“We Want a Living Solution”: Views of Harm Reduction Programs in Black U.S. Communities

Abstract

Illicit drug use in the US remains concerning, with injection drug use linked to transmission of blood-borne diseases as HIV/AIDS; persons of color, including Black Americans, experience disproportionately higher transmission rates. Harm reduction programs such as methadone and needle- and syringe-exchange (NEP/SEP) are empirically demonstrated to reduce HIV transmission, yet are believed largely opposed by Black communities. Using interview data from 21 service providers of substance abuse and related service organizations located in and/or serving predominantly populations of color, this study explored perceptions of harm reduction programming for illicit drugs and race in the US. Criticizing each program for unique reasons, respondents deemed them largely inadequate and inappropriate responses to community drug problems. While some believed these programs worsen Black communities, others believed they are becoming more accepted there. Views were informed by racial dynamics surrounding drugs in society, burdens borne by program host communities, and racialized stereotypes of drug use.

Opioid‐related overdose deaths among African Americans: Implications for research, practice and policy

“…Barriers to medications for opioid use disorders for many African Americans include lack of insurance, transportation and childcare. However, while the use of peer outreach [41] and mobile treatment [42] have demonstrated improvement in access to treatment among some African Americans, other studies show persistent cultural barriers and beliefs such as a general mistrust of methadone and needle/syringe exchange programs [43]. For example, some African Americans believe White community outsiders were 'experimenting' on them and that these programs served to locate and potentially isolate opioid-dependent African Americans in their own communities [43].…”

“…However, while the use of peer outreach [41] and mobile treatment [42] have demonstrated improvement in access to treatment among some African Americans, other studies show persistent cultural barriers and beliefs such as a general mistrust of methadone and needle/syringe exchange programs [43]. For example, some African Americans believe White community outsiders were 'experimenting' on them and that these programs served to locate and potentially isolate opioid-dependent African Americans in their own communities [43]. Furthermore, evidence suggests negative stigma associated with methadone treatment when compared to buprenorphine [44], however, buprenorphine treatment had lower early retention rates when compared to methadone treatment among African Americans [45].…”

“…There may be misconceptions in the African American community surrounding how an opioid use disorder affects the physiology of the brain and results in physiological dependence. Therefore, treatment with medications for opioid use disorders may be seen negatively as substituting one drug for another as opposed to a necessary part of recovery [43,66]. Providing education surrounding opioid use disorders and evidence‐based treatment options coupled with treatment providers issuing culturally competent care (e.g.…”

Commentary on Furr‐Holden et al. : As opioid overdose deaths accelerate among Black Americans, COVID‐19 widens inequities—a critical need to invest in community‐based approaches

“…We propose that existing local efforts should receive funding priority, including grassroots organizations engaged in outreach (e.g., Baltimore City's Bmore POWER) [16]. Organizations presently engaged with black communities can engender awareness and trust of addiction services that community outsiders and traditional medical programs have difficulty producing [16,17]. To effectively reduce the burden of overdose death among Black Americans, we must prioritize programs that build community trust.…”

Perceived Teacher Encouragement as Buffer to Substance Use in Urban African American Adolescents: Implications for Disconnected Youth

“…For example, Bass and Kane- Williams (1993) posit that the American society in general has the impression that a person involved with substances is most likely an adolescent African American male. In addition, the current general belief is that drug use is rampant within the African American community (Bass & Kane-Williams, 1993;Eversman, 2015). The media has played an impactful role in perpetuating negative stereotypes of African American youth by using such tactics as depicting them as criminals and amplifying their drug involvement in movies and television shows.…”