To My BIPOC Siblings: Healing Isn’t Found At The Bottom Of The Bottle

April serves as both an observance of National Minority Health Month and Alcohol Abuse Awareness Month. The convergence of those themes is extraordinarily important to me. Throughout my career as a trauma therapist, I have seen the devastating dual effects of racism and alcohol abuse on BIPOC communities. Alcohol abuse has been at least somewhat more commonly discussed over this past year, with many people finding themselves leaning on substances, especially alcohol, during the pandemic and seeking better ways to cope - or seeking treatment if their struggles had gone too far. But despite the increased national conversations about alcohol abuse and generally broad turn towards being more understanding of addiction as a disease instead of a choice, minority communities are still toiling to break stigma and find resources about alcohol abuse.

It doesn’t surprise me at all that alcohol abuse and misuse skyrocketed during the pandemic. Addiction - any addiction - is a flawed solution to regulating triggers and traumas, and the COVID-19 pandemic has been a devastating collective trauma that’s uprooted our ability to ground, regulate, and feel safe. Our society has been so reluctant to have the bold, honest conversations we need to have about the nature of trauma, and as a result, far too many people end up stewing in it and spiraling. Substance abuse and addiction do not resolve underlying traumas, but rather they temporarily numb the trauma. By using alcohol - or any other drug - to cope with problems, triggers, or emotional distress, people rewire their brains to seek out that avoidance. Not only does this leave them vulnerable to becoming physically dependent on alcohol, it also makes the behavior habitual in and of itself, burying the trauma they were self-medicating away even deeper down.

Not only is this self-medication approach flawed, it’s also incredibly dangerous. Over one-third of suicide victims used alcohol immediately prior to their death, and that devastating statistic doesn’t take into account the behaviors around alcohol that might’ve led up to that event in the previous days, weeks, and months. And alcohol abuse isn’t just dangerous for the person abusing it - it’s dangerous for the people around them. The World Health Organization found that 55% percent of domestic abuse perpetrators drank alcohol just prior to engaging in abuse. Our society is full of stories and statistics about how alcohol abuse generally closely foreshadows risky, violent behavior - drunk partners banging things around or punching through doors, inebriated fathers striking mothers in front of children, or even worse.

Despite these risk factors, alcohol too-often isn’t portrayed as a serious substance. Its widespread legality and availability is ingrained into social behaviors and it is portrayed on TV, film, and in music in wildly inappropriate, out-of-context ways that normalize its use while glossing over its dangers. The Wolf of Wall Street is a particularly intense example of how alcohol abuse is glorified on screen, and though the film is broadly meant to be a cautionary tale, its portrayal of alcohol is never touched on as its big lesson. The glorification of alcohol is omnipresent in American culture, and our understanding of what substance misuse correction, treatment, or sobriety can look like is coated in stigma and misconceptions.

For BIPOC communities, those stigmas and misconceptions are magnified tenfold - and treatment is even harder to come by. For example, although alcoholism occurs at a higher rate in white populations, Black people with that same illness are more likely to experience severe health consequences, legal problems, and difficulty finding quality, accessible treatment. This is because of a myriad of reasons tangled up in racism and societal intergenerational trauma. We’re less willing to grant compassion and understanding to Black or other BIPOC addicts in the ways that we grant it to white people. This is plainly visible in the disparities in national conversations around the current heroin epidemic, which arrived after Black communities had seen their lives swallowed up by it for decades already and had been met with apathy, as well as compared to how the crack cocaine epidemic - which mostly impacted BIPOC communities - was treated. BIPOC patients struggling with addiction, especially alcohol addiction, are more likely to be dehumanized and viewed as uneducated, dangerous, and violent.

BIPOC communities are impacted by racism all day every day in complex implicit and explicit ways. Alcohol addiction is no exception. You can go into BIPOC communities ravished by poverty in any city in America today and you’ll find neighborhoods that have no access to quality food yet have no shortage of liquor stores, billboards glamorizing alcohol, and drug paraphernalia. Advertisements and liquor stores are strategically placed in vulnerable areas, another passive aggressive move that creates a no-win situation for residents. BIPOC struggle to speak out about substance abuse issues they’re facing due to stigma and pervasive, pressured normalization of substances in our communities. Alcohol addiction can be seen as “weak” or like a simple choice. The financial cost to get treatment for alcohol abuse or other substance abuse is staggering - quality treatments and intensive rehabilitative treatments are often scarcely covered by insurance, particularly programs like Medicaid. Professionals who treat alcohol addiction and other substance abuse issues are more likely to be white and not be trained in culturally and racially competent services, leaving many BIPOC, not only those that are poor, feeling unable to connect to treatment or see themselves in a healthy future even if they’re able to overcome the hurdles of seeking help in the first place.

If we’re really going to fight alcohol abuse and commit to valuing Minority Mental Health, then we have to start breaking down stigmas around substance abuse in BIPOC communities. We must have more informed, intimate conversations in our communities. We must advocate for culturally and racially sensitive treatment. We must tell our own stories and the stories of people around us who have suffered from alcoholism. At the root of our strategy, along with showing people how to trace their substance misuse back to trauma and help them understand that alcohol - or any substance - isn’t a viable solution to regulating triggers and trauma, we must highlight the tremendous personal and collective resilience that BIPOC have. Decreasing shame is essential right now, and one way we can do that is to help people understand that when you don’t have opportunities to repair the devastation of trauma, any of us will do whatever it takes to get relief, even if it’s temporary. It means we’re trying to survive. But healing and survival are two different things, and healing will never be found at the bottom of the bottle. It will be at the intersection of boldness, honesty, re-envisioned trauma treatment for BIPOC, dedicated financial resources to provide state-of-the-art-treatment to these communities and trauma-informed communal support.