Addressing Substance Use and Social Needs of People of Color with Substance Use Disorders

Key Points: In this brief, we highlight the experiences and practices of substance use treatment providers
and their human services partners when serving people of color. We selected providers who
focused on serving people of color, and this study was not intended to assess outcomes or
effectiveness of any of the practices highlighted.

  • Treatment providers highlighted several practices that promoted active and positive
    participation in their programs by people of color:
    • Incorporate the community’s cultural values into organizational structures and
      treatment models.
    • Engage the community in designing programs and services and hire staff that
      reflect the community.
    • Address the comprehensive health, social, and economic needs of
      participants.
    • Incorporate harm reduction services and healing-centered approaches in the
      continuum of care.
  • Providers described several constraints when serving communities of color:
    • Structural barriers such as poverty, racism, and differential access significantly
      impede meeting clients’ social and economic needs.
    • Challenges retaining program staff with the appropriate language and cultural
      skills.
    • A complex patchwork of funding streams.
    • A lack of data and limited internal capacity for data analysis and program
      evaluation.
  • Providers emphasized that success required working with the strengths of the
    communities they serve and that every community has protective factors. More
    research is needed to understand how federal, state, and local policies and programs
    can maximize the strengths of communities of varied backgrounds, while also
    implementing evidence-based practices.

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Deaths associated with opioids, race and ethnicity, and years of potential life lost in Washington State

Introduction: This study examined disparities in years of potential life lost (YPLL) related to opioid use among racial and ethnic groups adjusting for individual- and neighborhood-level characteristics.
Methods: The study obtained data on 5265 geocoded death records associated with opioid use from the Washington State Department of Health. Death certificates included information on race and ethnicity, sex, marital status, and educational attainment. We linked these records to neighborhood-level indicators of rurality, area deprivation, and access to opioid treatment programs. Generalized linear mixed models tested associations between racial and ethnic identity and YPLL controlling for other individual and neighborhood characteristics.
Results: Among all decedents from opioid-related causes, the study found that racial and ethnic minorities-including Black, American Indian/Alaska Native, Asian, Native Hawaiian or other Pacific Islander-multiracial, or Hispanic adults died at younger ages than did White adults (33 to 44 vs 45). In the fully adjusted models, the estimated mean for YPLL was higher for Asian or Native Hawaiian or other Pacific Islander, multiracial, and Hispanic adults compared to White adults. Accounting for educational attainment and marital status substantially reduced YPLL differences between groups, by as much as 40% in some cases. Conclusions: The study observed striking differences in YPLL related to opioid causes among racial and ethnic minorities. Accounting for social determinants of health greatly reduced YPLL across all groups but racial and ethnic disparities in YPLL remained significant. Understanding and alleviating additional causes of disparities in YPLL is warranted to abate the epidemic of opioid related deaths in the United States.

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Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation

Abstract Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to healing that may be integrated into treatment models. Case data were gathered through an interview with a cultural practitioner and secondary sources, then analyzed using thematic analysis. Findings revealed that effective treatment affirms cultural identity, restores reciprocal relationships with ʻāina, promotes accountability and reconciliation through practices such as Hoʻoponopono, and embeds spirituality as a foundation for recovery. Results suggest that culturally grounded programs foster intergenerational healing, cultural resurgence, and community-level social change. Recommendations include increasing funding for culturally based services, training providers in Native Hawaiian health frameworks, and strengthening partnerships between licensed professionals and cultural practitioners to advance equity and contribute to long-term social change

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Overdose Prevention Hub for Tribes and Native Communities

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The initiative for establishing an online one-stop native overdose prevention resource hub came about as one component of the U.S. Centers for Disease Control’s Opioid Overdose Prevention in Tribes. Learn More

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