The US Census Bureau reports that as of July 1, 2016, around 13 percent of the American population was Black or African American. Even though African Americans make up an ethnic minority in the United States, the black community struggles with substance abuse and problems related to alcohol and drugs at high rates. The National Institute on Drug Abuse (NIDA) publishes that nearly one-quarter of all public substance abuse treatment admissions in 2008 were African Americans.
As an ethnic minority, African Americans actually tend to drink less, start drinking later, and abuse alcohol less frequently than other races and cultures. Despite this, the American Psychological Association (APA) reports that this demographic suffers from more negative consequences of alcohol use, including more injuries, illnesses, and negative social consequences that are alcohol-related.
Alcohol Use and Abuse within the Black Community
The National Survey on Drug Use and Health (NSDUH) publishes that approximately 43.5% of African American adults (aged 12 and older) currently drank alcohol at the time of the 2013 survey, and 7.4% struggled with alcohol addiction. Just 20% of the black community binge drank in the prior month (according to the 2014 national survey), the Substance Abuse and Mental Health Services Administration (SAMHSA) reports, which is below the national average of 23%. Fewer African American youths report underage drinking than the national average. In 2014, approximately 8.5% of black youths between the ages of 12 and 20 reported drinking alcohol in the prior month compared to a national average of 13.8%.
In general, then, alcohol use is generally lower in the black community than in other racial and cultural demographics. Interestingly, however, problems related to alcohol are greater within the African American community than they are for European Americans.
There may be several factors involved in why members of the black community are more likely to struggle with problems related to alcohol than other ethnic minorities, even though they tend to drink less. As a general rule, drinking may not be as socially acceptable in African American cultures, and often, these communities have a strong religious and spiritual component that may frown upon drinking. That being said, black individuals also face quite a bit of stress due to racial discrimination and may also be more likely to suffer legal or criminal consequences when drinking in public than other races simply due to the color of their skin.
The New York Times reports that close to 60 percent of the US prison population is African American. There exists a criminal bias that can contribute to this racial disparity in the criminal and legal system. There is also often a heightened police presence in black communities, which can further contribute to more negative social, legal, and criminal problems involving drinking.
Environmental and socioeconomic factors may play a role in problematic drinking, as African Americans more commonly live in poverty, have less education, and are more likely to be unemployed than European Americans, the Psychological Bulletin publishes. Young African American men who are economically disadvantaged have the most problems with alcohol and problematic drinking within this demographic, Science Daily reports, as this group generally has a less stable home and support system, and fewer positive influences in their lives that help to prevent drinking. Individuals living in poverty and in low-income communities are likely more apt to engage in substance abuse and to then struggle with addiction.
African American neighborhoods may have a higher density of establishments selling alcohol within their borders, thereby increasing access to it. Media portrayal of young and famous black individuals drinking alcohol and experiencing supposed positive effects may influence young people within black communities to drink as well.
It is also possible that African Americans may potentially experience heightened effects of alcohol when drinking less, Science Daily publishes. This means that even when drinking the same amount, or even less, than someone of a different ethnicity, African Americans may become intoxicated faster and experience added negative side effects of alcohol more quickly.
Understanding Treatment Needs for African Americans
Increasing access to treatment in disadvantaged neighborhoods and stepping up preventative measures in schools and black communities can educate the public regarding the potential dangers of alcohol abuse. Community involvement is key.
Within African American families, religion and spirituality often play a large role in healthy outcomes. Spirituality is also often an important aspect of African American culture. Addiction treatment programs that are sensitive to this, and understand how to strengthen a person's spiritual connection may improve the individual's overall health and sense of wellbeing.
The journal Minority Nurse publishes that treatment providers who understand and can relate to the sociocultural and inner workings of the African American community, and the positive role that spirituality can play in healing pain related to oppression and racism, can be intrinsically valuable to recovery efforts. Treatment programs that cater specifically to the black community can provide relevant care for this racial and cultural demographic.
African Americans also struggle with medical issues and complications related to alcohol at higher rates than other populations. West Virginia University (WVU) reports that this demographic battles heart disease, cancer, and cirrhosis more often than other ethnic groups. SAMHSA further publishes that African Americans have higher rates of mortality from major diseases, and 44 percent of HIV infections in America involve African Americans. Conversely, members of the black community suffer from mental health issues less frequently than national averages suggest; however, African Americans have higher than average rates of injury, homicide, suicide, and assault. These medical and mental health complications need to be addressed and managed during an alcohol abuse treatment program.
A medical detox program, followed with a comprehensive and integrated medically based residential addiction treatment program, is often ideal. Medical and substance abuse treatment providers, as well as mental health professionals, need to work together for medical, mental health, and alcohol abuse concerns to be addressed simultaneously.
Treatment Considerations in the Black Community
African Americans may initially enter into an alcohol abuse treatment program through the court system. Legal pressures can be just as successful as internal motivation in making positive changes. NIDA reports that individuals who enter into addiction treatment programs due to legal pressure may even stay in treatment programs longer and participate more actively than those who are not legally pressured or required to do so.
Generally speaking, the longer a person remains in a treatment program, the better the results. Longer stays can provide time to heal, and establish healthy habits and tools for minimizing relapse in recovery.
Behavioral therapies, including Motivational Interviewing (MI), can help individuals to find and develop internal motivation to make positive life changes and also to accept themselves for who they are. Behavioral therapies address self-esteem levels, and teach stress management and coping mechanisms for handling triggers and positively modifying negative and destructive thoughts. This can be especially helpful when addressing issues like racial discrimination and oppression. Providers will need to be culturally sensitive to these issues and how they relate to substance abuse concerns.
Aftercare, family, and community support programs are beneficial after completion of an alcohol abuse treatment program. They can provide continuous and ongoing support to reduce relapse and sustain recovery.
An alcohol abuse treatment program catering to the black community may include the following:
- Treatment for polydrug abuse, as there are high rates of concurrent drug and alcohol use in this demographic
- Medical detox, which uses medications to manage significant emotional and physical side effects of alcohol withdrawal
- Therapies that enhance motivation to participate in treatment programs, and to make positive modifications to thoughts and behaviors
- Educational programs to highlight the hazards of substance abuse and addiction
- Medical care, mental health support, and medication management for concurrent physical and emotional health issues
- Individual and group therapy sessions that are culturally sensitive and tailored to the African American demographic
- Peer support groups made up of other people with similar backgrounds and cultures in order to form a healthy social network for recovery
- Anger management classes and life skills workshops to teach tools for dealing with stress, anger, and other difficult emotions
- Aftercare programs to support individuals in recovery after completing a treatment program
Residential addiction treatment programs can provide individuals with a stable and safe environment to detox from alcohol and to improve quality of life in general through specialized programming. Outpatient programs are an option, too, when individuals need more flexibility in order to maintain familial, work, and/or school obligations. Alcohol abuse treatment programs are highly individual, and treatment coordinators can help people to find the right care plan.