Thank you, John Pitts!!

By Mark Sanders, LCSW, CADC

In January of 1986 I applied and became an instructor of Addictions Studies at Harold Washington Community College, Chicago. My desire to teach was inspired by my frustration as a young drug counselor. I felt there were too many counselors doing too much talking and not enough listening to clients! I decided to try to change that by teaching a new generation of drug counselors.

I was hired quickly for one semester by the chair of the Addictions Study Department, Jeffrey Shore. Jeffrey told me that at the end of the semester he would do a classroom observation to decide if I would be asked to continue to teach at the college. 

The start of the observation was a nightmare. I had a student that was monopolizing the class while Jeffrey was observing. An African American student, John Pitts, who was older than me and wise, interrupted the monopolizer by asking me a question I could answer. I was back on track! I looked at John Pitts to say thank you non-verbally and he gave a wink. John Pitts saved my teaching career!

I continued to teach at Harold Washington College for 14 years and ended my college teaching career as an Addictions Studies educator at the University of Chicago. I have lectured all over the world and can trace every lecture (6 degrees) to the 14 years I taught at Harold Washington College. Thank you again, John Pitts! Without your fast thinking, much of what I accomplished might not have happened.

If there have been John Pitt's who have played an important role in your life and career, please let them know.

The Early Years of the HIV/Aid Epidemic: Lessons Learned Counseling Gay African American Men With HIV and Substance Use Disorders

As a therapist I counseled Gay African American Men living with HIV or Aids and substance use disorders. These were the early 1990's prior to effective medication for HIV and increased life expectancy. Many clinicians and clients back then viewed a HIV diagnosis as ‘an immediate death sentence’. This post reflects those early years.

The Impact of solid recovery prior to HIV diagnosis – The African American clients I worked with that had 2 or more years of recovery prior to their HIV diagnosis, were much more successful in maintaining their recovery compared to those little to no recovery prior to the HIV diagnosis. A lesson learned is how quality recovery can equip clients with tools to cope with life challenges. This can include: loss, divorce, evictions, and progressive medical diagnoses.

Resilience and empowerment – A well know African American HIV Case Manager, upon sharing news of a positive diagnosis with African American male clients would say to his clients, "You have survived being a Black man in America and homophobia. You'll handle this too.” Tennis star Arthur Ashe was diagnosed with Aids following a blood transfusion. Ash stated, "Living with Aids has not been the greatest challenge of my life. The greatest challenge has been being a Black man in America."

Purpose and desire to help the Black Community – In groups many of these men reported that they were living their life purpose for the first time in their life, after being diagnosed with HIV or Aids. Renowned psychiatrist and Holocaust survivor Victor Frankl said the most common source of life purpose is life pain. In group one client stated, “Because of internalized homophobia, I was a people pleaser my entire life. After being diagnosed I am living my life for the first time without being a people pleaser. My purpose is to be happy!" Another client stated, "The last 10 years I stole things and I sold my body to pay for drugs. Now I found my purpose. Every week I go to a different mid-week church service in a Black neighborhood, share my story and give the church a wakeup call. I tell them that members of their congregation and community they serve are possibly HIV positive and they needed to take off their blinders and do something." His testimony and advocacy led to the formation of several church based HIV Ministries.

Anchoring recovery in the natural environment – A young African American man in recovery had sex with a partner. After the partner shared a few weeks later that they were HIV positive, the young man took an HIV test. Back then one had to wait 30 days for HIV tests results. He stated, "The wait seemed like forever! While I waited, I had a conversation with God. I said to God, if you let this HIV test come back negative, I will commit my life to helping members of the community who are HIV positive.” His HIV test was negative. He started a non-profit program which provided support groups and advocacy in the African American community for individuals living with HIV and addiction.

Harm reduction – Harm reduction is quite popular today. Three decades ago outreach workers in African American communities promoted harm reduction through regular condom distribution. They would encourage members of the community who were not HIV positive to wear condoms to avoid HIV infection. If they were already HIV positive the outreach workers would encourage condom use to avoid reinfection and to avoid infecting others. They provided needle exchange activities to reduce HIV transmission for IV drug users and methadone maintenance as an alternative to heroin addiction. A well-known medical doctor was accused of genocide because of his promotion of methadone in Black communities. The doctor stated, "I now feel vindicated because I know my prescription of methadone helped prevent many cases of HIV because with methadone there is no risk of needle sharing.” At a conference an African American harm reductionist stated "Harm reduction is community determined. In my community harm reduction is about jobs. When unemployment is high, despair sets in. Heroin use increases and so does the spread of HIV."

Heathy Suspicion vs. paranoia – Many members of the African American community were suspicious about the HIV virus. Many believed that HIV was a ‘nan made virus’ created to eliminate the Black community and some feared taking HIV medication. They were accused of being paranoid by non-African Americans. This was discussed in a forum at an HIV conference and a Black psychologist weighed in. "What some people view as paranoia, in the black community is actually healthy suspicion. All you have to do is remember the Tuskegee experiment and you can see how some members of the black community would be suspicious of HIV and the medicine to treat it." A white male at the conference, who identified himself as a person living with Aids spoke next. While coughing he said, "When people in communities of color say the issues around HIV in their community are different, we need to believe them!" 

This was some of the most rewarding work of my life!

Recovery In African LGBTQ Communities

June is National Pride Month. In this post we highlight Marsha P. Johnson (1945-1992), a person in recovery, advocate and founding member of the Gay Liberation Front and co-founder of the group Street Transvestite Action Revolutionaries (S.T.A.R). 

Marsha is credited with playing an important role in the Stonewall Rebellion of 1969 by push back as the New York Police raided the Stonewall Inn, a popular Gay Bar in Greenwich Village. During the riots Marsha yelled, "I got my civil rights." The aftermath of this rebellion played a major role in the Gay Liberation Movement and the first Gay Pride Rally, which ultimately became an important international celebration during National Pride Month.  

African Americans seeking recovery who are LGBTQ face triple discrimination based in race, sexual orientation and having a substance use disorder. Your resilience is celebrated.

Happy Pride Month!

Culturally Responsive Treatment for African Americans With Substance Use Disorders

For years I have heard substance use disorders professionals discuss culturally sensitive, culturally specific, afro-centric, African centered treatment for African Americans with substance use disorders. When I hear them describe their ‘Afro-Centric Program’ it is often, business as usual. In this post I will share my view of components of a program that is culturally responsive to the treatment needs of African Americans Seeking Treatment.

The Program Creates a Welcoming Environment. This can include warm and sincere greetings, pictures on the wall and magazines in the waiting room which reflect African American culture, a tour of the facility and positive service from the intake specialist. This says to African American clients, you are welcome here!

African American Staff. While I am not suggesting that all the staff need to be African American, research indicates that when African American clients work with African American counselors trust is developed quicker, the clients feel less of a need to code switch, that is, changing their dialect or style of speech to make the counselor comfortable. They also stay in treatment longer when working with Black counselors and they make more progress. The organization should strive for inclusion at all levels of the organization. When race determines who gets promoted, turnover among African American staff is the likely outcome. When that occurs, African American clients suffer.

Materials Which Reflect African American Culture. It is important that reading materials, audiovisual materials reflect the experiences of African Americans seeking recovery so that they can see themselves in the material.

Respect For the Diversity of African American Culture. In the book, Disintegration: The Splintering of Black America, Pulitzer Prize writer Eugene Robinson describes 5 sub-groups in the Black Community. The groups include: The Culturally Elite, which is the rich and influential such as Oprah Winfrey, Michelle and Barack Obama, Biillionaire Robert Johnson etc; The Bi-racial group, including individuals such as Halle Berry, Don Lemon, Tiger Woods, Naomi Osaka, Barack Obama; The Middle Class, which is the majority of African Americans; The Emergent, recent immigrants from Africa and the Caribbean Islands; The abandoned, 25% of African Americans who live in generational poverty. It is clear that there are cultural differences between each sub-group, therefore, a one size fits all treatment plan for African Americans would be ineffective.

Holiday Celebrations. Treatment centers often celebrate holidays. Consider adding Frederick Douglass Day to the list of celebrations. According to historian William White, MA, Frederick Douglass was the first prominent American Recovering Alcoholic. Another Holiday to consider is Malcolm X Day. In recovery, Malcolm was an advocate for millions. Another holiday to consider is the annual Afeni Shakur day. She was the mother of rap star Tupac Shakur. At the time of her death she was in long term recovery and founded the Tupac Shakur Center for Performing Arts. These holidays could be celebrated on the birthday of these 3 great recovery pioneers. These celebrations could send the message to African American clients that they are important and provide drug free celebrations for them post discharge from treatment.

Family Involvement. In African American culture the extended family is the primary unit. Efforts should go into assertive outreach by staff to involve the family in treatment.

Trauma Informed Care. Trauma is at the care for many clients with substance use disorders, including African American clients. For African American clients, this trauma often includes dehumanizing experiences such as: police stop and frisk, police brutality, police arrests, jail and prison, trauma, the trauma of shopping and eating in restaurants while Black. Trauma also includes community and family violence. Programs striving to be culturally responsive to the needs of African Americans seeking recovery should provide training on the organizational level on how to become a trauma informed system of care and provide training for front line staff on unique trauma experienced by African Americans and how to address that trauma and retraumatizing them while in treatment.

Continuous Care. We often use the term aftercare, but often aftercare is an afterthought. Continuous care often involves creating a plan to help support the recovery of African American clients post discharge from a current level of care. Continuous care planning can involve making referrals to mutual aid groups with reputations of being African American friendly and helpful. It is important to be aware of the community African American clients are returning to and discover in discussion with the client community factors which help support recovery and community factors which put the client at risk for relapse. Protective factors can include: a family that is supportive of recovery, jobs, prosocial recovery support groups, recovery coaches indigenous to the community. Risk factors include: easy access to drugs; the absence of drugs, a non-supportive family and the absence of mutual aid groups which support recovery

Continuous care planning can involve a plan to connect with the protective factors and avoid the risk factors. It is important to remember that African American clients have different stressors. Stress for those working in corporate America can include dealing with micro-aggressions, micro-insults and micro-invalidations. Those living in economically poor communities might have to deal with community violence which could trigger traumatic stress disorders. Others might be dealing with racial identity issues in recovery as First Lady Michelle Obama stated, My husband Barack Obama was too Black for some people and too white for others.

Conclusion. This writing was meant to be a start. Not a complete blueprint on how to provide culturally responsive services for African Americans seeking treatment and recovery. To learn more, click here  http://www.museumofafricanamericanaddictionsrecovery.org/webain

Letter To My Father

May 29, 2023

Mark Sanders, LCSW, CADC

May 29, 1986 I was giving a speech. Within the first 5 minutes of the speech I received an urgent phone call that my dad died at work while smoking crack cocaine. This is the 37th year Anniversary of his death. Two weeks after my fathers death college All American Basketball player LenBias died while snorting cocaine in celebration of his being drafted number one by the Boston Celtics. Following Bias's death, Congress intensified the war on drugs and the U.S. prison population increased from 400 thousand inmates in 1985 to 2.5 million in 2005. Disproportinately African American men with substance use disorders.

Dad, I spent the next 3 decades, speaking, advocating, writing books and articles on substance use disorders treatment and recovery for African Americans in honor of you. All of the speeches and materials I collected, culminated in the creation of this online museum. This year the Museum of African American Addictions, Treatment and Recovery was honored with the 2023 Faces And Voices of Recovery, Innovations In Recovery Award. I dedicate this award to you! Your son

Mark

Integrating Spirituality and Counseling with African American Clients With Mental Illness and Substance Use Disorders, Part 1

By: Kisha Freed and Mark Sanders

Publication Date: May 19, 2023

This post, the first in a three-part series, shares perspectives from Kisha Freed, a Success Coach, Six Seconds Certified EI Practitioner/Assessor, and mindfulness meditation teacher, and Mark Sanders, Licensed Clinical Social Worker and Certified Substance Use Disorders Counselor.

Over the years, counseling has addressed mind and body. There has been some apprehension about the effectiveness of integrating spirituality into counseling practice. However, in Does Spirituality Still Have Relevance For Recovery?, licensed professional counselor James E Campbell mentions that “interest in the spiritual implications of substance use, treatment, and recovery appears to be gaining momentum once again.”

In his article Integrating Spirituality in Counseling Practice, author Gerald Corey indicates “There is growing empirical evidence that our spiritual values and behaviors can promote physical and psychological well-being. Exploring these values with clients can be integrated with other therapeutic tools to enhance the therapy process.”

While continuing research studies are underway to identify the beneficial effects of spirituality in mental health and SUD practices, a 2009 survey conducted by the California Mental Health & Spirituality Initiative revealed that 88% of African Americans agree that their faith is an important factor for their personal and family’s well-being.

In this three-part series, we explore some implications of integrating spirituality and counseling with African American clients with mental illness and substance use disorders. We hope that mental health and addiction recovery counselors will find that integrating spirituality into their practice can help them to increase connection, foster a safe space for belonging, and promote quicker recovery for their clients.

In Part 1, we build a foundation for the overall discussion by defining spirituality, discussing the differences between spirituality and religion, and, lastly, the importance of spirituality for present-day African Americans within the context of past oppression and survival. In parts 2 and 3, we will discuss the integration of spirituality and counseling, how to conduct a spiritual assessment, and varieties of spiritual interventions that can be helpful when counseling African Americans with mental health and SUD.

Click here to continue reading.

Black, Hispanic Patients Receive MOUD After Opioid-Related Events Less Frequently Than White Patients

Tom Valentino, Digital Managing Editor

05/16/2023

Despite making a similar number of visits to healthcare providers in the 6 months following an opioid-related event, White patients receive medication for opioid use disorder (OUD) up to 80% more frequently than Black patients and up to 25% more frequently than Hispanic patients, according to a recent study by researchers at Harvard T.H. Chan School of Public Health and Dartmouth College.

Findings from the study were published in the New England Journal of Medicine.

Researchers reviewed a random sample of Medicare fee-for-service beneficiaries with disability—a group of Americans who are among the most affected by OUD—who experienced at least 1 acute OUD-related event, such as overdose, infection, or detox admission, between 2016 and 2019. Among the Medicare claims reviewed, researchers identified 25,904 OUD-related events—15.2% of which occurred among Black patients, 8.1% among Hispanic patients, and 76.7% among White patients.

In the 6 months following OUD-related events, Black patients received and filled a prescription for buprenorphine 12.7% of the time. For Hispanic patients, the rate was 18.7%, and among White patients, the rate was 23.3%. Rates for naloxone, the opioid overdose reversal medication, were similar: 14.4% for Black patients, 20.7% for Hispanic patients, and 22.9% for White patients.

In a news release announcing the findings, study lead author Michael Barnett, associate professor of health policy and management at Harvard Chan School, noted that opioid overdoses have been rising more quickly among Black individuals than any other racial group, surpassing overdose rates in the White population for the first time in decades in 2021. Overdose rates in the Hispanic population are up 40% recently, he added.

 “We need to understand barriers to obtaining life-saving addiction treatment for minority populations to address this huge demographic shift and public health crisis,” Barnett said in the release.

 Prescriptions for opioid analgesics and benzodiazepines, meanwhile, were received and filled frequently. Regardless of race, prescriptions for opioid analgesics were received and filled 23% of the time after OUD-related events. Benzodiazepine prescriptions were received and filled by Black patients 23.4% of the time, 29.6% by Hispanic patients, and 37.1% by White patients.

“Skyrocketing rates of overdoses in minority groups are unlikely to shift without a major overhaul in the addiction treatment system,” Barnett said. “Addressing the overdose crisis and racial disparities in addiction will likely require community-specific interventions that engage with minority populations and the clinicians who serve them to reduce stigma and bolster trust.”

Reference

Substantial racial inequalities despite frequent health care contact found in treatment for opioid use disorder. News release. Harvard University T.H. Chan School of Public Health. May 10, 2023. Accessed May 16, 2023.

https://www.hmpgloballearningnetwork.com/site/ap/news/black-hispanic-patients-receive-moud-after-opioid-related-events-less-frequently-white

Community Mobilization is No Guarantee of Long Term Success in Movements to Address Addictions Treatment and Recovery in African American Communities: Lessons From the Civil Rights Era and Other Ideas

Never in history have more groups come together to address substance use disorders treatment and recovery in African American Communities like we are seeing today. This mobilization could be inspired by the Black Lives Matter Movement and the murder of George Floyd by a Minneapolis, MN. police officer. Communities are now motivated to address addiction in Black Communities comprised of individuals in recovery, allies, Ph.D.’s, MD's, researchers, university educators, frontline clinicians, writers etc. In essence, because of this commitment and talent pool we are in position to do a work which can have a lasting impact as it pertains to treatment and recovery in Black Communities. A review of the past 60 years suggests that this great impact should not automatically be assumed. History reveals that each decade a crisis occurs, the community responds, and when the crisis decreases in intensity the work stops. Usually with no blueprint for the next generation to follow to continue the work beyond the crisis. Here are some examples.

1960's Heroin crisis in Black Communities. Groups such as The Black Panthers and Nation of Islam called addiction a form of genocide in the Black Community and advocated nonuse as a form of protest. 

1970's Alcoholism seen as a major problem throughout the country. A profession was born to certify addictions professionals nationwide. The National Black Alcoholism Council (NBAC) was formed to help African Americans to become certified addictions professionals and to advocate for Black people with alcoholism.

1980's, 90's, 2000's Peter Bell begins writing on Counseling The Black Alcoholic. The Crack Cocaine crisis occurred. Len Bias died snorting cocaine; congress intensified President Nixon's War on Drugs. African American men became the most imprisoned group on planet earth and thousands of African American women had their new born and older children taken away because of the stigma of addiction. Advocacy started occurring across the country, second chance legislation was passed. Black churches across all denominations formed church based drug ministries in response to the crisis. An incredible movement which fell apart primarily because of denominational differences. Recovery homes owned by African Americans were opened throughout the country. Visionary leaders such as Joe Powell, Andre Johnson, Anita Bradley, Dora Wright were a part of the RCSP and RCO movement.

Today Comprehensively, a group of talented professionals have come together to address substance use disorders in African American Communities. While the groups today represent, in my opinion the most talented group ever assembled to address the issue, there are several things that are important to help assure a lasting impact. These are suggestions for us to consider.

Always prepare the next generation to continue the work. In the before mentioned movements the leaders died or the crisis subsided and the movement stopped. This pattern can also be seen in our civil rights movements. Death and retirement can halt movements for years.

 We should put as much of the work as possible in writing which leaves a blueprint for the next generation.

As soon as we are ready, come together  as organizations to assure comprehensive planning. Our history reveals that fractions within ranks usually stop our movements. We can apply what we have learned from civil rights and other movements to this work.

Create a 20 year vision. Thinking about and planning for the future and what it will take to get there can help propel us to have a lasting impact.

Addressing Alcohol Use Disorder in African American Youth

Addiction comes in many forms and does not discriminate. However, it’s important to understand its impact on specific populations to develop more targeted and effective strategies aimed at improving health equity. In honor of Black History Month, we will explore alcohol use disorder (AUD) and its impact on African American (AA) youth. We will also discuss the role of research in achieving more equitable health outcomes.

Across the U.S., underage drinking is a serious public health concern. Alcohol remains the most, and often, first substance used among youth. In 2021, nearly 6 million people aged 12 to 20 reported drinking alcohol. Among those, more than half (3.2 million) reported binge alcohol use (SAMHSA, 2023). An estimated 29.5 million people aged 12 and older were diagnosed with an AUD in 2021 including 900,000 youth aged 12-17 (SAMHSA, 2021). Nearly 5% of those youth identified as Black or AA and 3% identified as two or more races (SAMHSA, 2021).

Understanding the development of alcohol behaviors is important to understanding why some adolescents drink. First, alcohol-related cognitions, known as alcohol expectancies (AE), develop as early as age 4 (Smit, et al, 2018). AE significantly influences drinking behaviors. A positive AE is the belief that alcohol leads to more pleasurable outcomes (e.g., being more social) and is associated with increased drinking. In contrast, a negative AE is the belief that alcohol leads to undesirable outcomes (e.g., feeling ill) and is associated with less drinking (Smit, et al, 2018). 

Longitudinal examination of AE and alcohol use outcomes show that AA youth aged 7-10 reported higher positive AE compared to White youth (Banks, et al, 2020). Despite higher positive AE in AA youth, White youth were more likely to use alcohol, suggesting positive AE posed lower drinking risk for AA youth (Banks, et al, 2020). However, even though AAs report later alcohol initiation and lower rates of use, they still have more significant alcohol-related problems compared to Whites. Unfortunately, the lack of diversity in most studies makes it difficult to understand why the relationship between AE, alcohol use, and its consequences differ among racial and ethnic groups. Click here to continue reading.

Trauma causes high levels of intergenerational substance use among Black women

SOCIAL SCIENCE RESEARCH INSTITUTE

FEBRUARY 21, 2023

By Melissa Krug

UNIVERSITY PARK, Pa. — Government data show that approximately 7.2 million women in the United States have substance use disorders (SUDs) and almost 20 million reported illicit substance use in the past year. New research suggests that trauma leads to high levels of intergenerational substance use among Black women, and race and gender may play a role, according to researchers from Penn State and the University of Kentucky.  

“More attention is needed to better understand the needs among Black women as the relationship between trauma and SUDs may be more pronounced because of their race and gender,” noted Abenaa Jones, assistant professor of human development and family studies and Ann Atherton Hertzler Early Career Professor in Health and Human Development. 

In the first study of its kind, the researchers examined the effects of trauma and intergenerational substance use on substance use and child welfare outcomes among Black women. Each increase in the number of parents or grandparents with drug and/or alcohol problems was associated with 30% increased odds of women’s drug use and 40% increased odds of these women having an open Child Protective Services (CPS) case with their children, according to Jones. Click here to continue reading.

Recovery & Resiliency - 2023 Black History Month Reflections

By Laurie Johnson-Wade

Co-Founding Director of Lost Dreams Awakening (LDA) Recovery Community

Organization & Peer Recovery CoE Steering Committee Member Recovery Reader Peer Recovery Center of Excellence

February, a month when our nation turns its focus towards Black Excellence and the history of Black citizens of the United States of America, and as I try to celebrate by working on these brief reflections, I must take note that this celebratory month is being eclipsed by the reality that a great number of black citizens still struggle to realize full agency here in the USA; a reality that is substantiated by the most recent public, and traumatic, events that we have collectively witnessed and are now grappling with in 2023.

 Black History Month allows me to reflect on the layers of my identity, something I am always hyper aware of, I’m a black female in substance use disorder (SUD) recovery since 1991, coupled with many other intersectional aspects that make me who I am;  I recognize “resiliency” as an indispensable strength of my life and other Black citizens of our great nation. 

 I would like to offer the following as a gift during Black History Month 2023. This is a briefing that was sent to me from Dr. Ryan Niemiec, at VIA, following the murder of George Floyd (a Black citizen who struggled with Substance Use Disorder) in 2020. Click here to continue reading.

Black History: A Protective Factor and Recovery Tool

Today is the first day of Black History Month. As I type this post there are 502 political bills aimed at blocking the teaching of Black History at elementary schools, high schools and colleges throughout the country. What makes the teaching of Black History so dangerous for those set out to ban it? The teaching of Black History is a threat to the status quo. When taught it has the ability to reduce ignorance, increase empathy and bring people closer together, especially those in the next generation. For African Americans, the history can be a source of pride and a reminder of your resilience. Cultural pride can lead to self-love. Self-love is a substance use disorder protective factor. Resilience offers hope that life transformation, including recovery is possible. Happy Black History Month!

Recovery Definition and Principles for African Americans With Substance Use Disorders Authored by Jonathan Lofgren, Joe Powell, Kasi Reed and Mark Sanders

There are numerous definitions of recovery. Most of the definitions focus on the individual. The most well known definition was developed by SAMHSA.

A process of change through which individuals improve their health and wellness, live a self directed life and strive to reach their full potential.

In interviews with African Americans in long term recovery we learned that recovery in African American communities has additional features beyond the individual. They viewed recovery as more communal, holistic and connected to the upliftment of the African American community as a whole. A group of seasoned substance use disorders professionals formed a committee to define recovery in African American Communities and the communities recovery principles.

African American Recovery Defined

African American recovery is restorative, holistic, and preventive; it includes physical, mental, social. and spiritual growth. Recovery embraces values and traditions of African American culture, and it’s communal and interconnected with our people. Recovery involves participating in family, neighborhood, community, and individualized healing that contributes to sustained health and wellness.

Principes of Recovery for African Americans

1. Hope. With all that we have endured, hope increases in recovery; it’s the belief that maintaining recovery leads to a bright future.

2. Purpose. Nia (purpose) in recovery for African Americans involves activities which help individuals and families make meaningful change, and that those changes also strengthen and support the health and wellness of our neighborhoods and communities.

3. Cultural Expression. Cultural expression is a protective factor that can be manifested in cultural celebrations, cultural holiday’s, art, dance, movement, music, poetry, singing, spoken word, and theater.

4. Trauma Informed Recovery. Recovery involves healing historical and present trauma in our body, mind, and community.

5. Recovery is supported through socio-economic-political-cultural justice. This activism involves seeking, pursuing, and demanding justice in all areas of life, and is an important aspect of African American culture and recovery.

6. Joy. In recovery, joy is an inner experience of happiness and satisfaction with life; it becomes an inspirational light for our community.

7. Recovery is a dimension of Freedom. Recovery is healing, empowering, restorative and liberating for African American individuals, families, and communities.

8. Advocacy. African American recovery concerns itself with the community. In the spirit of mutual aid societies and civil rights movements, recovery involves taking a stand for, lifting-up, in solidarity with and speaking-out for the health and wellbeing of our community.

9. Spirituality. Spirituality in recovery is often maintained with a strong sense of correction, peace, meaning, and love. There are multiple pathways of spirituality in recovery, including; religion, Imani (faith). mindfulness, breath work, physical disciplines, belief in higher powers and beyond.

10. Family, neighborhood, and community driven. African American recovery includes connection with the recovery community, family, friends, neighbors, and the community as a whole.

    © 10/2021 Jonathan Lofgren, Joe Powell, Kasi Reed, Mark Sanders

National Women's History Month

A salute to African American Women who have made historical contributions to Substance Use Disorders Treatment and Recovery.

Clara McBride-Hale. "Mother Hale" Founder of Hale House in New York City. Mother Hale housed children prenatally exposed to heroin in the 1960's and 70's, children prenatally exposed to cocaine in the 1980's and 90's and children born HIV positive.

Andrea Barthwell, MD, FASAM. Dr. Barthwell is the former President of The American Society of Addiction Medicine and she served as Director of Demand Reduction at the Office of the National Drug Control Policy under President George W. Bush.

Lonnetta Albright. As former Director of Great Lakes ATTC, Lonnetta helped shift Substance Use Disorders Treatment from the acute care model solely, towards a recovery oriented system of care. Under her leadership Great Lakes ATTC published a monograph series authored by historian William White, MA on recovery management and recovery oriented system of care. This series played a role in helping to shape the future of treatment and recovery services.

Corrie Vilsaint, PHD. Dr. Vilsaint is the principal investigator at the Recovery Research Institute and Center for Addiction Medicine at Massachusetts General Hospital and research fellow at Harvard Medical School. Some of her research focuses includes recovery capital, reducing discrimination among individuals in recovery and racial health equity in remission and recovery.

Ijeoma Achara-Abraham, PsyD. In her role as a consultant, trainer and strategic planner, Dr. Achara-Abraham is one of the nation’s experts in helping cities and states transform their system to a recovery oriented system of care.

Tonier Cain. Tonier is an author, entrepreneur, movie producer and one of the nation’s foremost advocates and speakers on trauma informed substance use disorders treatment.

Anita Bertrand Bradley, LSW, LICDC. Anita is founder of Northern Ohio Recovery Association. NORA is a model program offering a full range of recovery services. Anita's work has been recognized nationally. She is the recipient of Faces and Voices of Recovery, Joel Hernandez Community Recovery Award, she was honored by President Obama 's Administration as a champion of change and Smart Women Magazine, Women who Excel Entrepreneur Award.

Ayana Jordan, MD, PHD. Dr. Jordan's extensive research, educational and clinical work focuses on increasing access to evidence based substance use disorders treatment for Black, Latinx and Indigenous persons of color nationally and abroad.

Dawn Tyus, PHD, LPC. Dawn Tyus is the Principal Investigator of the African American Behavioral Health Center of Excellence, she is also PI and Director of Southeast Addiction Technology Transfer Center at Morehouse School of Medicine.

A Storied Career: Interview with 2021 NAADAC Enlightenment Award Winner, Mark Sanders

Mark Sanders, LCSW, CADC, is the Illinois State Project Manager for the Great Lakes ATTC, MHTTC, and PTTC. Mark is a published author, trainer, educator, and mentor, as well as the founder of the Online Museum of African American Addictions, Treatment, and Recovery and the co-founder of Serenity Academy of Chicago, the only recovery high school in Illinois. 

If you have never attended a training hosted by Mark Sanders, you're missing out. Mark has a unique ability to be at once both energizing and reassuring. His presentations are equal parts inspiration and intellect – a captivating mix of stories, memoire, and facts. He has motivated and educated countless members of the SUD workforce throughout his nearly 40-year career. For these reasons and many more, Mark Sanders, LCSW, CADC, has been selected as the recipient of the 2021 NAADAC Enlightenment Award, the 2021 Community Behavioral Healthcare Association of Illinois Frank Anselmo Lifetime Achievement Award, and the Illinois Association for Behavioral Health’s 2021 Lawrence Goodman Friend of the Field Award.   

The Great Lakes ATTC, MHTTC, and PTTC congratulate our colleague, Mark Sanders, on these well-deserved awards for his many years of exemplary service and leadership. In celebration of his accomplishments, we asked Mark to share his thoughts on the field of SUD recovery services and how he has achieved success throughout his career. Click here to continue reading.

Lessons Learned From Native American Communities on Recovery

November is National Native American Heritage Month. In this post I would like to share lessons we all can learn about addictions recovery from Native American Communities. One commonality African Americans share with Native Americans is centuries of trauma imposed on us by White Americans. As African Americans we experienced 250 years of slavery, Jim Crow Laws, lynchings, police brutality and mass incarceration. Native Americans experienced several hundred years of massacre, their culture and land taken away. As a result of this historical trauma, Native Americans developed the highest alcoholism rate in the world.

Today, some Native Americans tribes are achieving some of the highest recovery rates in the world, by healing historical trauma and returning to the cultures which were taken from them. One group I would like to highlight is White Bison founded by Don Coyhis, by helping tribes return to culture and healing historical trauma, White Bison is helping tribes achieve 40 to 70% recovery rates. 

Canada, our neighbors to the north also have a history of inflicting trauma on First Nation Tribes. There is a documentary called The Honour of All, which tells the story of a First Nation Tribe that went from 100% alcoholism to 95% recovery. They have maintained a 95% recovery rate for over 35 years by returning to culture. 

I once presented at a research conference on Addictions in Canada. All the top U.S. researchers were there. I suggested that the entire conference take a journey to the reservation and learn how a First Nation Tribe has maintained a 95% recovery rate for 35 years. I truly believe that recovery in African American Communities will involve a return to the culture that was stolen from us during chattel slavery.

A LETTER TO JUDGES: WHO HEAR CASES INVOLVING CUSTODY OF AFRICAN AMERICAN CHILDREN OF PARENTS WITH SUBSTANCE USE DISORDERS

I have had a long and rewarding career as a substance use disorders professional. Still, there is one day that haunts me and probably will for the remainder of my career. A lawyer asked me to serve as an expert witness on behalf of his client, who was facing the potential permanent loss of custody of her daughter in the court system. The lawyer went on to say, Although the hearing has not occurred yet, the judge has probably already decided the case, since she won't allow the daughter to testify about how much she loves her mom. 

The lawyer then handed me 1300 pages of social service progress notes on his client. These notes were so deficit based I knew that there was nothing written in these 1300 pages that would lead a judge to be empathetic to the birth mother’s cause. I conducted a strength-based interview with the mother, in prison. She was incarcerated for minor drug related offenses. I learned that she was an honor roll student and track star in high school. She enrolled in university following high school. At age 19 she fell in love with an older man. Through this relationship she was introduced to drugs. She started using to cope with feelings of abandonment when the relationship ended. He left shortly after their daughter was born. At the time I met with the mother she was arrested for, stealing goods from a store to buy drugs and food for one day. I immediately thought of the Lord’s Prayer, that says Give us this day our daily bread.

The day of the court appearance, the biological mother, who is African American showed up for court wearing a prison striped jump suit. Her hands and feet were shackled, and she was facing the possibility of total loss of custody of her daughter to White Foster parents. The only African Americans in the courtroom that day were me and the biological mother. This scene gave me images of slave auctions, where Africans were shackled, and their children were bought and sold.

During my testimony, the prosecutor asked me ‘yes’ or ‘no’ questions like, “Can stress lead to a relapse? Can parenting be stressful?”  I answered ‘yes’ to both questions. Each time I tried to elaborate on my responses, the prosecutor asked the judge to silence my responses to questions I had responded to. A complete story could never be told about parenting in recovery.

I was able to share information about addiction and recovery during my testimony. The judge stated, “Your testimony is illuminating.” Then she told the biological mother that she would lose permanent loss of custody of her daughter. To say the mother was distraught would be an understatement. I will remember the look on her face when she learned that she would be separated from her daughter forever. Below are my recommendations for judges. 

• Make sure the voice of children is heard in these proceedings.

• Change the format of the hearings. Child custody should not be manipulated by ‘yes’ or ‘no’ questions and answers. Whole stories need to be told.

• Study addiction as a chronic disease. While it is progressive like cancer, I have never heard of a cancer patient losing custody of their children when symptoms return.

• Be aware of your biases as a judge. Are there any racial or addictions biases which may impact your decisions in the court room?

• Never allow mothers facing a loss of their children show up to court shackled.

YOU'LL HANDLE THAT TOO!

An African American female friend called me and said she relapsed recently. I immediately thought of the words of African American tennis star, the late Arthur Ashe, who contracted HIV through a blood transfusion.. A reporter asked Ashe, “Was Aids the hardest thing you ever had to deal with?” Ashe replied, “The hardest thing I have ever had to deal with is being Black in this society.”

Thinking of Ashe's comments, the trauma my friend has endured in her lifetime and her resilience, I said to her, “You have handled being a Black Woman in America. You will handle this too!”

I listened as my friend shared what led to her return to drug use and we also discussed language. I introduced her to the term reoccurrence of symptoms as an alternative to the term relapse. The term relapse is perceived as negative. Cancer patients don't relapse I suggested, symptoms return. I shared that Women for Sobriety calls a relapse A temporary setback! I shared with my friend the words of writer Johann Hari, “The opposite of addiction is not recovery. Its connection.

My friend smiled and said, I'm going to a meeting today.

THE DEATH OF ACTOR MICHAEL K. WILLIAMS: IMPLICATIONS FOR HARM REDUCTION AND TRAUMA INFORMED CARE

On September 6, 2021, Emmy Award Nominated Actor Michael K. Williams died of a drug overdose which included a combination of, cocaine, heroin and fentanyl. Williams played the iconic role of Omar in the HBO series The Wire and Chalky White in the HBO Series Boardwalk Empire. When drug related deaths occur, substance use disorders counselors are able to examine these tragedies from our clinical lens and think about the implications of such tragedies for our future work. 

As a youth Michael K. Williams experienced abuse, neglect and depression. We now know that these co-occurring conditions lie at the core of addiction and almost always precede a substance use disorders. At seminars I often ask substance use disorders professionals to raise their hands if they are a trauma or co-occurring disorders specialist? Approximately 1% of participants raise their hand. In addition, many professionals in our field remain resistant, sometimes even hostile regarding the idea of harm reduction.

It is time for more substance use disorders counselors to become trauma specialists. According to Dr. Gabor Mate, trauma is at the core of addiction. The fact that over 50% of individuals with a substance use disorder also have a co-occurring disorder provides a strong rationale for us to become dual disorders specialists as well. With fentanyl being 50 times more potent than heroin, would Michael K. Williams still be alive if fentanyl strips were used as a harm reduction strategy? How many of your clients would stay alive long enough for the miracle of recovery to occur if harm reduction strategies were used?

Black Opioid Deaths Increase Faster Than Whites, Spurring Calls For Treatment Equity

September 10, 20215:00 AM ET

MARISA PEÑALOZA

 A study published Thursday reveals a growing racial disparity in opioid overdose death rates. Deaths among African Americans are growing faster than among whites across the country. The study authors call for an "antiracist public health approach" to address the crisis in Black communities.

The study, conducted in partnership with the National Institute on Drug Abuse at the National Institutes of Health, analyzed overdose data and death certificates from four states: Kentucky, Ohio, Massachusetts and New York. It found that the rate of opioid deaths among Black people increased by 38% from 2018 to 2019, while rates for other racial and ethnic groups did not rise.

The study used data collected before the coronavirus pandemic began; preliminary data show that overall drug overdoses rose in 2020.

In the earlier waves of the opioid crisis, African Americans had lower rates of overdose deaths than whites, according to another study published last year in the journal Addiction, and Black rates stayed level from 1999 through 2012. However by 2013, white rates began to level off while Black rates began increasing.  The new study from NIDA confirms the trend.

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