ALCOHOL AND BLACK AMERICANS

April 21, 2024 Mark Sanders

by Mark Sanders, LCSW, CADC

While African Americans do not dominate alcohol use in the United States, alcohol use has had a devastating effect on us. I have an African American friend of five decades who recently died of multiple medical complications. At the root of his death was alcoholism. Both of my grandfathers and many uncles and aunts died from alcoholism as well. Alcohol has had a severe impact on Black America. The two are even linked in history. During the slave trade, enslaved Africans were shackled and shipped to the West Indies in exchange for molasses, sugar, and other manufactured items. Then, enslaved Africans were shipped to North America, along with the molasses and sugar (which was converted into alcohol). Weapons and alcohol were shipped to Africa in exchange for more enslaved Africans. This is known as the Triangular Trade. I once shared this history at an African American elementary school and a fourth grader asked two questions. Are you saying we were sold for alcohol? Then why does my father drink so much?

Frederick Douglass, the first prominent recovering alcoholic reminded us, “We cannot stagger to freedom.” Douglass revealed that alcohol was used to control enslaved Africans. Douglass stated, “They would work us and beat us Monday through Friday and allow us to drink on weekends. The belief was that once we tasted alcohol we would never want to escape. It was the sober minded slave that they feared most.”

There are several things which stand out for me in Douglass' quote. During the Jim Crow Era when my grandfather’s generation of Black Americans migrated from the southern states to the north in search of good jobs, they would work hard Monday through Friday and drink hard on weekends. My grandfather would even pour salt into his cans of beer. Today I know that combination was a shot a high blood pressure. The second thing which stands out in the Douglass quote is that alcohol was used as medicine for our historical trauma.

The authors of the book Doin' Drugs stated that during the great migration, the center of socialization for African Americans shifted from the Black Church in the south to bars in the north. Thus, the famous quote,” There is a liquor store on every corner.” Published int the 1990’s, the book Message In The Bottle: The 40 Ounce Scandal, author Alfred Powell revealed that certain brands of alcohol were specifically targeted to the Black Community. Today, well known hip-hop artists promote and sell varieties of high-end alcohol. What impact does this advertisement have on youth?

Across the country there are African American youth who have declared that they will never use any drug besides marijuana! Yet in clinical practice I have had numerous African American emerging adult clients buy alcohol legally to celebrate their 21st birthday. As it pertains to homicides in the Black community, alcohol and marijuana are the two most common drugs which appear in the drug tests of the perpetrators.

Over the past several decades crack and heroin have grabbed headlines as the drugs having catastrophic effects on African American communities. In Drug use For Grownups, Dr. Carl Hart reveals that alcohol use is involved in nearly 70% of opioid overdose deaths. We should never forget alcohol. During the crack cocaine era many African Americans who went to treatment would return to cocaine use after one drink. That drink would lower their inhibition, making it easier to return to cocaine. Over the years I have had numerous African American clients who grew sick and tired of hustling and going to jail and prison for charges connected to cocaine and heroin use/possession. Many would shift to alcohol and die of cirrhosis of the liver, delirium tremors, car accidents under the influence and other alcohol related causes.

I have written this post so that my soul can rest, having lost so many loved ones to alcohol use disorders, including a 50-year friend. As I reach this final sentence I exhale. It is my hope that addictions professions focused on treating stimulant use disorders, opioid use disorders and other addictions, won't forget about alcohol.

The Needs of African American Children of Parents with Substance Use Disorders Part III

January 29, 2024 Mark Sanders

Donald Gunther and Mark Sanders

In part I of this series we shared our personal story of surviving and thriving as African American adult children of fathers with substance use disorders. Part II focused on the role of families and schools in supportive African American Children of parents with substance use disorders. In today’s post we focus on the role of the entire community and social service organizations in helping these children flourish!

What the Community Can Do

Donald’s view

Metaphorically, systems are like families; generations are like the roots and seeds are considered to be the child or children. The seeds planted and entangled, causing enmeshment, and an unhealthy garden will produce unhealthy fruit. Although the seed was planted with good intention, someone or a country forgot to plot and plow! I must mention there is a season for every reason a farmer would say, so digging up and airing out is uncomfortable but extremely important before you start to harvest your garden and or fruits of your labor. Could this be a new beginning (Recovery) or a never-ending story (addiction)? Since our underlying conditions were never noticed the root cause of our addictive thoughts, beliefs and behaviors would be the birthplace of our codependency also known as an addiction to unhealthy relationships with our families and within the community.

In many African American communities, it has been said “It takes a village to raise one child.” The communities consist of families, neighbors, businesses, schools, recreation centers, park districts, business owners etc. Since becoming a recovery coach professional facilitator for Connecticut Community for Addictions Recovery (CCAR). I have educated and empowered myself with their Evidence-based curriculum, which any part of the community can access to become recovery coaches. Some recovery coaches work with entire families and communities. This is offered through their Recovery Coach Academy. Information on the CCAR training can be accessed here https://addictionrecoverytraining.org/

I envision a day when recovery coaches will increasingly work with families and entire communities in promoting recovery and generational healing. In the 1980’s and 90’s, when crack cocaine was present in New York City, Chicago, Detroit and Compton, California, entire communities were impacted. Interventions should also address the entire community, including children. Growing up in NY and being able to see the stronghold that addiction had on families was very traumatic. Many of our family’s safe place (home) was not safe at all. In fact, every block seemed to have had their own pharmacist filling prescriptions that was killing our communities and those family members that were unable ‘to just say no’.

Decades later with INTERVENTION on my mind I needed a solution so I became a CCAR recovery coach professional facilitator so that I could collaboratively address SUD and Mental Health Disorders that has generationally oppressed fathers, family members and important people battling addiction. Now as Georgia’s Grateful Recovery Coach Professional I can educate communities with an evidence-based recovery coaching curriculum to motivate the plan for change that provides an opportunity to OVERCOME substance use disorders and mental health disorders and empowering African American communities.

Mark’s view

Like with other communities, the majority of African Americans have loved ones impacted by substance use disorders. The good news is there is room for everyone in providing support for children. Some African American barbers have been contracted with to provide mentorship for African American children.

The African American business community could also get involved in mentoring. Seeing individuals who look like you and are successful can instill hope. As many of the children don’t feel like they belong, there is definitely a role for park districts in black communities to help break isolation, build community and resilience. I was inspired when I visited a library in an African American community which had a book section focused on families with addictions and resources for children.

What Social Service Organizations Can Do

Donald’s view

African American children are impacted by the trauma of growing up in homes with parental substance use disorders. Many are also impacted by community violence such as gang violence, shootings, police brutality etc. Living with trauma increases the risk of PTSD and complex trauma, which if unaddressed can increase the risk of heavy substance use to cope with the trauma. Social services organizations could administer the ACE’s scale and provide trauma informed care and prevention services for children at risk for substance use disorders. Providing life skill trainings for children could also be helpful. Social service organizations could provide specialized groups for children impacted by parental substance use.

Ironically, listening to my father’s silence speak loud and clear about our abject poverty was psychological abuse. A soldier in a foreign war who trained to fight was not able to provide for his family but he could protect his country. These would be the words that dad would murmur from time to time with his facial expression. My dad and many men of color could’ve used resources like CCAR Recovery coaching academy. Social services should collaboratively work with agencies that can empower a recovery process. Therefore, schools, work readiness programs, churches and many other communities based and nonprofit organizations should be part of the recovery community organizations that promote a dual development with some S.O.B.E.R-F.A.C.T.S. Fortunately, my lived experiences and dealings with social services as an impoverished youth was a negative experience. In hindsight, CCAR Recovery Coaching has provided me an opportunity to promote the need for Compassion, Empathy and Understanding to collaboratively motivate change within the system. In fact, blogs like this can become topics of interest to collaborate social services with social media as a BLOGCAST (blog and podcast) that could be the start of the uncomfortable changes that’s needed to reunify families with the assistance of social services and other recovery community organizations (RCO's).

Mark’s View

Donald, I really agree with you about administering the ACEs to assess the impact of trauma in the home. There is a newer tool called The Philadelphia ACE’s. which also evaluates the impact of community violence, which many African American children are exposed to. It includes categories such as witnessing community violence, police harassment, experiencing racism etc.

SAMHSA has a new prevention initiative where substance use disorders prevention programs partner with other youth programs to help them provide prevention services. In adopting such a program in African American communities, schools, child welfare agencies, the juvenile justice system, pregnant and parenting teen programs, gang intervention programs could be trained in substance use disorders programming. Expanding the prevention net would allow us to help more children.

The Needs of African American Children of Parents with Substance Use Disorders

December 14, 2023 Mark Sanders

By Donald Gunther and Mark Sanders

An emergency room social worker from an African American community was distraught as she shared the story of an African American man who survived an overdose as he was rushed to the ER in the nick of time! He was accompanied to the ER by four adult relatives and his 10-year-old daughter.

The Social worker educated the family about how to use NARCAN and offered the overdose medicine to the family. All the adults refused NARCAN, and the 10-year-old daughter stated, You can give the NARCAN to me and I will use it if my daddy gets sick again at home.

That story reminds me of the nightmare African American children of parents with substance use disorders have been experiencing the past four decades. In 1986 there was a crack cocaine epidemic which intensified the War on Drugs. Some called it a war on African American men as so many were incarcerated and received felony convictions, in some instances for possessing minute amounts of cocaine. Thousands of African American children were now living with fathers behind bars. The next fastest growing population behind bars were African American women/mothers with substance use disorders.

In 1993 I had an African American client who was incarcerated at cook county jail for possession of a small amount of crack. She was pregnant and delivered her baby at Cook County hospital with her hands and feet shackled to the bed. Following the delivery, she was escorted back to jail by male guards, who incidentally were in her room during delivery. Her newborn was immediately taken by caseworkers into the child welfare/foster care system. I have spent 4 decades wondering about the impact of that delivery on the child. These draconian methods were repeated throughout the country.

While advocacy measures were put in place to address the before mentioned disparities and practices, the needs of the children have primarily gone ignored.

This two-part blog series is written by Donald Gunther, a Certified Connecticut Community Addiction Recovery Coach Professional Facilitator and a Georgia Certified Mental Health Peer Specialist and Mark Sanders, Founder, Museum of African American Addictions, Treatment and Recovery. They both are adult children of fathers with substance use disorders. In part 1 they each share their story with the hope that readers will be inspired to facilitate their own healing and help African American children of parents with substance use disorders heal as well. Part II will include their recommendations to help African American children of parents with SUD thrive!

Donald's Story

My father was a War World II veteran who suffered from PTSD. His traumatic experiences would be the cause of our ACE’S. These adverse childhood events would teach us how to promote surviving in silence. Ironically, history reveals that in our early wars soldiers were given alcohol to cope with the trauma of war. Thus, my father returned home a hero with an alcohol use disorder. Thus, I am what is known as an ACOA, an adult child of an alcoholic. My father was a great man who raised ten children along with my mother. We were traumatized by my father’s trauma and alcoholism. My father had PTSD. I developed Complex Trauma (multiple layers of trauma), dealing with my father’s PTSD, addiction, and poverty, growing up in New York City with no hot water or bathtub, and no heat in the winter. Metaphorically, my silence would not be heard until five decades later when the consequences of being emotionally neglected became the root cause of my behavior and beliefs of myself. Silence would be the beginning of my underlying conditions (Codependency 101).

Mark's Story

Donald, I really relate to your childhood trauma. I feel like my four siblings, and I came out of a war too! My mother left my father when I was in third grade and that was traumatic! A year later she married my stepfather, who moved in with us from the battlefield, Stateville Penitentiary. We later learned that he was incarcerated for drug related crimes. He would beat our mother in front of us and my mother would beat us in front of each other. As war veterans described, we were walking on eggshells. It always felt like a bomb could explode at home at any moment. My mother took care of my stepfather. He ultimately died of an opioid overdose. I have carried the residue of that experience for decades.

The Good News!

The research says that 75% of children of parents with substance use disorders do quite well! The resilience which comes from being an ACOA can lead to great achievement. Presidents Ronald Reagan, Bill Clinton and Barack Obama are all ACOA's.

We both believe that growing up as COA's has contributed to our resilience and life purpose, to help individuals and families recover! In Donald's words, I am processing my pain, which has led me to my purpose.

Conclusion

While the majority of children of parents with substance use disorders do well in a racialized society, African American COA's disproportionately get expelled from school, attend alternative schools and wind up in the criminal justice system. In essence, their pain is more likely to be punished. It is our hope that you compassionately help these young people soar.

Celebrating Dual Recovery in African American Communities

September 8, 2023 Mark Sanders

September is National Recovery month. In honor, there will be marches, parades and other celebrations of substance use disorders recovery. African Americans have caught the spark of recovery month and have joined the rest of the country in celebrating this sacred month. While research indicates that substance use disorders and mental illness overlap at the rate of 50-70%, little attention is paid to mental health recovery.

This post is meant to encourage African American communities to also celebrate mental health recovery. Because of historical trauma, as a community we have our fair share of PTSD, complex trauma, depression, anxiety disorder, and ADD. According to Dr. Joy Degruy, we also suffer from a condition she calls Post Traumatic Slavery Syndrome as a result of 400 years of historical trauma,

So let us march and celebrate mental health recovery in African American Communities! This visibility could help reduce the stigma of mental illness in African American communities. Once mobilized we could also form African American mental health advocacy movements. This movement could fight for treatment as an alternative to incarceration, Medicaid expansion, an increase in mental health services in African American communities, and the need for more African American mental health professionals.

Graduation: From Marijuana to Crack and Opioids

August 22, 2023 Mark Sanders

For years I specialized in working with African American adolescents who primarily smoked marijuana. Most began smoking marijuana between the ages of 11 to 13 and just about all made a declaration that marijuana was not addicting and that they would never use real addictive drugs like crack and heroin. When asked the reasons they would never use crack or heroin, they would say things like:

My aunt smoked crack and she sold her body for pennies to buy more crack

My uncle used heroin and overdosed in an alley with a needle in his arm.

Evidence indicates that in spite of the declaration of marijuana only, many of these youth will graduate to cocaine, opioids and other drugs as they age and as addiction progresses. Many of these youth begin experimenting with xanax, molly and other pills. When they turn 21, they celebrate adulthood by buying their own liquor, legally for the first time. As they enter emerging adulthood many will begin to add stimulants like cocaine, Oxycotin and heroin to their menu of drugs.

One study found that if an adolescent smokes marijuana for over 200 days in a year, they become more vulnerable to stimulant and opioid dependence. I have seen this in clinical practice and have talked with colleagues who have also witnessed this phenomenon.

For states which legalize marijuana, legalization begins at age 21. For teens who begin smoking marijuana before age 16 they become more vulnerable to mental health symptoms and a permanent drop in IQ caused by early marijuana use. In addition, many youth who start smoking marijuana at young ages do so to medicate childhood trauma and are at an increased risk of addiction. Many African American adolescents have said to me, “There is gun violence and gangs in my community. Of course I smoke marijuana to deal with that!” Once the addiction process has set in, they become more vulnerable to cocaine and opioid dependence, in spite of the early declaration, “I'll never use those drugs!”

For African American adolescents, prevention of stimulant and opioid dependence can involve addressing marijuana use as early as possible including primary and secondary prevention. Early treatment for those whose marijuana use has been diagnosed as early stage dependence is also recommended. Addressing the trauma which often precedes substance use is of the upmost importance.

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

June 27, 2023 Mark Sanders

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 14, 2023 Mark Sanders

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!

400 Years of Perseverance, Resilience and Success

February 23, 2019 Mark Sanders

This post is meant to offer hope to African American seeking recovery. The first kidnapped Africans were brought to America as Slaves in 1619(city of Jamestown, Virginia). This year marks the 400th year anniversary of Africans living in America (1619-2019). There are two ways this story can be told. One, from the perspective of the 10 PM News in any city in American which routinely and stereotypically depicts African Americans as lazy, dishonest, criminal, oversexed, immoral, addiction prone individuals, who have contributed little to the success of this country. Then there is the truth! Objectively, historians 100 years from now looking back on our first 400 year history in America and conclude, "What an amazing people! During their first 254 years in America they were brutalized in Chattel slavery (1619-1863). This was followed by 146 years of lynchings, victims of burnings (especially churches and Black owned businesses), beatings (read the story of Emit Till), bombings (read the story of the four little girls, Birmingham, Alabama and Black Wall Street), medical Maltreatment (read the story of the Tuskegee Experiment), Jim Crow Laws, discrimination, racism, redlining, voter suppression, job discrimination, last hired/first fired, police brutality, police shootings and Mass incarceration. Yet, they rose to produce some of the most successful people in world history." When Tennis Arthur Ashe was diagnosed with HIV he said, "I handled being black in America. I'll handle this too." For African Americans reading this post who are seeking addictions recovery, know that recovery is within your reach in that you come from a people who persevere and succeed. Scroll down to view a partial list of African American Achievers.