This September, ICH is holding space for Recovery Month by celebrating an inclusive and multifaceted vision of recovery and the many paths that people take to get there.
Substance use disorders (SUDs) are widespread in the US. The Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) found in their 2021 National Survey on Drug Use and Health (NSDUH) that 46.3 million people across the country met DSM-5 criteria for having a substance use disorder in the past year. Only 6% of those were in treatment. Although drug use cuts across divisions of race, gender, and class, the negative consequences of using drugs—including substance use disorders, overdose deaths, arrest, and incarceration—accrue disproportionately to Black, Latinx, and Indigenous people in the US (1). At the same time, treatment availability for members of these groups is more limited than it is for White people who misuse substances (1, 2, 3).
ICH is entering the third year of evaluating a pilot program that seeks to remedy some of these inequities in Massachusetts. The Recovery-based Reentry Services for Black and Latino Men (BLM) pilot program, funded through the Massachusetts Department of Public Health’s (MDPH) Bureau of Substance Addiction Services (BSAS), was conceived in response to state data showing that Black and Latino men and people with incarceration histories are at increased risk of overdose. Providers in five of the Massachusetts municipalities hardest hit by the opioid epidemic are receiving funding to provide person-centered, culturally responsive, and community-oriented pre-release and community-based case coordination and recovery support to people reentering the community from local jails.
Traditional care models for people with SUDs tend to be prescriptive and compliance-oriented, with a focus on personal responsibility over collective care, and abstinence over a more holistic conception of recovery that honors individuals’ unique needs, priorities, and experiences. This pilot program aims to disrupt business-as-usual approaches by building communities rooted in mutual care and respect that honor participants’ unique cultures, capacities, and recovery goals.
In our evaluation of the BLM pilot, it was important for us to learn more about what recovery means to the individual men participating in the program. In the summer of 2022, we spoke to 24 program participants to learn about their experiences in the pilot, the impact of a highly individualized and high-touch support model, and how their recovery goals were being supported. The BLM pilot participants we spoke to talked about recovery as a form of self-improvement, but what that looked and felt like was different for every single person we spoke to. For some, recovery was an end goal, while for others it was an ongoing process.
Although each person defined recovery in a slightly different way, there were some themes that emerged when we asked people what they envision when they think about themselves in recovery. People talked about staying sober, but they also talked about obtaining independent housing and employment, getting their lives back on track, reconnecting and spending more time with their children and families, engaging in counseling, and using their lived experience to help others in similar situations, as exemplified by the following quote:
“Uno tiene que rehacer su vida […] para ser una mejor persona. Y si ellos me necesitan para yo dar mi opinión a personas así como esas que lo necesitan, yo con mucho gusto lo hago. Yo no tengo ningún problema en hacerlo. Lo que tengo es que no hablo mucho inglés. Pero muchas palabras las sé y puedo ayudar a mucha gente. Y es bonito poder ayudar. Uno se siente bien cuando uno ayuda a los demás, como ellos me están ayudando a mí. Tú me ayudas a mí, tú me enseñas a mí, yo enseño a otro. Y así, si todos nos unimos y enseñamos cada uno el valor de la vida del ser humano, podremos ser algo mejor en el futuro.”
“People have to start a new life […] to become a better person. And if they need me to give my opinion to such people who need it, I will do it with pleasure. I have no problem doing it. It is just that I don’t speak much English. But I know many words and I can help a lot of people. And it is nice to be able to help. You feel good when you help people, just as they are helping me. You help me, you teach me, I teach someone else. And that way, if we all unite and each of us teach the value of a human being’s life, we can become something better in the future.”
Regardless of their individual visions, all of the people we spoke to recognized the importance of recovery as a means of achieving their personal goals, and found hope in being in community with people who shared their experiences and identities. As evaluators, we’re reminded to continue to develop ways to measure program outcomes in ways that center individual participants’ goals and visions of success. We are excited to continue to share our learnings about what participants find helpful in their recovery journeys to help other providers and grantmakers learn from this approach.
- Farahmand P, Arshed A, Bradley MV. Systemic Racism and Substance Use Disorders. Psychiatry Annual. 2020; 50(11):494-498.
- Barnett ML, Meara E, Lewinson T, Hardy B, Chyn D, Onsando M, Huskamp HA, Mehrotra A, Morden NE. Racial Inequality in Receipt of Medications for Opioid Use Disorder. New England Journal of Medicine. 2023; 388:1779-1789. DOI: 10.1056/NEJMsa2212412
- Acevedo A, Lanas L, Garnick D, Acevedo-Garcia D, Miles J, Ritter G, Campbell K. Disparities in the Treatment of Substance Use Disorders: Does Where You Live Matter? Journal of Behavioral Health Service Research. 2018 Oct; 45(4): 533–549. DOI: 10.1007/s11414-018-9586-y