The Realities of SUD for Black Americans

Updated: Feb 9

Substance Use Disorder (SUD) effects people from all races, ages, and socioeconomic backgrounds. Over the past year, many have called the increase of people with SUD a pandemic within a pandemic. However, during Black History Month, it is important to recognize that the realities of living with and seeking treatment for SUD is more challenging Black Americans.

In order to understand where we are now, we must reflect on how we got here. This is not the first time America has seen an uptick in SUD on such a large scale that disproportionately effected Black Americans.

The “crack epidemic” was a surge of crack cocaine usage that took place between the early 1980s to early 1990s. Crack spread quickly through low-income and inner-city neighborhoods. Due to racial segregation and housing discrimination, this drug impacted the Black community far more than other groups. As a reactionary and racially targeted response, President Reagan resurrected the Nixon-era “War on Drugs”. These policies allocated almost $2 billion towards anti-drug law enforcement programs, which enacted harsher penalties for drug-related crimes, and imposing mandatory-minimum prison sentences for drug offenses. In addition to racial disparities in the criminal justice system, this led to the stigmatization of addiction as a public safety issue as opposed to a public health issue.

The downstream impact of those racially targeted policies can still be seen today. We are still working to undo the injustices in our criminal justice system caused by the War on Drugs.

According to the American Psychology Association, despite relatively uniform rates of substance use among racial and ethnic populations, today there is still a disproportionate rate of drug arrests in the Black community. Our carceral injustice system continuously racially profiles and over-polices Black communities. Although Black people make up only 12.5% of illicit substance users, Black people consist of 33% of all drug incarcerations. Over-policing impacts communities for generations.


Members of marginalized racial groups are most likely to experience barriers that prevent them from accessing SUD treatment. According to the Association for Addiction Professionals (NAADAC), Black individuals are more likely than White individuals to report unfavorable substance use treatment experiences. Discrimination in health care and adequate behavioral services is seen in Black communities through regional maldistribution of medical resources, lack of effort from medical providers, and lack of access to insurance. When it comes to seeking treatment for SUD, being unable to afford services and not having access to health insurance are significant barriers to recovery.

Black Americans have less access to effective treatment options. Discrimination in health care creates significant barriers to recovery.

The recovery community must resist bias embedded in the medical and judicial systems. Through education we must work to break down barriers to access, reimagine the way we provide treatment, and focus on equity in our systems of care. Beyond this month, it is important to educate ourselves on the truths of Black history and its impact on our communities.