett and Gene Brody titled  A Fraught Passage : The Identity Challenges of African American Emerging Adults. The aforementioned authors offer a much needed discussion regarding the identity challenges of African Emerging Adults, and how they face many of the same challenges of identity explorations as other emerging adults do. However  for African American emerging adults their identity explorations are complicated by the fact that these explorations are taking place within a society they perceive as possessing negative assumptions about them{Way,Santos,Niwa,& Kim-Gervey 2008}. Accoording to Erikson{1950} forming  a stable identity takes  place through assessing one's abilities and interests, reflecting on the persons one has admired in the  course of earlier development, and then trying  to find a match between one"s desires and goals  and the opportunities offered by society. But what if the range of opportunities is restricted due to racial prejudice. For  African American emerging adults, the challenge  is not just to sort out their own assessments of who and what they wish to be but to reject and overcome the negative stereotypes that others hold of them.

Emerging adulthood is the key period  for confronting these issues, not only because this is  when most people begin to move toward making enduring choices in love and work, but because this is the period when most move  further beyond the immediate social social world of family, friends, and neighborhood and into the larger society{Phinney,2006}.

African American Emerging Adults and Mental Illness

Mental illness affects 25-30% of adults ages 18 years and older in the United Sates in a given year {Kessler,Chiu,Demler,et,al2005}. Of those individuals , about 41% fail to utilize mental health services{Natioanl Institute of Mental Health, 2006} Studies show that factors such as race [being Afican American} and age and being between the ages of 18-29 or an emerging adult are associated with decreased  rates of mental health service utilization when compared to Caucasian emerging adults .

Additionally studies show when diagnosed with mental illness. African American adults 18 and older utilize outpatient mental service at only half the rate of their Caucasian counterparts{Davis&Ford,2004, Snowden&Yamada, 2005}.