Prioritizing Addiction Treatment For People Of Color In Ohio

For a period of 18 years, Ohio communities will be receiving billions of dollars from opioid companies as settlement compensation for the astronomical harm caused by opioid drugs during the course of the American opioid epidemic. This money is intended to be used to help Ohio reach out to those experiencing substance abuse and addiction, providing lifelines and treatment pathways to help pull individuals and communities back from the brink. 

However, concerns have been raised that the OneOhio Recovery Foundation, a nonprofit with a board made up of volunteer members that is charged with distributing the majority of this money, may not adequately represent the communities they are charged with serving. In fact, of the 29 members on the board, only two are black, a disparity that mirrors the experience that countless people of color in Ohio have had with substance abuse, addiction, and addiction treatment services. 

Unequal Exposure, Access, And Care

Substance use disorders (SUDs) are not new, nor are the proven treatment resources and practices used to help those who experience them. However, as with other forms of medical care, addiction treatment services are not equally accessible in the United States, including the state of Ohio specifically. In fact, the number of treatment services, the quality and levels of care they provide, and the financial assistance opportunities available to help Ohioans access these services can all vary dramatically from area to area. 

Nevertheless, there is strong evidence that people of color in Ohio are underserved by addiction treatment services, while they are also at a greater risk of developing SUDs and being subject to more severe legal consequences related to substance use.

According to the Health Policy Institute of Ohio (HPIO): 

• As of 2019, Black Ohioans have a higher rate of unintentional drug overdose rate than white Ohioans (42.9/100,00 vs. 37.7/100,000).
• Black children were 1.8 times more likely than white children to experience adverse childhood experiences (ACEs), which are significant risk factors for future SUD and mental health problems.
• In 2020, the drug crime arrest rate for Black Ohioans was 2.4 times higher than that of white Ohioans (628/100,000 vs. 265/100,000).
• During this same period, Black Ohioans represented 27% of all drug arrests, but only 17% of those in drug treatment courts, compared to white Ohioans who represented 71% and 79% respectively.
• Black Ohioans in general were 5.4 times more likely to be incarcerated than white Ohioans.

While less information is available for Latino/Hispanic Ohioans, national studies have demonstrated that those in this group are less likely to attend substance abuse treatment programs than other groups, especially when compared to white Americans. According to estimates from SAMHSA, from 2015-2019 Hispanic or Latino Americans who needed treatment were less likely than white Americans, Black Americans, and any other group except for Asian Americans to have sought treatment (17.6% Hispanic/Latino, 23.5% white, 18.6% Black/African American, and 8.3% Asian). 

However, a variety of changes have been recently proposed to help address this imbalance and allow Ohio’s recovery system to better provide addiction treatment for people of color, and for all Ohioans. 

How Ohio’s Addiction Treatment Centers Can Better Serve Americans Of Color

In 2021, in response to the ongoing opioid epidemic and high rates of stimulant, alcohol, and other substance abuse, including Ohio’s status as the seventh-worst U.S. state for drug overdose mortality, according to CDC data, the HPIO published a Health Policy Brief entitled, “Taking action to strengthen Ohio’s addiction response.” This document outlines specific state-level policy changes and priorities designed to improve Ohio’s ability to treat substance use disorders in general, and also to improve addiction treatment equity.

These proposed policy changes include:

• saving lives by ending fentanyl overdoses, including by expanding access to opioid antidote medications and drug supply testing
• reforming the criminal legal system to reduce incarceration and support recovery, employment, and housing
• strengthening Ohio’s prevention-treatment-recovery continuum, including treatment capacity, medication-assisted treatment (MAT), and recovery housing

These high-level recommendations synchronize with another set of program-level changes created by Boston Medical Center’s Grayken Center for Addiction and published in the report, “Embracing Anti-Racism in Addiction Treatment, Research and Policy: Engaging Black People with Lived Experience of Substance Use Disorder.” These recommendations are specifically intended to help treatment programs reach Black individuals and those of other marginalized backgrounds, and to meet their particular needs. This should improve treatment access and effectiveness in meaningful ways. 

The specific suggestions laid out in the report include the following.

Improved Leadership Commitment

The commitment to inclusion and equity in treatment must start at the top. Treatment center leaders must be committed to elevating the experience of marginalized clients and rooting out bias that may otherwise prevent POC from accessing care. This includes intentionally addressing unconscious bias and microaggressions. 

Organizational Changes

All treatment center staff must be held accountable for the experiences of their clients, especially POC. Centers should be able to demonstrate that their treatment is designed to meet the needs of POC coming from a variety of different cultural backgrounds. Likewise, the environment and decor of a treatment center should be chosen to be warm, welcoming, and reflect diverse cultural identities. 

Changes To Hiring, Training, And Support

By intentionally hiring POC and those with lived experience with SUD as staff, treatment centers will naturally become more equitable and inclusive, allowing them to appeal to a far broader treatment population. In addition, training and education can be provided to all staff to keep them current on cultural topics as well as topics in diversity, equity, and inclusion. 

Empowering And Supporting Clients

Evidence suggests that POC in treatment centers (and Black individuals in particular) are more likely to be seen as disruptive and, in many cases, removed from treatment as a result. Self-governance systems can help address this issue, allowing treatment center participants, rather than staff, to respond as a group to individual patients who violate community rules.

Reshaping Addiction Treatment To Be Less Punitive And More Strength-Based

POC often face significant cultural barriers to entry when it comes to addiction treatment, and may benefit from different, client-centric approaches that emphasize positive reinforcement over judgment-based approaches. In addition, clients should be informed about all of their treatment options, and alternative treatment approaches like art therapy, martial arts, exercise therapy, music therapy, spirituality-inclusive services, and family-inclusive services should be made available when possible. 

Addressing Trauma

As with adverse childhood experiences, racial trauma and discrimination are often overlooked factors that can play a foundational role in the development of SUDs, while also acting as a lasting barrier to their treatment. Treatment centers must be able to provide trauma-informed care to address these challenges and others during the recovery process.

Removing Barriers Between Clients & Mental Healthcare Providers

Mental health conditions like PTSD, depression, ADHD, bipolar disorder, and others frequently co-occur with SUDs, and are often overlooked during the recovery process. Because POC are also underserved by mental health treatment services, and because untreated mental illnesses can contribute heavily to reduced treatment outcomes, it is important that all patients be screened for these co-occurring issues and provided with a dual diagnosis treatment plan when warranted.

Expert Recovery Care At Ohio Recovery Center

Choosing to participate in the addiction treatment and recovery process is an act of courage for anyone, no matter who you are or what you have experienced in the past. At Ohio Recovery Center, we are proud to be a part of the recovery journeys of Ohioans of every background, and we offer a variety of evidence-based and inclusive treatment services to help meet your unique treatment and recovery goals.

As part of our own commitment to equity and accessibility, ORC has already implemented many of the recommendations listed above, including:

• maintaining a diverse staff of treatment professionals, including those with lived experience with SUD
• providing a welcoming, warm, secure, and comfortable treatment environment
• offering empowering, personally tailored treatment services
• emphasizing the importance of dual diagnosis care for co-occurring mental health issues
• providing access to MAT treatment options
• providing trauma-informed care
• offering a variety of engaging and rewarding alternative treatment programs like art therapy, yoga, exercise, nature exposure, and more

To learn more about opportunities for addiction treatment for people of color in Ohio, Ohio Recovery Center’s own treatment services, and how ORC can serve you or your loved one through the recovery process, please contact us today.