Editor’s Note: Today’s post comes from Christiana Verdelus. Verdelus is a Haitian-American woman, feminist, and first-generation college student studying Health Education and Women’s Studies at the University of Florida. This work was inspired by her research on women of color and substance abuse treatment approaches and was completed through the Preston Haskell Faculty and Student Award program.
My first presidential election is right around the corner and let me tell you—I am not looking forward to it. Don’t get me wrong: making Biden and Harris the next leaders of this nation is definitely a small step (or maybe a tiptoe) in the right direction. But I’m angry that it’s only my first election and I’m already tired of settling.
Within our polarized society, Republicans administrations are known to exacerbate issues that disproportionately affect people of color. But Democrats have neglected important issues. Just getting Trump out of office isn’t going to single-handedly repair black and brown communities. I am happy that history is being made with a black woman nominee for Vice President. But “representation” won’t rebuild these communities either. Every four years we spend holding onto hope that the next election will bring real change is another four years of governmental abuse and abandonment of communities of color. As a nation we cannot afford it. And as a black woman and a feminist, I won’t stand for it.
The last few months have witnessed tireless demands for justice for the murders of black people, including Ahmaud Arbery, Breonna Taylor, and George Floyd. These protests have recognized systemic violence as a symptom of the oppression that plagues the lives of black and brown people.
Another symptom of that oppression is the substance abuse crisis that communities of color face. Like militarized policing—and linked to it—substance abuse is a major POC public health problem that has been on the backburner of political reform for far too long. One reason for that neglect is racism. Another is that reform is hard. We don’t need to repeat history to see that an increase in punitive policies is not the answer—the effects of the War on Drugs tell us that. Healthcare professionals play a critical role in managing the health of chemically dependent individuals and decreasing distribution of opioids, but a reactive biomedical approach isn’t the answer either. Treatment programs can work —that is, if they are established in ways that promote the retention of black and brown participants. But no sole entity has succeeded in remedying the multifaceted, deep-rooted, and widespread problem of substance abuse among people of color.
To be clear: the 2018 National Survey of Drug Use and Health makes it clear that substance abuse (defined as use sufficient to seek treatment) is more prevalent among whites than among people of color. But while the current opioid crisis has been described as “a white problem,” in the last few years overdose deaths among non-Hispanic blacks have increased more rapidly than among whites. As we know from the heroin crisis of the 1970s and the crack wars of the late ‘80s and ‘90s, communities of color will continue to suffer long-lasting damage that the white community will not. That’s why this moment offers a perfect opportunity to invest in black and brown communities. Using what public health historian Samuel K. Roberts has called a harm reduction of color approach (HRoC) to the opioid crisis, we can actually garner sustainable change.
HRoC requires addressing the social, political, and economic aspects of drug-related harms; understanding their connection to the historical roots of struggle and stigma; and working within and against the overall structures that perpetuate inequity for communities of color. HRoC-informed analysis fueled the development of small treatment programs for chemically dependent women of color during the 1990s. Mary Jackson’s research on The Iwo San, an Afrocentric women’s recovery program in Cleveland (the term “Iwo San” means “House of Healing in Swahili) and Ijeoma Achara-Abrahams’s work with the Amistad Village Project in New Haven are two examples. These projects predate— and paved the way for— “culturally competent” treatment by foregrounding the roles of racism, domestic violence, sexual abuse, and power relations within households of color played in women’s drug-use histories. They framed “recovery” as not merely abstinence and improved social functioning, but also women of color’s full recognition of their places in society. “Treatment” provided a safe environment to address the structural issues on which the addiction is founded and gave women tools for dealing with them and demanding change.
Another, longer-lived example of HRoC is the Community Coalition of Los Angeles. It was founded in 1990 by Karen Bass, an emergency room physician assistant turned community organizer. Currently chair of the Congressional Black Caucus, Bass was, for a thrilling couple of weeks, a contender for Joe Biden’s VP slot. In its response to the crack crisis, the Coalition provides multiple models of initiatives rooted in a HRoC perspective that can be used to mobilize investment in communities of color on a national level.
A critical component of its success was Bass’s regard for social service providers as first
responders and for residents as key informants of what was going on in their communities. After all, according to Bass, “If you want successful policy, you must include the affected communities in the formulation of new policy.” So when she learned that the bulk of crime imperiling their communities typically occurred in the late nights and early mornings, Bass led the implementation of late-night summer recreation programs. This reclaimed parks that gangs used as territory and kept the youth, who were susceptible to joining these gangs, in a safer environment. “Harm reduction” is the term we use to indicate safer practices of using drugs, but “harm reduction of color” extends far beyond this mechanistic understanding. Instead it delves into the economic and cultural core of substance abuse crises to understand what causes and prolongs their destructive effects on communities of color.
So I’m angry that America missed the opportunity to have Karen Bass as Vice President. Her demonstrated progressive understanding of the important role community organizations play in informing policy and social services would have made my first presidential election worth the wait. But all hope is not lost. The HRoC perspective, embodied in the models that Bass’s Community Coalition and other women of color-led organizations created in the 1990s, can be used to lift the United States out of the substance abuse crisis that has been the country’s reality and a nightmare for communities of color for decades. This, and the improvement of the lives of communities of color in every arena can be realized if those in power could ever hold true to their promises and put the needs of the people first. If there was ever a time to hold our politicians accountable, it’s now.