Cultural Coproduction in Recovery Science: A Conversation with Mark Sanders

By billstaufferpa on August 13, 2025

The Frontiers of Recovery Research Interview Series – William Stauffer

What is this series of interviews?

In April of 2024, I had the distinct honor of being asked by William White author and thought leader of the new recovery advocacy movement to present his words as the keynote to open up the first annual NIDA Consortium on Addiction Recovery Science (CoARS) conference. The paper was titled Frontiers of Recovery Research. It is one of his most important writings. It should serve as a blueprint for the future of recovery research in America. One of the challenges we have suffered for at least the last six decades is a deficit focus in respect to addiction treatment and recovery research instead of a recovery orientation. His paper properly orients future research efforts on long term recovery and resiliency. To that end, I have decided to do interviews with key thought leaders on recovery research across the 12 domains that Bill White delineated in his 2024 paper. One of the first people I thought to interview was Mark Sanders. He has taught me a great deal about recovery, particularly in respect to recovery in African American communities.

Who is Mark Sanders?

The first time I had heard about Mark Sanders was when, as the executive director of PRO-A, the statewide RCO of PA,  I was preparing for Black History month in 2013. I wanted to highlight the history of recovery within African American communities in our quarterly recovery newsletter. I quickly found his Online Museum of African American Addictions, Treatment and Recovery. It is easily the most comprehensive history of African American recovery and the contributions of African Americans to recovery efforts ever compiled. It is an invaluable resource for scholars and practitioners and without Mark Sanders, much of this history would be lost forever. He has contributed so very much to what we know in ways that will benefit us for generations to come.

Mark Sanders is a licensed clinical social worker and a person in long term recovery for the last 43 years. He lives in Chicago and as an international speaker, trainer, and consultant he has reach thousands of people across the United States, Europe, Canada, Caribbean, and British Islands. He co-founded the Serenity Academy of Chicago, the first recovery high school in Illinois and was the past president of the board of the Illinois Chapter of NAADAC. He has taught at the University of Chicago, Illinois State University, Illinois School of Professional Psychology, and Loyola University of Chicago, School of Social Work.

As a writer, he has authored several books including Slipping through the Cracks: Intervention Strategies for Clients Multiple Addictions and Disorders (2011) and Substance Use Disorders in African American Communities: Prevention, Treatment, and Recovery (2013) and has had stories published in the New York Times bestselling book series Chicken Soup for the Soul. He is the recipient of the Lifetime 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. In 2021 he was honored by the Community Behavioral Healthcare Association of Illinois, Frank Anselmo Lifetime Achievement Award.

Mark, what are your thoughts on the opportunities to expand recovery research in respect to pathways and styles of recovery across diverse communities?

Let’s start with some basics. It matters a great deal what questions we ask, and also how those questions are developed.  When doing research in diverse communities, if we ask the wrong questions the findings may be irrelevant. To assure relevance it might be helpful whenever possible to include researchers or research assistants indigenous to the community involved in formulating research questions, interviewing participants, interpreting research results and recommending clinical approaches based in the findings.

There is a basic assumption that clinical models not developed within communities of color are automatically ineffective with members of diverse communities. At a seminar on culturally responsive therapy, Dr. Carl Bell, the prodigious author and American professor of psychiatry at the University of Illinois at Chicago, was asked if the work of Sigmond Freud on psychoanalysis was culturally relevant to African American communities. Dr Bell reflected on the question and responded by saying, “In the hands of a culturally responsive therapist, any model has the potential to be culturally responsive. Especially when integrated with the needs of the cultural group in mind. I am also reminded of when a young Gladys Knight first performed in Las Vegas, and she met with the legendary Sammy Davis Jr and asked him how she should sing the songs she was set to perform. He told her she would be magnificent, and to make every song she sang her own, to sing those songs in her own way.

This is a vital concept in consideration of how we apply or consider any interventional or evidence-based treatment in African American communities, in Latino / Hispanic Communities or in First Nation or Native American Communities. It gets to the heart of that paper and keynote speech that he asked you to present at the opening of the NIDA Consortium on Addiction Recovery Science conference last year, Frontiers of Recovery Research which emphasizes coproduction and authentic collaboration with the community. If heeded by our field, it would positively shape research on addiction recovery over the course of the next generation and beyond it to successive generations to come. We should do so. Bill White calls for coproduction of research and interventional strategies with the recovery community across those 12 domains of the Definition & Measurement of Recovery,  the Neurobiology of Long-Term Recovery, Incidents and Prevalence of Recovery, Resolution and Recovery Across the Severity Spectrum, Pathways and Styles of Recovery Across Diverse Geographical / Cultural / Religious Contexts and Clinical Subpopulations, Recovery Across the Lifecycle, Stages of Recovery, Social Transmission of Recovery, Family Recovery, Recovery Management & Recovery Oriented Systems of Care, New Recovery Support Institutions, Service Roles and Recovery Cultural Production and Flourishing / Thriving in Recovery. This paper is a blueprint for how we should proceed moving forward. The coproduction facet is vital, and just as Dr Bell noted about Dr Freud’s work and what Sammy Davis Jr said to Gladys Knight years ago in Las Vegas, to be effective efforts require us to expand the coproduction and representation of our communities in a myriad of ways across all of our diverse communities.

There are several evidence-based practices which can be utilized in culturally responsive manners. One such approach is Feedback Informed Treatment (FIT) pioneered by Scott Miller. Miller and his colleagues. They created a session rating scale, a tool used to receive immediate feedback from clients at the end of each session. These studies reveal that incorporating client feedback increases retention and outcomes. It can be adapted to include questions centered around cultural feedback from clients, such as:

• Does your family or culture have a perspective on heavy substance use or addiction?

• From your cultural perspective, how is addiction defined?

• From your cultural perspective how are individuals with addiction viewed?

• From your family or cultural perspective what causes addiction?

• From your cultural perspective, how is addiction addressed?

• Does your family or members of your cultural group have a perspective on counseling?

• In our session today, what worked?

• What didn’t work?

• If we continued to work together what are some things you would like to occur in future sessions in order to feel the meetings are worthwhile?

• What would make you feel more comfortable when discussing difficult subjects?

• Who do members of your family or cultural group turn to during difficult times?

• Should these individuals be included in future sessions?

• From your cultural perspective, are drug related problems considered individual, family or community problems?

• Based upon your perspective of family, who should be invited to future sessions?

• Is there a role for religion or cultural practices in addressing drug use challenges?

• Is there anything else about your culture that is important for me to know in order to be most helpful?

• I have asked you many questions, do you have any questions to ask me?

The above questions illustrate that it is possible to incorporate cultural feedback from clients in SUD counseling. I am reminded of a psychiatrist working with an African American client who was experiencing schizophrenia and alcoholism. He asked some of the questions above and learned that in the client’s faith-based community, there was a belief that the causation of addiction and mental illness was demon spirits, and the resolution involved prayer with the laying on of hands. Empathy was established and rapport created as the psychiatrist and client listened to and received feedback from each other. Ultimately the treatment plan included medication, counseling, case management and participation in Alcoholics Anonymous along with client church attendance where he received prayer and the laying on of hands. The lesson here is that if we want evidence-based approaches to work, it can be helpful to receive and incorporate culturally responsive feedback into the approach.

Another evidence-based practice that lends itself to cultural responsiveness is Motivational Interviewing. It can be utilized in ways that are effective in working with African American communities, Latino / Hispanic Communities, First Nation or Native American Communities and beyond. Motivational interview calls for counselors to stay with clients where they are at. The approach allows the client to lead as the counselor walks along side of the client in the change process and when resistance occurs the client is likely to be told by the clinician, “it’s up to you.” This client centered approach can be empowering for clients of color who have often experienced generational systemic oppression and racism where their voice and will were taken away. Heavy handed strategies and strategies which make the counselor the expert on the clients life will often be met with much resistance. One must stay inquisitive and open to possibilities and to explore doors of healing collaboratively and from the client’s perspective. There is a book, Motivational Interviewing for African Americans A Culturally Responsive Guide for Practitioners that can be really helpful in considering how to use motivational interviewing in the spirit of what Sammy Davis Jr told Gladys Knight years ago. The key is to utilize the practice in a way that it is relevant and resonates with members of these communities. When clinicians are culturally responsive, they make the approach their own in order to meet the needs of clients. Future research should focus on the outcomes of integrating culturally responsive evidence-based practices. Click here to continue reading.

Source: https://recoveryreview.blog/2025/08/13/cultural-coproduction-in-recovery-science-a-conversation-with-mark-sanders/

A Historical Event!

On July 31, 2025 history was made when Dr. Olykunbi Oyedele launched the first annual conference on Trauma, Mental Health and Substance Use sponsored by Living Vines Mental Health Foundation, an organization founded by Dr. Oyedele to address the intersection between trauma, mental illness and substance use disorders in Nigeria.

This informative conference was historic in that this was the first major conference which primarily featured African American and Nigerian speakers. In order for members of the African diaspora to heal historical trauma, the root cause of many of our mental health and substance use challenges, collaborations across the Atlantic Ocean between African Americans (the descendants of the European slave trade) and Africans living in the Motherland will play an important role in that healing. 

African Americans bring to the table knowledge of evidence based practices and peer based recovery support and our brothers and sisters in Africa bring a great awareness of African cultural practices and the teachings of the ancestors. This combination when integrated could ignite healing and recovery worldwide.

The conference was particularly inspiring given current tensions between African Americans and Africans. A biproduct of the psychological impact of colonialization. Onward!!

Interview With Kenneth Ginlack, author of the book Motivational Interviewing for African Americans

1. What was your motivation for writing a book on Motivational Interviewing With African Americans?
   My motivation came from years of watching clinicians try to use Motivational Interviewing in ways that did not align with the cultural realities of the clients they served. MI has deep value, but the way it was originally taught often overlooked the lived experiences, language, and historical trauma of African American communities. I wanted to create a resource that acknowledged these realities while remaining true to the clinical core of MI. This book is about making space for what has always been present in our communities.

2.  What are you hoping readers get from reading the book?
   I hope readers walk away with a deeper understanding of how MI can be practiced in culturally responsive ways. I want them to feel more confident and more connected. Whether you are new to the field or deeply experienced, this book invites you to reflect, to listen differently, and to build trust with intention and care.

3.  How can Motivational Interviewing be utilized for counselors who work with African Americans with substance use disorders, who are often court-mandated to treatment?
   It starts with building trust. Many African Americans enter mandated treatment carrying a long history of being misunderstood or overlooked. MI gives us a way to break that cycle when it is practiced with humility, presence, and real connection. Counselors can use MI as a way to meet clients with respect, to honor their ambivalence, and to offer a path toward change that feels authentic and collaborative rather than forced or imposed. We must be present in a way that affirms their value and voice.

11 Influential Black Americans Who Shine a Light on Addiction and Recovery

Recovery Stories

Latest UpdateDec 19, 2024

Black Americans have made invaluable contributions to reshaping the understanding of mental health, addiction, and recovery, offering holistic and inclusive perspectives that challenge conventional norms.

From groundbreaking research to impactful policy reforms, their work spans fields such as psychiatry, therapy, public policy, music, and athletics. These individuals bring unique insights born of lived experiences and professional expertise, fostering progress in addressing substance use disorders and mental health challenges.

This list celebrates the achievements of some of these trailblazers who have driven transformative change in addiction recovery. Their efforts deserve recognition not only during Black History Month but every day of the year.

Michelle Alexander, J.D.

Michelle Alexander is a civil rights lawyer, writer, and scholar whose groundbreaking book, The New Jim Crow: Mass Incarceration in the Age of Colorblindness, examines the intersection of racial bias, drug policies, and the criminal justice system in the United States.

Her work exposes the deep inequities faced by Black and Hispanic communities due to disproportionate drug-related arrests and incarcerations.

“It’s not enough to end the drug war,” Alexander asserts. “We must also repair the harms caused by it.”

Her writings in The New York Times and other publications continue to spotlight systemic injustices and advocate for comprehensive reforms.

Chaney Allen

Chaney Allen broke barriers as the first Black woman to author a recovery memoir, I’m Black and I’m Sober: The Timeless Story of a Woman’s Journey Back to Sanity. Beyond her literary impact, she founded pivotal organizations like the California Black Commission on Alcoholism and the California Women’s Commission on Alcoholism.

Through the Alcoholism and Counseling Education Center, Allen trained counselors to support minorities struggling with alcohol use. Her legacy includes organizing two rehabilitation houses and a women’s detox center in Cincinnati, which now bears her name.

Carl Bell, M.D.

Dr. Carl Bell was a leading psychiatrist, educator, and mental health advocate whose work profoundly influenced addiction research and treatment.

As a prolific writer for the National Institute of Mental Health, he authored over 450 publications on topics including addiction, co-occurring disorders, fetal alcohol syndrome, and social determinants of health.

His career spanned roles as a professor of psychiatry and public health at the University of Illinois at Chicago, focusing on systemic challenges affecting Black communities and youth.

Following his passing in 2019, tributes from health professionals and scholars, including one from the U.S. National Library of Medicine, celebrated his enduring legacy.

Claude Brown

Claude Brown’s influential novels Manchild in the Promised Land (1965) and The Children of Ham (1976) captured the devastating impact of the mid-20th-century heroin epidemic on Black teenagers in Harlem.

Written during his time at Howard University, Manchild is widely regarded as a classic of American literature. The New York Times praised its raw, honest portrayal of poverty, drug abuse, and violence, describing it as “fierce, uproarious, obscene, and tender.”

Upon his death in 2002, The New York Times reflected on Manchild as a “classic of American literature,” underscoring Brown’s enduring influence in addressing the socioeconomic roots of addiction.

Frederick D. Harper, Ph.D.

Frederick D. Harper’s groundbreaking work on historical alcohol problems among Black Americans remains a cornerstone of addiction studies. His 1976 book, Alcohol Abuse & Black America, explored the societal and cultural dimensions of substance use during a time when modern treatment approaches were emerging.

Harper also contributed deeply to understanding happiness, psychotherapy’s future, and the hierarchy of human needs through his prolific writing and research.

John Lucas II

John Lucas II, a former professional basketball player and current player development coach for the Houston Rockets, has been a powerful advocate for addiction recovery within professional sports.

A recovering cocaine addict, Lucas has spent over three decades supporting NBA players suspended under the league’s substance use policies.

He authored the NBA’s drug policies, developed counseling programs in NBA and NFL cities, and shared his journey in his book, Winning a Day at a Time.

Maxie Clarence Maultsby Jr., M.D.

Dr. Maxie C. Maultsby revolutionized addiction and psychotherapy treatment through his development of rational behavior therapy, emphasizing emotional and behavioral self-management.

By integrating neuroscience into cognitive-behavioral therapy, Maultsby created short-term techniques with long-lasting effects in clinical therapy. His pioneering work on emotional self-help solidified its place in scientific and therapeutic communities.

Jacki McKinney, M.S.W.

Jacki McKinney, a survivor of trauma, addiction, and homelessness, dedicated her life to advocating for African American women and trauma survivors. As a consultant to the Center for Mental Health Services, she addressed issues like seclusion, minority representation in public mental health, and intergenerational family support.

Her advocacy earned her the Clifford W. Beers Award from Mental Health America and a Lifetime Achievement Award from the Substance Abuse & Mental Health Services Administration’s Voice Awards program.

Lonnie Edward Mitchell, Ph.D.

Dr. Lonnie Mitchell was a trailblazer in the field of addiction treatment and workforce development during the 1980s. As the director of Washington’s drug and alcohol treatment agency, Mitchell played a pivotal role in the establishment of the National Institute on Drug Abuse (NIDA), focusing on the training and credentialing of a primarily “ex-addict” workforce.

His work helped shape the professional landscape of addiction care and counseling by training medical professionals and social workers to meet the growing demands for addiction services.

Mitchell also contributed to the academic community as a professor at Howard University’s medical college, where he served as deputy director of the Center for Youth. He passed away in 1997, leaving behind a lasting legacy in the field of addiction treatment.

Mark Sanders

Mark Sanders is a respected educator and author whose work focuses on African American male substance abuse and individuals with multiple addictions and disorders. His book Treating the African American Male Substance Abuser and his contribution to Substance Use Disorders in African American Communities are integral text in the field.

Sanders is also the founder of the “Online Museum of African American Addictions, Treatment, and Recovery,” which was launched in 2016 to preserve and share vital research. His efforts to educate and provide intervention strategies for those with addiction challenges have made him a key figure in the development of culturally competent treatment approaches.

Read more about his work and contributions in an interview with the Addiction Technology Transfer Center Network.

Wilma Townsend

Wilma Townsend was a pioneering leader in the recovery movement, known for her dedication to cultural competence and improving access to care for people of color.

As a Public Health Analyst at the Center for Mental Health Services and a board member of the National Leadership Council for African American Behavioral Health, Townsend was instrumental in advancing recovery-oriented behavioral health care.

Her advocacy also expanded peer-based recovery support services, improving the quality of care for underserved communities. Townsend authored influential books such as Emerging Best Practices in Mental Health Recovery and Consumers in the Mental Health Workforce: A Handbook for Community Providers, which have been widely adopted to improve mental health services.

For a more comprehensive list of Black Americans who have significantly contributed to the field of addiction and recovery, visit MuseumofAfricanAmericanAddictionsRecovery.org/pioneers.

Recap: Addressing Addiction Through a Holistic Lens

The work of these trailblazers has significantly shaped the understanding and treatment of addiction, especially within marginalized communities. The intersection of race, mental health, and substance use has highlighted the need for culturally competent, inclusive treatment models that recognize the unique experiences of Black Americans.

We emphasize a holistic approach that combines medical detox, CBT, and peer support, addressing both the neurological and social factors that contribute to addiction. Our programs are designed to provide comprehensive care that incorporates the cultural nuances of each individual, helping them recover and thrive.

As addiction continues to be a growing public health issue, understanding the social determinants that influence substance use—such as poverty, systemic racism, and lack of access to healthcare—is vital in creating more effective and inclusive treatment solutions. Research consistently shows that addressing these factors within addiction treatment leads to better outcomes for individuals in recovery.

By celebrating the contributions of Black Americans to addiction research and recovery, we honor their legacy and continue to build a more inclusive and effective system of care.

Source: https://www.sunriserecoverycare.com/11-influential-black-americans-who-shine-a-light-on-addiction-and-recovery/

Mental Health Recovery Month: A Need For Advocacy In African American Communities

In Early May I drove past the former Community Mental Health Council on the South Side of Chicago, founded by President and CEO Dr. Carl Bell (October 28, 1947-August 2, 2019) and saw that the building was boarded up. The program closed in 2012 following state audits. I parked my car to pay homage for the culturally responsive services provided there and the program’s great psychiatrist Dr. Carl Bell.

Seeing the building boarded up, I reflected on the wonderful contributions of the program’s President and CEO Carl Bell, MD. Dr. Bell was seen by many in the community as a genius and advocate for African American Mental Health. I viewed him as a true innovator. A modern day, African American Sigmund Freud! Clients and patients receiving mental health and addictions services there made progress.

Dr. Bell graduated from Meharry Medical School and did much of his groundbreaking work as a psychiatrist in Chicago. Instead of focusing on African American pathology, much of Dr. Bell's work focused on African American strengths and mental health protective factors. In addition to leading Community Mental Health Council, Dr. Bell was Director of Illinois Institute For Juvenile Research (the birthplace of child psychiatry) and on the faculty of the University of Illinois/Chicago. Dr. Bell published nearly 600 journal articles and was the author of several books on mental health in African American communities. He did cutting edge research on how community violence impacts academic performance of Black children and offered numerous behavioral health and public health intervention strategies. Dr. Bell was appointed to Dr, David Satcher's Surgeon General’s work group on mental health, culture, race and ethnicity. He is the recipient of numerous national psychiatry awards. In 2017 Dr. Bell was inducted into the Museum of African American Addictions Treatment and Recovery Hall of Fame as a result of his innovative strategies for addressing Fetal Alcohol Syndrome in Black communities.

In summary, Dr. Carl Bell was an accomplished Statesman! If ever there was ever a program worthy of remaining open while addressing what was reported in state audits, it was Community Mental Health Council. At the same time Community Mental Health Council closed, Mayor Rahm Emanual closed nearly all of the mental health facilities in Chicago which serve Black communities. Was this happenstance or part of a strategic plan? Given the fact that today, White led mental health facilities are expanding into Black communities in Chicago, while black led agencies are becoming extinct leads me to conclude that this is part of a racist agenda. When mental health facilities close jails and prisons become the center of mental health treatment.

During Mental Health awareness month I am calling for a new mental health advocacy movement to address racism in mental health treatment and disparities. Advocacy has played a major role in African American liberation the past 400 years. Now we can apply what we have learned about advocacy to mental health.

Black Don't Crack on the Outside. It Sure Cracks on the Inside! (Racism as a contributing Factor)

The three photos of rapper MC Lyte taken between ages 20 to 54 were posted on Facebook and the most common response by thousands of followers were, "She looks younger at age 54. It’s the melanin in our skin that keeps us looking so young. Black don't crack."

While Black might not crack on the outside, studies by the Center for Disease Control (CDC) suggests that black can crack on the inside and racism is a major culprit! According to the CDC, racism contributes to physical and mental health disparities among African Americans. Racism increases rates of cardiovascular disease, obesity, heart disease, high blood pressure, inflammation, asthma, depression, anxiety disorders, eating disorders, psychosis, other chronic medical conditions, and premature death (CDC 2019 research review).

Substance Use as Medicine

Many African Americans use alcohol and other drugs to cope with racism which produces medical complications of its own, including premature death.  Below are other ways of coping and thriving.

Coping and Thriving

Below are ways African Americans have been able to thrive in the midst of racism. While each method may not work for everyone, perhaps you can find what works for you.

• Having a tribe to talk with about racism. This can include an inner circle of other African Americans whom you don't feel the need to censor your words. This tribe listens non-judgmentally and you benefit from the me too experience when you talk with them.

• Social Activism. Studies by a Harvard sociologist found that tragedies like the murder of George Floyd can impact the mental health of the entire Black community and community activism can serve as a mental health protective factor.

• Seek Therapy. Preferably from a culturally responsive therapist. Studies show that African Americans stay in therapy longer when working with Black therapists and they make more progress.

• Strengthen Racial Identity. Studies indicate that African Americans who have a positive racial identity are more likely to have greater self-esteem, fewer symptoms of depression and are less likely to internalize racism. 

• Reading and Writing. Reading books about African Americans who have thrived in the midst of racism can be helpful. Some African Americans have used racism as fuel for greatness and history making! This includes: Harriet Tubman, Frederick Douglass, W.E.B. Dubois, Jackie Robinson, Jessie Owens, Angela Davis, Dr. Martin Luther King Jr., Coretta Scott King, Shirley Chism, Rosa Parks, Malcolm X, President Barack Obama, Michelle Obama. Journaling about your experiences with racism and your methods of coping with it can also be helpful. It you journal enough; your writings could one day become a book which could help others.

• Humor. Laughter is good for the soul! Listening to your favorite comedians during racially trying times can be quite helpful.

• Creative Outlets. The book My Grandmother’s Hands highlights how racialized trauma lodges itself within black bodies. Somatic experiences such as movement and dance can remove some the trauma from the body. Music from blues to hip-hop has helped African Americans deal with racism and thrive.

• Spirituality and Religion. Many African Americans find church fellowship, community, worship, and prayer helpful in coping with a racist society. Others find spiritual practices such as walking in nature, meditation, and mindfulness practices to be quite helpful as well.

Overdose Mortality Is Trending Down, but the Story is Different for Elder Black Men

by Michael Abrams

Overview

Preliminary data indicates that overdose mortality declined significantly in 2024, with one exception, elder Black men. One 2022 study found that deaths among Black men aged 19-30 years are expected to decline by 9 percent in 2025 relative to 2020, while deaths among Black men aged 31-47 years are expected to rise by 11 percent.

After years of sharp increases in drug overdose deaths nationwide, the tide began to turn in 2022 and 2023, and preliminary data now indicates that overdose mortality declined significantly in 2024. The reasons for this decline are a matter of ongoing research and debate. While law enforcement agencies have claimed increased operations against fentanyl are responsible, public health researchers have shown that the decrease actually started before many prominent enforcement actions against fentanyl imports. Those experts instead point to local public health interventions that have increased the availability of overdose reversal medications, drug testing supplies, and medications for opioid use disorder.

Still, a national average only tells part of the story. A recent joint investigation by the New York Times, the Baltimore Banner, and several other local newsrooms reveals one pattern that diverges from the larger narrative: across various localities, elder Black men face increasingly disproportionate rates of overdose deaths. The pattern was detected across 10 cities, including Baltimore, Chicago, San Francisco, Newark, Washington D.C., Milwaukee, and Philadelphia. No similar pattern exists among the white population, for whom drug overdose deaths are more evenly distributed across age groups, with some heightened concentration in younger age groups. Click here to keep reading.

Source: https://www.networkforphl.org/news-insights/overdose-mortality-is-trending-down-but-the-story-is-different-for-elder-black-men/

Jazz Music is Better Medicine for Black Rage Than Drugs

Ella Fitzgerald    Louis Armstrong      Billie Holiday       Frank Sinatra

In 1961writer and civil rights activist James Baldwin said, “To be Black in this country and relatively conscious is to be in a state of rage almost all of the time.”

Historically, African Americans have paid a high price for speaking out against the oppression, racism, and discrimination they have experienced in the United States the past 400 years including: whippings, lynchings, house burnings, forced exile to other countries, FBI and CIA surveillance, police brutality and murder, discrimination and firing in the work place.

Having to suppress feelings connected to these horrific, catastrophically traumatic experiences leads to rage which can be medicated with the use of alcohol, heroin, marijuana and other drugs. The use of drugs as medicine increases rates of community violence, arrests, felonies and high overdose rates. While opioid overdose rates have decreased in many middle class to affluent white communities they still remain high in African American Communities (DPH Report. Massachusetts, 2023).   

With its smooth harmonies, jazz music also has medicinal qualities, without the heavy consequences of drug use. Studies indicate that jazz music reduces stress and depression, improves sleep, elevates mood, lowers blood pressure and increases creativity (Benefits of Listening To Jazz: Riddle Village, 2021). Dr. Cornell West says, Jazz music increases hope and optimism!

While several famous Jazz performers died of complications caused by drug use including Billie Holliday whose addiction was triggered by childhood trauma and Charlie Parker, many of the greats entered recovery and continued to inspire the world with their music. A partial list of the greats in recovery include: Natalie Cole, Ivan Neville (and several other members of the Neville family), John Coltrane, Ray Charles and his daughter, singer Sheila Raye Charles.

My barber of 40 years the late Sidney Terrell was in long term recovery from heroin addiction. When I would ask him his pathway of recovery he would say, “Jazz music and working all day as a barber.” In the 40 years he cut my hair, I don't ever remember a time when you didn't hear the songs of the Jazz greats being played in the barber shop. I always remember leaving the barber shop feeling relaxed. April is Jazz Music Appreciation Month. I dedicate this post to my barber, Sidney Terrell.

Rock and Roll Hall of Fame Inductees Run-DMC sang, Music is the key to end all our woes, your ups your downs, your highs and your lows. Music has always been a part of the fight for African American liberation from blues through Hip Hop. During active addiction, many African Americans move away from music as their addiction progresses and they often embrace music again in recovery. If you are celebrating another day of recovery, join me in listening to some music today, including some smooth Jazz!

Dr. Martin Luther King Jr. Day of Service Event: A Reminder of How Recovery Oriented Systems of Care (ROSC) Align with King's Vision by Mark Sanders, LCSW, CADC

On January 15, 2025, Healthcare Alternative Systems (HAS) and the Westside Heroin and Opioid Taskforce hosted a Day of Service event on the West Side of Chicago to honor and make a commitment to Dr. King's legacy of service. The event was a reminder of how a ROSC beautifully aligns with Dr. Kings words and vision.

Dr. King encouraged cultural groups to work together to accomplish common goals. The two sponsoring organizations of this annual event were HAS and the West Side Heroin and Opioid Taskforce. This partnership exemplifies part of Dr. King's vision of working together for common causes across cultures. HAS specializes in providing bilingual and bicultural treatment and recovery services for Hispanic communities and the West Side Heroin and Opioid Taskforce provides harm reduction services for African American communities.

Present at the event were individuals and organizations representing the components of a comprehensive recovery oriented system of care. A ROSC is a network of clinical and nonclinical services and supporters which work together to support community based recovery. In attendance were: certified addictions counselors, harm reduction outreach workers, recovery coaches, clergy, people in long term recovery, politicians, employment specialists, crisis workers, mental health specialists, medical doctors, recovery homeowners, mobile health providers, employment specialists, SUD providers and Illinois Department of Public Health personnel.

Some of the speakers included: Illinois State Representative La Shawn Ford. He is the founder of the West Side Heroin and Opioid Taskforce. Representative Ford stressed the importance of service and collaboration.

Illinois State Senator Lakesia Collins. Senator Collins discussed the importance of community action in addressing the substance use disorder crisis which impacts communities.

Project Director Great Lakes ATTC Chicago Mark Sanders. My closing comments were centered around two Dr. King quotes. “Everyone can be great because each of us can serve.” Those present in the room serve as a reminder that there is a role for everyone in a recovery oriented system of care. Dr. King also said, “Our lives begin to end the day we become silent about things that matter.” Opioid overdose death has had a dramatic impact on the West Side of Chicago. Those attending the event expressed a strong desire to continue addressing this issue.

As I left the event, I found myself believing that if Dr. King were alive today, he would address substance use disorder and overdose crises which plague communities nationwide. I visualized Dr. King organizing gatherings like the day of service event. In my imagination I can hear Dr. King sharing his powerful words with groups mobilized to address SUD. “All you need to serve is a heart full of grace and a soul generated by love.”

How African Americans joined Alcoholics Anonymous

Photo from NPR 2013 article "Sleepy, Southern And Segregated: What D.C. Was Like In '63" by Brian Naylor

Written by Tom Adams, Date Published February 11th, 2025

Writing a book is full of surprises – some that are delightful and others that are what you might call challenging growth opportunities. Beginning with this post, I will share some of what I have learned. By far, the greatest joy is the many people I have met and their generosity in sharing their experiences and wisdom. Each of them enriched my life and I hope to add depth and light to the book, A Marriage That Changed The World, for readers. (Now available on Amazon.)

Given it’s February and Black History Month, I’d like to start with another marriage that changed the world in A.A.’s early days and a present-day contributor to carrying the message about African Americans in recovery.

Jim S., or Jim Scott as he is known since his death, and his wife Vi, are among the many couples who became friends with Bill and Lois Wilson as Alcoholics Anonymous (A.A.) and Al-Anon Family Groups were being founded. Jim and Vi were the first African Americans to start an A.A. group open to African Americans in segregated Washington D.C. in 1945. A.A. had come to Washington D.C. in 1939 through the efforts of Fitz Mayo, the son of a Protestant minister from Maryland who traveled to New York and found sobriety in meetings with Bill and Lois Wilson in New York.

Jim’s father was a country doctor in Virginia. Jim tells about his drinking problem, becoming an alcoholic and finding recovery through A.A. in the “story section” of the book Alcoholics Anonymous, (Jim’s Story, 232, 4th edition).

He writes about growing up in rural Virginia with a mother who he describes as a “religious fanatic” and overly protective. He attended college and medical school at Howard University in Washington D.C. and successfully became a doctor and surgeon.

The Depression and Prohibition slowed down the arrival of his drinking problem. Times were hard and money was tight; he didn’t start drinking until 1935. Within five years, in 1940, his drinking progressed to where he realized he had written a prescription for a patient while he was in an alcoholic black-out and didn’t remember writing the prescription. That scared him into giving up his medical practice, never to return to it. But he was unable to stop drinking, resulting in long absences from home to “find work” and to drink.

In 1945, Jim was introduced by Ella Gant, an African-American woman he knew from an electrical repair store to Charlie G. who became Jim’s friend and A.A. sponsor. Charlie guided Jim in his journey of getting sober, reuniting with his wife Vi, and rebuilding trust and their relationship. Jim and Vi started the first A.A. meeting for African-Americans in Washington D.C and one of the first in the United States.

My recently published book, co-authored with Joy Jones, A Marriage that Changed the World: Lois and Bill Wilson and the Addiction Recovery Movement provides more details on the difficult path Jim and Vi Scott traveled in starting A.A. in segregated Washington D.C. It was against the law for African-Americans and white people to be together in public places like restaurants. They met in homes because churches turned them down as they sought a meeting place. They eventually rented space from the YMCA and began holding regular meetings there.

On November 10, 1954, Jim and Vi Scott met with Bill and Lois Wilson at the Bedford Hotel in Bedford, New York. Their talks that day were recorded, Bill interviewing Jim and Lois interviewing Vi. Jim and Bill discussed their drinking, strained relations with their wives, and their recovery. Lois and Vi discussed their awakening to the fact that practicing the Twelve Steps was just as important for them as for their husbands. They saw they had to change and let go of the painful past in order to move forward in their marriage.

Lois asked Vi how many men with drinking problems she had provided a place to stay in her home and she replied about a hundred!

Jim Scott became the first African-American to speak at an A.A. International Conference when he spoke at the 1955 St. Louis convention.

The details of Jim and Vi’s role are part of this story because of the research and generosity of a man I met for the first time in attending the anniversary of the Cosmopolitan Group of Alcoholics Anonymous, the meeting that evolved from the one Jim and Charlie started almost 80 years earlier. Mr. Lee M. is the archivist for the Cosmopolitan Group. Never before having met me, he generously offered me his entire notebook of research about Jim and Vi Scott and the growth of the Cosmopolitan Group.

Before I started work on this book, I knew nothing of Jim and Vi Scott, the Cosmopolitan Group, and had never met Mr. Lee M. My life is enriched through learning this and many other stories. I am reminded of the many marriages and friendships that I have and are changing the world.

Source: https://thadams.com/recovery-growth/how-african-americans-joined-alcoholics-anonymous/

2024 Presidential Election Ignites Historical Trauma among African American SUD Providers, Clients and Other Communities of Color

The Candidates for the 47th Presidency of the United States featured Republican Donald Trump versus Democrat Kamala Harris. At the start of the campaign Trump was interviewed by a group of Black women and claimed Kamala Harris didn't really view herself as Black until she decided to run for president. He suggested that she viewed herself as Indian, in spite of the fact that she attended an HBCU and was a member of a Black sorority. It was clear that this was an effort to separate her from Black people and the African American vote. This is a trick as old as the Willie Lynch letter.

During the period of Chattel slavery in the U.S., enslaved Africans were revolting and supposedly, White slave holders sought council from Willie Lynch on how to control the enslaved Africans. Willie Lynch advised, Make a list of their differences and then exaggerate those differences. Some are lighter, some are darker, some are old and some are young, some are men and some are women, some work in the house and others in the field....pit them against each other based upon those differences and they will be so busy fighting each other that they will never rebel against you.

Early in the campaign Trump also talked about evidence of cheating which created traumatic flashbacks of the last time he complained of cheating during and after he lost an election. It was January 6th 2020 and his phantom complaint of voter fraud triggered the takeover of the U.S. Capital building where we witnessed a White male walk through the building carrying a Confederate flag, a traumatizing symbol of the time African Americans were enslaved. 

Trump defeated Harris and will be inaugurated as the 47th President of the United States. He will enter office with the republicans controlling both branches of congress and the Supreme Court, with six of the nine justices being republican nominated.

One of the 6 Principles of SAMSHA's dimensions of trauma informed care in behavioral health is Predictability and Transparency. Immediately after Trumps victory, I started hearing from African American behavioral health specialists. Below are some statements I heard from colleagues.

“Trump is so unpredictable. With his control of every branch of the government. I bet he would try to vote us back into slavery if he could.”

“Donald Trump has hated Black people for a long time. As a property owner, years before running for President he discriminated against Blacks in housing. Like a slave master he called for the lynching of the Central Park 5, even when it was clear they were innocent of rape.”

“We can expect to see an increase in police brutality under Trump and mass incarceration. As the 13th amendment said, no man can enslave another, unless he is incarcerated.”

“I have had to put my trauma on the shelf and hold space for my Black clients who are also traumatized by the election results.’

‘Our programs are already underfunded. Trump will assure we lose even more funding.’

It is clear from the above comments, Donald Trump's victory has reignited historical trauma for African Americans. I also started receiving emails and phone calls from Latino/Hispanic, Native American and Asian colleagues who shard fear and similar stories of historical re-traumatization. 

I have been reflecting since election about our post traumatic growth as African Americans having endured slavery, the reconstruction era, Jim Crow Laws, lynchings, riots, mass incarceration, policy brutality and modern discrimination. I concluded that if we thrived in the midst of all of those traumas, we will handle this too! My colleagues from other communities of color expressed a similar sentiment.

The intersection of substance use stigma and anti-Black racial stigma: A scoping review

International Journal of Drug Policy Volume 133, November 2024, 104612 Rashmi Ghonasgi, Maria E. Paschke, Rachel P. Winograd, Catherine Wright, Eva Selph, Devin E. Banks

Highlights

• This scoping review includes 22 peer-reviewed articles published 1999–2023, with discrepant findings based on method.

• Qualitative findings suggest substance use stigma is a more common treatment barrier among Black than White people who use drugs.

• Most quantitative findings suggest Black people face less substance use stigma than their White counterparts.

• Racial prejudice was consistently linked with greater substance use stigma.

• Gaps include a little attention to structural stigma and stigma toward interventions, and a focus on “race” rather than racism.

Abstract

Background

Substance use stigma poses a barrier to treatment and recovery from substance use disorder. Stigma is amplified when intersecting with other stigmatized identities, particularly Black racial identity. Despite increasing attention to the intersecting roles of racial and substance use stigma, it is unknown how these stigmas interact to impact treatment and health outcomes among Black people who use drugs. This scoping review examines empirical research documenting differential impacts of race and racism on substance use stigma.

Methods

We systematically searched PsychInfo and PubMed databases. Eligible studies were conducted in the U.S.; examined a Black sample, subsample, or experimental condition/variable (i.e., in a vignette); and measured substance use stigma (excluding alcohol or nicotine). Qualitative studies describing a theme related to substance use stigma were also included.

Results

Of 1431 unique results, 22 articles met inclusion criteria. The most measured substance use stigma type was interpersonal (e.g., discrimination). Most quantitative findings (n = 15) suggested that Black members of the general public endorse less substance use stigma and Black people who use drugs face less substance use stigma relative to their White counterparts. Qualitative studies (n = 7) suggested stigma was a more common and pernicious substance use treatment barrier for Black people compared to White. Across methods, racial prejudice was associated with substance use stigma, supporting hegemonic ideas that substance use is stereotypically characteristic of Black people.

Conclusions

The interaction between substance use stigma and race is complex and varies by in-group and out-group raters as a function of racial identity and identity as a person who uses drugs. Contradictory findings reflect methodological differences, emphasizing the need for more unified measurement of substance use stigma. More research is needed among Black people who use drugs to improve understanding of the impact of these intersecting stigmas on racial inequities in substance use treatment, morbidity, and mortality. To read more click here.

Overdose Deaths Are Rising Among Black and Indigenous Americans

Gov & Politics Health Care Indigenous Affairs Civil Rights

Oct 29, 2024 By Tim Henderson

The recent decline in overdose deaths hides a tremendous disparity by race: Deaths have fallen only among white people while continuing to rise among people of color, according to a new Stateline analysis of federal data.

Health experts in nonwhite communities say they’re finding strategies that work in their areas, but that they still struggle for recognition and funding to address the problems, especially among Black and Native people.

In all, nearly 5,000 more people of color died from overdoses in 2023 than in 2021, while deaths among white people dropped by more than 6,000, according to the analysis of provisional data from the federal Centers for Disease Control and Prevention.

Overdose deaths are down nationally, but up in many Western states

As of early this year, based on partial counts, Black and Native people remain the hardest hit, having earlier in the pandemic surpassed white rates. Hispanic and Asian people are still experiencing more overdose deaths as well.

White people had the highest rate of overdose deaths in 2019, before the pandemic, at 25.4 deaths for every 100,000 people in the U.S. population. But rates for Black and Native people quickly surpassed white rates and continued to grow as white rates declined between 2021 and 2023. In 2023, the death rates were 49.5 and 39.8 per 100,000 for Black and Native people, respectively.

Tracie Gardner, co-director of the National Black Harm Reduction Network, said Black and Native people often have trouble navigating white-dominated institutions, including many harm reduction agencies. Such agencies need to have more people of color in leadership positions to gain the trust of Black, Native and other people who use drugs, she said.

“It is our contention that Black harm reduction isn’t about drug use, it’s about the harms of not being a white person in this country,” Gardner said. “The only people doing worse or as poorly are Native Americans.”

Different trends

Between 2021 and 2023, overdose deaths among white people dropped in all but a dozen states, most of them in the West. But few states saw any decline in deaths among Black or Native American populations. Deaths among Black people did decline, however, in Indiana (-75), the District of Columbia (-29) and Illinois (-22), while deaths among Native people declined in North Carolina (-34), Colorado (-11) and North Dakota (-9).

Connecticut was one of the few states to see a small rate drop among its Black residents. There was no change in the number of overdose deaths, but the Black population grew between 2021 and 2023.

The Connecticut Harm Reduction Alliance is working to bring more harm reduction tools to the Black community and others, with 100 mobile kits available at a moment’s notice.

Most recently, staff started going to meet people leaving detox programs, also known as withdrawal management, when they choose to leave early and are at especially high risk of overdose.

“The message is, ‘Even though this didn’t work out, we care about your welfare, we care about your safety, we want to see you come back,’” said Mark Jenkins, the alliance’s executive director. Click here to continue reading.

A Tribute to Beverly Hamilton Robinson

I recently attended the funeral/celebration of life for Beverly Hamilton Robinson. I first met Beverly in 1982, the first year when I became a drug counselor. Beverly and other African American leaders in the addictions profession concluded that the additions profession was a growing field and that the Black community being greatly impacted by addiction had to prepare a generation of counselors to become certified as addictions professionals.

Beverly and these other great leaders trained my generation to become certified addictions counselors. She also invited us to become members of the National Black Alcoholism Council (NBAC), a national organization which advocated for culturally responsive treatment and policies for African Americans with addictions. Beverly invited me to give my first professional speech ever at NBAC and 42 years later I am still delivering speeches on addictions, treatment and recovery in Black communities.

Beverly was a proud African American woman who made others feel proud of who they were. She was like royalty. In his autobiography, Malcolm X said of singer Billie Holiday, "I met a queen and her name was Billie Holiday.” I met a queen before as well and her name is Beverly Hamilton Robinson. Rest in peace Beverly.

World Mental Health Day A Chance to Celebrate African American Resilience and Determination

Today we celebrate world mental health day! Immediately I thought about Black/American Americans who have been able to maintain a great deal of mental stability while having endured 250 years of slavery, Jim Crow Laws, lynchings, employment and housing discrimination, mass incarceration, police brutality/murder etc.

With all of this trauma, our rates of mental illness is equivalent to other groups in the U.S. and as it pertains to substance use we continue to rank fourth nationwide. In the midst of all this oppression we have produced astronauts who went to the moon, astrophysicists, Nobel Prize Winners, billionaires, inventors, a president and some of the greatest entertainers the world has ever seen.

How have we achieved all of this and maintained our mental health in the midst of such oppression?

The answer according to Dr. Carl Bell is our protective factors, including:

• Spirituality

• A strong worship and belief in God.

• Extended family orientation-knowing that lots of people love you.

• Sunday dinners! Which promotes unity.

• Movement and dance! Trauma lodges itself in the body. Movement releases trauma.

• Music

• Laughter. From the Vaudeville days through, Moms Mabley, Redd Foxx, Ricard Pryor, Wanda Sykes, Dave Chappelle etc. These gifted comedians have helped us get through oppression.

• Sports. Which promotes bonding and reduces stress.

• Advocacy. Sociologists have pointed out that when tragedies occur such as the murder of George Floyd, the mental health of the entire Black community is affected. Their studies illustrate that advocacy serves as a mental health protective factor.

Nora's Blog Older Black Men are Disproportionately Affected by the Overdose Crisis

August 30, 2024 By Dr. Nora Volkow

©Getty Images/xavierarnau

Saturday, August 31, is International Overdose Awareness Day, when we collectively remember those who have lost their lives to drug overdose, support those who grieve those losses, and offer encouragement to those who seek recovery from addiction. It is also an opportunity to share new knowledge about the overdose crisis and strategies for confronting it. There is some very good news this year: Provisional data from the CDC show that, overall, overdose deaths dropped by 7.5% in the 12 months ending March, 2024, the largest decline in decades. It is cause for optimism. But unfortunately, for some groups, we continue to see only greater escalation of the overdose crisis.

A recent New York Times article highlighted the tragic epidemic of overdose deaths among older Black men in Baltimore. It is a city that has been especially hard-hit by the overdose crisis, but the trend is being seen nationwide. Although white and Black people use drugs at similar rates, fatal overdoses have escalated in Black people at a much higher rate than in other groups over the past decade, and multiple recent studies have documented especially high rates of overdose deaths among older Black men.

Fentanyl, often in combination with stimulants, is driving increased overdose deaths in most demographic groups. In all groups, men are at greater risk of overdose than women, but additional factors, including age-related health disparities, social isolation, and lifetime exposure to structural racism, may be colliding to produce the rise in overdoses among older Black men especially, and it points to the urgent need for intervention.

A NIDA analysis found that between 2015 and 2023 (provisional data), there was a nearly 5-fold increase in overdose deaths among non-Hispanic Black men 55 and older (figure). In 2023, deaths in that demographic category were nearly triple the national average for that age group. The largest proportion of these deaths, and the steepest increases, involved fentanyl and cocaine. The overdose rate in older Black men is markedly higher than that for Black men overall. Source: National Institute on Drug Abuse. Click here to continue reading.

African American Music Appreciation Month: One of our Mental Health and Substance Use Disorders Protective Factors

In 1979, President Jimmy Carter declared June as National Black Music Appreciation month. African American music is the most listened to music throughout the world. Beginning with the Africans enslaved in the southern states who created blues music as medicine for their trauma, every generation of African Americans have created music to deal with our oppression. During the turbulent civil rights era of the 1960's Jazz was popular as we used it to simmer rage caused by racism and Motown music kept us focused on love when there were many reasons to be filled with hate. During the civil rights era, when the great Dr. Martin Luther King Jr. grew fearful for his life or needed spiritual upliftment, he would call upon gospel singer Mahalia Jackson to sing church songs to him.

Historically, each time the black community has faced substance use crisis, prominent singer and rappers have chimed in and sung songs which served as cautionary tales about the danger these drugs pose for Black communities. Click here to listen to some of those songs.

Click here to learn about the history of substance use among African Americans as depicted in music.

Today I listened to 7 genres of Black Music. Let’s enjoy the music this month!

REFLECTIONS: AFRICAN AMERICAN MEN AS THERAPISTS AND RECOVERY COACHES WITH AFRICAN AMERICAN WOMEN

By

Mark Sanders and Donald Gunther

In this post Mark Sanders, a licensed therapist and Donald Gunther a certified CCAR Recovery Coach discuss lessons learned and tips as it pertains to providing recovery related services for African American women as African American men.

Introduction

A well-known trainer spent years traveling from state to state saying that men were incapable of counseling women and girls. While men in all 50 states were counseling women and girls. The trainers’ statement was inconsistent with the research which says that helping professionals who strive for gender competence can do a good job of serving men and women, although few if any attain full competence.

Our experience working with African American women is that the helping relationship serves as a microcosm of the current and historical relationship between Black men and women in the broader society. Some African American women have had positive relationships with African American men which might make engagement in the helping relationship relatively easy. Like women of all cultures, African American women also have high rates of trauma which triggered their addiction. In many instances (not always!), the perpetrator(s) were African American men. The trauma can include incest, childhood sexual abuse, sexual assault, domestic violence, father desertion etc. These issues can lead to mistrust and fear when their therapist or recovery coach is an African American male. The good news is that a solid helping relationship can be a corrective experience.

We as African American men can also bring interface issues to our work with African American women. Beginning with our mothers, other adult care takers, female siblings, spouses, and partners this experience can affect our work with African American women as clients, positively and negatively. When our negative experiences impact our work with African American women, these countertransference reactions are actually a gift because they are a reminder of the work, we still need to do to help assure that our negative experiences don't negatively impact our relationship with African American women served.

Mark's Experience

The first time I counseled an African American woman was when I was a graduate school intern in 1983. She told me that she paid for her drug of choice cocaine, by dancing. I thought our session went well and the next day she told my supervisor that she did not want to work with me. She was my first client, and I was convinced that my career was over before it started!

My supervisor talked with the client about the importance of closure and suggested one more session with me, client choice. The client agreed to another session. Prior to the session my supervisor told me that there are some things women have done to support their addiction which they are uncomfortable talking with men about, but they might offer hints to explore nonjudgmentally. My supervisor encouraged me to explore what the client meant by supporting her drug use by dancing. In hindsight, if I were the supervisor, I am unsure if I would have suggested one more session, but it worked out and taught me a great deal.

When I explored the client supporting her drug of choice through dancing the client said, she danced topless in order to buy cocaine. I received this disclosure nonjudgmentally and the next day the client told my supervisor, I can work with him. I still had a career! This experience taught me to listen with a third ear, for what's not being said, listen for hints, ask questions, and respond nonjudgmentally. 

My next experience counseling African American women was in the mid-1980's when the majority of the clients in treatment were males. Consistently the few women in treatment would either sit close to the therapist or close to the door in groups. They didn't feel safe. I did research and learned that the majority of women with substance use disorders across cultures were either sexually abused as girls or sexually assaulted as women. This knowledge shaped my work with African American women for the next 3 decades. I have continued to learn with the clients being my teacher. These are the lessons I learned. Feel free to use what works for you.

1. Listen more than I talk. Listening builds rapport!

2. Move at the client’s pace.

3. Try not to be shocked by any disclosure. The good news is that after 4 decades few disclosures shock me.

4. If I find myself being judgmental, talk myself out of it.

5. If there is mistrust, be willing to discuss her experiences with African American men outside of therapy.

6. Have impeccable boundaries.

7. Sit at a 45-degree angle during sessions. Trauma can make it difficult to hold eye contact. Sitting at an angle provides the opportunity for the clients to hold eye contact or not.

8. No unwelcome touch.

9. Search for strengths and offer affirmations.

10. Do what you say you're going to do when you say you're going to do it! Many of the African American women I have worked with were deserted by their father. Consistency can provide a corrective experience.

Donald's Perspective

African American women  seeking recovery face a number of challenges. Starting with the underlying traumas that they endured. As we discussed on many occasions with you being an African American counselor and I as an African American certified peer specialist-mental health and a CCAR recovery coach facilitator our life experiences can help with the recovery process if we are able to establish a trusting helping relationship. Ironically, in 1983 when you thought your first session with an African American  woman went well only to hear that your client informed your supervisor that your services were no longer wanted, and your response was “She was my first client, and I was convinced that my career was over before it started!”.  That same year 1983 my relationships with the African American women in my life were tumultuous to say the least. My feelings were being emotionally arrested by one cognitive distortion after another. It was your professional experience with your client and my personal experience with my female friends, mother and five sisters that served as learning experiences for us. Hindsight your perception was your career was over and my perception was that I cannot emotionally connect with African American women due to the lack of trustworthy relationships that I was having with African American women in my life. Most importantly the ones closest to me. Everything happened for a reason and in time our past experiences would lead us to our destination to be therapeutic change agents.

In retrospect you were knowledgeable about feelings and behaviors as new counselor (CEU’s) continued educational units would empower you to be hopeful. On the other hand, I was totally in another space because those relationships made me feel hopeless. Now, as a recovery coach and peer specialist-mental health I can value the importance of Unconditional Positive Regard without judgment. My (CEU’s) compassion, empathy and understanding did not happen until I educated myself about Person Centered Therapy, Maslow Hierarchy and Motivational Interviewing. This would be my protein in terms of gaining knowledge about counseling, coaching and peer support.

Five decades into my life my next is now! Recovery is progress, not perfection! This knowledge has helped me as a Certified Addiction Counselor in training, a Certified Connecticut Community for Addiction Recovery Coach and a Georgia Certified Peer Specialist Mental Health. I am also a student, brother, uncle, husband, father, and peer. The emotional intelligence that women, especially the African American women in treatment has displayed towards me has taught me forgiveness and acceptance. In fact, my learned behavior was hearing my dad say to me “Treat a woman like you want your mother to be treated and actions speaks louder than words.” This remains to be my foundation along with UPR without judgement (Unconditional Positive Regard).

The ten lessons you have learned as av therapist working with African American women were lessons that were priceless for me as well. As a CCAR Recovery Coach, the principles or three legs we stand on are 1) listen actively; 2) manage our own stuff; 3) ask good questions helped me build good relationships with African American women seeking recovery. I have learned that boundaries are essential physically, emotionally, and mentally placed in order to protect the participants in treatment as well as the counselor, peer specialist and  recovery coaches. The beginning of this professional relationship can be uncomfortable, however the connection once a rapport / trust has been established can play a role in life transformation. THE communication should be authentic, transparent and safe as many African American women report histories of trauma with male perpetrators. When boundaries are unhealthy and safety has not been established, African American woman can re-traumatized in helping relationships.    

This work has given me an appreciation of the depth of the current and  historical trauma  women bring to treatment. My Mom and my five sisters I carry with me every day because it was my dad’s voice saying treat every woman like you want your mother and your sisters treated meaning it is not about your feelings, Donald!  

Ironically, it was my father’s alcohol use disorder that has empowered me to passionately become a messenger with a message about a mess that does not belong to me. So, dad thank you for teaching me Harm Reduction. Most importantly being able to recognize, identify and appreciate that I come from a diamond. So, I would like to say that being an African American man who is a recovery coach and peer specialist with African American women provides us opportunity to work through some of our past traumas. Personally, this becomes a teachable moment to collaboratively engage, educate and help to empower African American woman. Recovery requires respect, repetition, reciprocity, relationships, and a re-connection with their true self.  The recovery coaching process can help increase a positive sense of self and play a role in a recovery process that is imperfect and priceless like a diamond so that they can have their own recovery (jewelry) box.

Diamonds come from pressure, Recovery is Imperfect, Priceless and Valuable!

ALCOHOL AND BLACK AMERICANS

by Mark Sanders, LCSW, CADC

While African Americans do not dominate alcohol use in the United States, alcohol use has had a devastating effect on us. I have an African American friend of five decades who recently died of multiple medical complications. At the root of his death was alcoholism. Both of my grandfathers and many uncles and aunts died from alcoholism as well. Alcohol has had a severe impact on Black America. The two are even linked in history. During the slave trade, enslaved Africans were shackled and shipped to the West Indies in exchange for molasses, sugar, and other manufactured items. Then, enslaved Africans were shipped to North America, along with the molasses and sugar (which was converted into alcohol). Weapons and alcohol were shipped to Africa in exchange for more enslaved Africans. This is known as the Triangular Trade. I once shared this history at an African American elementary school and a fourth grader asked two questions. Are you saying we were sold for alcohol? Then why does my father drink so much?

Frederick Douglass, the first prominent recovering alcoholic reminded us, “We cannot stagger to freedom.”  Douglass revealed that alcohol was used to control enslaved Africans. Douglass stated, “They would work us and beat us Monday through Friday and allow us to drink on weekends. The belief was that once we tasted alcohol we would never want to escape. It was the sober minded slave that they feared most.”

There are several things which stand out for me in Douglass' quote. During the Jim Crow Era when my grandfather’s generation of Black Americans migrated from the southern states to the north in search of good jobs, they would work hard Monday through Friday and drink hard on weekends. My grandfather would even pour salt into his cans of beer. Today I know that combination was a shot a high blood pressure. The second thing which stands out in the Douglass quote is that alcohol was used as medicine for our historical trauma. 

The authors of the book Doin' Drugs stated that during the great migration, the center of socialization for African Americans shifted from the Black Church in the south to bars in the north. Thus, the famous quote,” There is a liquor store on every corner.”  Published int the 1990’s, the book Message In The Bottle: The 40 Ounce Scandal, author Alfred Powell revealed that certain brands of alcohol were specifically targeted to the Black Community. Today, well known hip-hop artists promote and sell varieties of high-end alcohol. What impact does this advertisement have on youth?

Across the country there are African American youth who have declared that they will never use any drug besides marijuana! Yet in clinical practice I have had numerous African American emerging adult clients buy alcohol legally to celebrate their 21st birthday. As it pertains to homicides in the Black community, alcohol and marijuana are the two most common drugs which appear in the drug tests of the perpetrators. 

Over the past several decades crack and heroin have grabbed headlines as the drugs having catastrophic effects on African American communities. In Drug use For Grownups, Dr. Carl Hart reveals that alcohol use is involved in nearly 70% of opioid overdose deaths. We should never forget alcohol. During the crack cocaine era many African Americans who went to treatment would return to cocaine use after one drink. That drink would lower their inhibition, making it easier to return to cocaine. Over the years I have had numerous African American clients who grew sick and tired of hustling and going to jail and prison for charges connected to cocaine and heroin use/possession. Many would shift to alcohol and die of cirrhosis of the liver, delirium tremors, car accidents under the influence and other alcohol related causes.

I have written this post so that my soul can rest, having lost so many loved ones to alcohol use disorders, including a 50-year friend. As I reach this final sentence I exhale. It is my hope that addictions professions focused on treating stimulant use disorders, opioid use disorders and other addictions, won't forget about alcohol.

My Dad's Chair

by

Donald Gunther

Editor's Thank you

Thank you Donald for the previous series of posts which shed light on the challenges faced by African American children of Parents with substance use disorders and your thoughtful recommendations as to how we can help the children thrive in the future. Thank you for this current post which reveals the fact that intergenerational healing is possible.

History is rooted in someone's story and that is why I am adamant about telling you mine. My roots started in Virginia (mom), grew down to North Carolina (dad) and sprouted up in New York. So, like any good seed you go down before you sprout up through many storms and seasons have come and gone and gave birth to a beautifully broken recovery story.

Metaphorically speaking some have said I write white and silently scream like I am black with my writings about my adverse childhood events that turned into post trauma stress disorders and complex traumas that would suppress my pain and tarnish my brain. My introduction to Intergenerational Trauma a life lesson that would turn my mess into a message.

Discovering a transformation so I can learn to transition from a beginning that perceived to be my end. Since birth, my family and culture have not been accepted or respected so being built to fail would be my family's reality or what I would see as a mess. The USA would underserve stigmatized and abuse my family's culture and humanity. My parents' traumas (reality) I perceived as just alphabets would be KKK and JC (Jim Crow) the protein that my ancestors were fed. Ironically, it has been said "you are what you eat ". Now I see why the soup that I consumed consisted of (A.C.E.P.T.S.D.) adverse childhood experiences and post trauma stress disorders. It was complicated, and I did not understand why my parents were feeding me this type of pain. My recovery process, many decades later with no parents in sight, would start an uncomfortable journey that is providing me an opportunity to emotionally detox from EMOTIONAL SCARS. In being transparent America I can hear my dad saying, " Son, I was blind, but you will see. " Well dad my response is thank you because your integrity provided for me. An integrity that no one would see, not even me. As you know MY eyesight as an underprivileged stigmatized and abused child was a perception not a reality. Since my next is now and my now is the next message or life lesson. I am still uncomfortable processing through the history of psychological abuse. Unfortunately, now you cannot tell who the abusers are! The trauma that was fed to us, unconsciously was our protein, starch, and vegetables as well. This is why an emotional detox is required for all African American Families who have suffered from psychological abuse. The Abuse that continues to happen and minimizes my trauma because those with eyesight suddenly become blind and those with ears suddenly become deaf. Metaphorically, I will stand on my three legs and sit down on the principles that you instilled in me. Ethics should prevent Exclusions; Integrity supports Inclusion and then we can value our Differences and validate Diversity.

My dad is no longer with me in the flesh some might consider him to be HISTORY. I have the pleasure of owning the flag of this veteran who served in WWII an HISTORICAL event that would birth a family disease known as addiction and many decades later with dad gone promote a generational change and allow the greatest metaphor to take place. A love story that would birth recovery. Recovery has given Isaiah, my son, an opportunity to speak about his story.

I am Donald Gunther, and this is my father’s chair, and I would like to share my seat with you!