Close

Realizing the Promise of Principle 4 in your Strategic Planning: A Comprehensive Framework from Black Faces and Black Voices

By: Sahvanah Prescott and Phil Rutherford

The opioid crisis has had devastating impacts on communities all over the country, particularly in communities of color. While communities of color experience substance use disorders at similar rates as white communities, the rates of drug overdose deaths have increased more rapidly for communities of color. Factors that shape the health outcomes of people of color with substance use disorders are multifold and impacted by numerous levels of racism in interconnected and reinforcing ways. Many of the same parameters attributed to the social determinants of health including structural racism, systemic biases, lower socioeconomic status, toxic stress, the mistrust of systems, and lack of social and emotional support contribute to the disproportionate increases in overdose deaths we have witnessed in communities of color. 

The experiences of marginalized populations often have not informed strategic plans for addressing the negative impacts of the opioid epidemic. The impact of the opioid epidemic in black communities particularly has largely been unrecognized. Black individuals are more likely to be arrested as a result of their opioid use and are disproportionately criminally sanctioned. Black people are incarcerated for drug offenses at a rate 10 times greater than that of whites, despite similar substance use rates. While accessing treatment for OUD is generally difficult for everyone regardless of race, Black individuals are more than twice as likely as whites to have no access to treatment and Black individuals are less likely to successfully complete substance use disorder treatment than compared to their whites counterparts. Despite national and state-level efforts to improve access to buprenorphine, racial and ethnic disparities persist. Systemic inequities such as lower income with greater reliance upon public insurance sources, lack of transportation and childcare, residential segregation, discrimination, and racial stigma serve as significant barriers impacting treatment outcomes and treatment quality for communities of color. Access to high-quality culturally competent substance use disorder treatment has been shown to enhance client engagement, retention, and treatment outcomes for communities of color.  Given the unique experience of structural and systemic biases Black populations face, there is a great need for federal and state governments to develop more culturally targeted programs that benefit black communities in addressing the impacts of the opioid crisis. 

Black Faces Black Voices (BFBV) is a national collective of Black substance use disorder professionals whose purpose is to bring visibility to the Black recovery movement and help promote culturally responsive addiction services that meet the needs of Black communities. BFBV offers a comprehensive framework that aims to create a multi-faceted and community-centered approach to address the opioid crisis within Black communities through the use of opioid settlement funds. A group of four domains including; community, finance, health, and wellness are discussed as ways in which jurisdictions can evaluate and invest in activities that support the growth and development of the Black community. 

1. Community

  • Conduct Needs Assessment

Conducting a community-level needs assessment that examines factors such as healthcare access, addiction treatment services, mental health support, education, employment opportunities, and community development is a great step toward identifying areas for improvement. Information collected through these assessments can guide future plans to address community challenges and aid in informing how resources should be allocated to best meet the needs of the community. Specifically, identifying gaps in health equity is a first step to mitigating the problem.

  • Community Engagement and Representation

Forming an advisory committee composed of representatives from Black recovery-centered organizations, health experts, addiction specialists, legal experts, and community members can help create a connection between communities and substance use health experts. In ensuring these individuals have a say in the distribution and decision-making process of how opioid settlement funds are expended, jurisdictions can prioritize the concerns of affected communities. 

  • Collaborating with Faith-Based Organizations

Faith-based organizations often play a significant role in providing support and resources to their communities by offering additional assistance and outreach to people impacted by the opioid crisis. Black individuals with substance use disorders are an underserved population who face many challenges, including a lack of resources, access to affordable and effective care, and other hardships. Faith-based organizations may work to fill some of these gaps as they ​​have well-established networks and a shared legacy of caring for marginalized populations and addressing the negative impacts of the opioid epidemic.

2. Finance

  • Long-Term Sustainability

 For the long-term sustainability of initiatives supported by opioid settlement funds, it is important to consider how investments made today can continue to benefit black communities in the future. Given the funds short-term nature, jurisdictions should prioritize funding projects in need of one-time or start-up costs avoiding funding areas where other funds may be available. 

  • Investing in Telemedicine and Telehealth Services

Expanding accessibility to addiction treatment and counseling services through telemedicine and telehealth services may be particularly valuable for reaching individuals facing transportation issues, living in remote settings, or connecting to individuals who are reluctant to receive care in physical settings. Research has shown telemedicine care to be just as effective as in person care in the treatment of opioid use disorder. Telehealth has the potential to address gaps in treatment, making treatment services more accessible and convenient, improving health outcomes, and reducing health disparities.

  • Investing in Legal Assistance and Reentry Programs 

Many people with substance use disorders have a history with the criminal legal system. Individuals with felony drug convictions face public stigma and significant policy barriers in improving their social determinants of health, such as restrictions on housing and employment. Black individuals are more likely to be arrested as a result of their substance use and are disproportionately incarcerated. Jurisdictions may consider investing in resources that provide legal assistance to individuals with substance use disorders, supporting them in navigating the legal system and addressing legal challenges related to their addiction. Investment in reentry programs can support individuals’ transitions back into society after incarceration.

3. Health

  • Supporting Cross-Sector Collaboration

Building partnerships across sectors ensures a holistic and coordinated approach to addressing the opioid crisis. The overdose crisis is complex and requires multisector solutions. Cross-sector collaboration can work to inform the early detection of emerging substances and trends, inform prevention and response strategies, and determine how resources should be allocated to best meet community needs. Facilitating collaboration among various sectors, including healthcare, education, law enforcement, social services, and community organizations can help ensure each organization understands their role in reaching shared goals.

  • Supporting Mobile Health Care Clinics

Investing in opportunities to support mobile health clinics that can reach underserved areas within Black communities, providing access to healthcare services, addiction treatment, and mental health support. Mobile health clinics can easily adapt to meet the changing needs of the communities they serve. Research has shown mobile health clinics are particularly efficient at helping underserved communities access preventative care, manage chronic disease, and improve outcomes among communities disenfranchised from traditional healthcare. By reaching remote and underserved communities, mobile health clinics work to address geographical and transportation barriers, both of which have been cited as significant obstacles to healthcare access. 

  • Expanding Access to Culturally Fit Healthcare Services

Invest funds to improve healthcare access and quality in Black communities. This includes targeted efforts to expand addiction treatment facilities, and recovery support activities, increase mental health services, and promote preventative measures to reduce opioid misuse in black communities. The lack of culturally fit healthcare services can put patients at a higher risk of having negative healthcare consequences, receiving poor quality care, or dissatisfaction with their care. Culturally fit healthcare works to address racial and ethnic health disparities and can help improve health outcomes and quality of care.

4. Wellness

  • Address Trauma

Develop and implement trauma-informed care initiatives and resources that recognize the impact of opioid addiction on mental health and emotional well-being. Support counseling and mental health services that are sensitive to the trauma experienced by individuals and families affected by addiction.

  • Integrate Art and Culture

Integrate art and culture into the initiatives to celebrate the rich heritage and creativity of Black communities. Artistic expressions can serve as powerful tools for healing and community building.

  • Supporting Resources to Support Recovery and Rehabilitation

Provide resources to support individuals and families in recovery, including counseling services, peer support programs, and job training opportunities. Additionally, allocate funds to establish long-term rehabilitation centers and sober living facilities within Black communities.

About the Authors:

Sahvanah Prescott is a policy intern for Shatterproof, a nonprofit organization committed to reducing the devastation of addiction through advocacy. She completed her Masters of Science in Addiction Policy and Practice at Georgetown University where she primarily focused her research on harm reduction and prevention efforts. Sahvanah’s academic journey has ignited her interest in researching culturally responsive solutions to addressing substance use-related issues with a specific focus on assisting communities of color and improving access to treatment for parenting mothers and individuals in carceral settings. 

Philip Rutherford is the strategy lead for substance use at The National Council for Mental Wellbeing. Rutherford has managed strategy and operations for several recovery-focused organizations. He is a member of committees at the National Institutes of Health, the Food and Drug Administration and other federal agencies. He serves as board chair for Serve Minnesota and the Police Treatment and Community Collaborative. He also holds board seats at the National Association of Addiction Treatment Providers and the Recovery Policy Collaborative. In 2020 Rutherford launched Black Faces Black Voices, a community-focused collaborative centering the needs of Black communities. This group now represents roughly 100 organizations around the country. Prior to the nonprofit world, he spent most of his career at Microsoft, Micron Electronics, and the Taylor Corporation. Rutherford is an active member of the recovery community and has considerable experience in the areas of reentry and equity.