Becoming a Research-Minded Social Worker

2

Substance Abuse and the Opioid Crisis Among African Americans

Taliegha Carter

Capella University

Research in Social Work Practice

Prof. Selina Matis

7/12/26

Problem Statement

Substance abuse and the ongoing opioid crisis continue to be important social issues and should be discussed and addressed on an ongoing basis by social workers in both practice and training. While the opioid epidemic has impacted all racial and ethnic populations, African Americans remain disproportionately impacted on access to prevention, treatment, and recovery services and pain management. Structural racism, poor access to health care services, stigma and discrimination are factors that delay the diagnosis of and treatment to opioid use disorder. These obstacles can contribute to overdose, family dysfunction, loss of employment, homelessness and criminal justice system engagement. In hospitals, schools, community agencies, mental health programs, and correctional programs, social workers often work with individuals and families who may be impacted by substance use disorders. Thus, knowledge and awareness about EBIs and culturally responsive practices will be critical for improving outcomes and addressing health disparities.

This issue closely aligns with the National Association of Social Workers (NASW) Code of Ethics. First, the core value of social justice requires social workers to challenge social inequities and advocate for equal access to healthcare and addiction treatment (NASW, 2022). The provision of medication-assisted treatment, behavioral health and recovery support services has been disproportionate between African Americans and White Americans. Addressing these inequities is a profession's ethos to ensuring equality and reducing discrimination. Second, the core value of the dignity and worth of the person emphasizes respecting every individual's inherent value and supporting self-determination (NASW, 2022). People suffering from opiate addictions, and need for treatment, should be treated with compassion and evidence-based practice, not stigmatized or punished. Social workers have a moral obligation in delivering culturally responsive services, agitation for policy changes, as well as empower their clients to actively participate in their recovery. When implemented, these ethical principles: enhance professional practice and promote health equity among African Americans.

Literature Review Summary

Gondré-Lewis et al. (2022) investigated the increasing effects of the opioid epidemic on black Americans in urban areas. The study aimed to examine the racial disparity in trends of opioid overdose fatalities among Black and White residents in large urban areas between 2013 and 2020 from official public health data. The results indicated that the rate of overdose deaths among blacks more than doubled and, in some cities, far outpaced White overdose rates by 4-6 fold. Most overdose-related deaths involved fentanyl and/or heroin, and the COVID-19 pandemic exacerbated this inequity. The study adds to the understanding of the problem by revealing the opioid crisis's progression from being seen as largely a rural White problem to becoming the opioid crisis as a serious public health crisis for Black urban communities. Additionally, the authors discussed how structural barriers such as poverty, housing insecurity, lack of transportation and treatment accessibility can affect their progress. One of the drawbacks was that the states recorded the information in different ways, which decreased uniformity in the data reported. In addition, surveillance data could not fully explain individual experiences or community perspectives. Though these are restrictions, the article is very credible because it was based on the state's health records and published in a peer reviewed journal. Results of research apply directly to social work as they inform culturally relevant interventions, inter-professional approaches, and approaches to resource allocation that address both social determinants of health and addiction.

This study by Nicholson et al. (2024) examined the prevalence and risk factors for prescription opioid misuse among Black Americans from the 2019 National Survey on Drug Use and Health (NSDUH). The study aimed to describe the factors that were associated with prescription opioid misuse versus White adults. The results state that the rate of prescription opioid misusing occurred evenly among Black and White adults, differing from the prevailing thought that the misuse of prescription opioids is a White problem. The risk factors of depression, other substance use, risky behaviors and young age were associated with increased risk of misuse for both groups. Religious importance and rural residence seemed to diminish misuses, however, only among Black participants. By recognizing protective and risk factors within African American communities which can inform prevention and intervention to help address the opioid crisis. A weakness is that the study was based on self-reporting measures such as questionnaires; this can cause reporting bias. Additionally, pre-pandemic data may not completely capture the use and patterns of opioid misuse today. The article is credible as it presented a nationally representative data analysis and applied sound statistical techniques that was published in one of the peer-review journals. Its findings also have significant implications for social work practice in their call to practitioners to be aware of culturally-specific protective factors and in recognizing the need to provide mental health-first prevention measures that account for social environments and substance use.

Stevens-Watkins 2020 reviewed the available literature on the epidemiology of opioid-related overdose deaths among African Americans and the implications for research, policy-making and practice. The purpose of the commentary was to highlight the structural and cultural factors contributing to increasing overdose deaths and to recommend improvements in future interventions. The author concluded that stigma, insufficient access to opioid use disorder medication, criminal justice involvement, healthcare discrimination and systemic racism are all associated with the increasing rates of overdose death for African Americans. The article adds to the understanding of the issue by urging research and practice to move beyond racial comparisons and to shift to culturally relevant prevention, harm reduction and treatment strategies for African American communities. The commentary also suggests that naloxone distribution be expanded, that more care is culturally competent, that providers have to overcome bias, and that there is more education about addiction in the community. One restriction of the article is that it is predominantly a commentary, does not include original empirical evidence. It, however, draws in a vast body of peer-reviewed evidence while critically reviewing current research areas. This article exhibits a high level of credibility since it utilizes a lot of research by scholars and offers recommendations that have sound evidence. It is really relevant to social work practice because it emphasizes ethical practice, anti-racist service provision, culturally-responsive service provision, and policy advocacy towards reducing health disparity and equitable access to treatment for opioid impacted African Americans.

References

Gondré-Lewis, M. C., Abijo, T., & Gondré-Lewis, T. A. (2022). The opioid epidemic: A crisis disproportionately impacting Black Americans and urban communities. Journal of Racial and Ethnic Health Disparities, 10(4). https://doi.org/10.1007/s40615-022-01384-6

National Association of Social Workers. (2021). Code of ethics. National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Nicholson, H. L., Alawode, O. A., & Ford, J. A. (2024). Determinants of prescription opioid misuse among Black Americans: Evidence from the 2019 National Survey on Drug Use and Health [Review of Determinants of prescription opioid misuse among Black Americans: Evidence from the 2019 National Survey on Drug Use and Health]. Addictive Behaviors, 149, 107890. https://doi.org/10.1016/j.addbeh.2023.107890

Stevens-Watkins, D. (2020). Opioid-related overdose deaths among African Americans: Implications for research, practice and policy. Drug and Alcohol Review, 39(7). https://doi.org/10.1111/dar.13058

2

Substance Abuse and the Opioid Crisis Among African Americans

Taliegha Carter

Capella University

Research in Social Work Practice

Prof. Selina Matis

7/12/26

Problem Statement

Substance abuse and the ongoing opioid crisis continue to be important social issues and should be discussed and addressed on an ongoing basis by social workers in both practice and training. While the opioid epidemic has impacted all racial and ethnic populations, African Americans remain disproportionately impacted on access to prevention, treatment, and recovery services and pain management. Structural racism, poor access to health care services, stigma and discrimination are factors that delay the diagnosis of and treatment to opioid use disorder. These obstacles can contribute to overdose, family dysfunction, loss of employment, homelessness and criminal justice system engagement. In hospitals, schools, community agencies, mental health programs, and correctional programs, social workers often work with individuals and families who may be impacted by substance use disorders. Thus, knowledge and awareness about EBIs and culturally responsive practices will be critical for improving outcomes and addressing health disparities.

This issue closely aligns with the National Association of Social Workers (NASW) Code of Ethics. First, the core value of social justice requires social workers to challenge social inequities and advocate for equal access to healthcare and addiction treatment (NASW, 2022). The provision of medication-assisted treatment, behavioral health and recovery support services has been disproportionate between African Americans and White Americans. Addressing these inequities is a profession's ethos to ensuring equality and reducing discrimination. Second, the core value of the dignity and worth of the person emphasizes respecting every individual's inherent value and supporting self-determination (NASW, 2022). People suffering from opiate addictions, and need for treatment, should be treated with compassion and evidence-based practice, not stigmatized or punished. Social workers have a moral obligation in delivering culturally responsive services, agitation for policy changes, as well as empower their clients to actively participate in their recovery. When implemented, these ethical principles: enhance professional practice and promote health equity among African Americans.

Literature Review Summary

Gondré-Lewis et al. (2022) investigated the increasing effects of the opioid epidemic on black Americans in urban areas. The study aimed to examine the racial disparity in trends of opioid overdose fatalities among Black and White residents in large urban areas between 2013 and 2020 from official public health data. The results indicated that the rate of overdose deaths among blacks more than doubled and, in some cities, far outpaced White overdose rates by 4-6 fold. Most overdose-related deaths involved fentanyl and/or heroin, and the COVID-19 pandemic exacerbated this inequity. The study adds to the understanding of the problem by revealing the opioid crisis's progression from being seen as largely a rural White problem to becoming the opioid crisis as a serious public health crisis for Black urban communities. Additionally, the authors discussed how structural barriers such as poverty, housing insecurity, lack of transportation and treatment accessibility can affect their progress. One of the drawbacks was that the states recorded the information in different ways, which decreased uniformity in the data reported. In addition, surveillance data could not fully explain individual experiences or community perspectives. Though these are restrictions, the article is very credible because it was based on the state's health records and published in a peer reviewed journal. Results of research apply directly to social work as they inform culturally relevant interventions, inter-professional approaches, and approaches to resource allocation that address both social determinants of health and addiction.

This study by Nicholson et al. (2024) examined the prevalence and risk factors for prescription opioid misuse among Black Americans from the 2019 National Survey on Drug Use and Health (NSDUH). The study aimed to describe the factors that were associated with prescription opioid misuse versus White adults. The results state that the rate of prescription opioid misusing occurred evenly among Black and White adults, differing from the prevailing thought that the misuse of prescription opioids is a White problem. The risk factors of depression, other substance use, risky behaviors and young age were associated with increased risk of misuse for both groups. Religious importance and rural residence seemed to diminish misuses, however, only among Black participants. By recognizing protective and risk factors within African American communities which can inform prevention and intervention to help address the opioid crisis. A weakness is that the study was based on self-reporting measures such as questionnaires; this can cause reporting bias. Additionally, pre-pandemic data may not completely capture the use and patterns of opioid misuse today. The article is credible as it presented a nationally representative data analysis and applied sound statistical techniques that was published in one of the peer-review journals. Its findings also have significant implications for social work practice in their call to practitioners to be aware of culturally-specific protective factors and in recognizing the need to provide mental health-first prevention measures that account for social environments and substance use.

Stevens-Watkins 2020 reviewed the available literature on the epidemiology of opioid-related overdose deaths among African Americans and the implications for research, policy-making and practice. The purpose of the commentary was to highlight the structural and cultural factors contributing to increasing overdose deaths and to recommend improvements in future interventions. The author concluded that stigma, insufficient access to opioid use disorder medication, criminal justice involvement, healthcare discrimination and systemic racism are all associated with the increasing rates of overdose death for African Americans. The article adds to the understanding of the issue by urging research and practice to move beyond racial comparisons and to shift to culturally relevant prevention, harm reduction and treatment strategies for African American communities. The commentary also suggests that naloxone distribution be expanded, that more care is culturally competent, that providers have to overcome bias, and that there is more education about addiction in the community. One restriction of the article is that it is predominantly a commentary, does not include original empirical evidence. It, however, draws in a vast body of peer-reviewed evidence while critically reviewing current research areas. This article exhibits a high level of credibility since it utilizes a lot of research by scholars and offers recommendations that have sound evidence. It is really relevant to social work practice because it emphasizes ethical practice, anti-racist service provision, culturally-responsive service provision, and policy advocacy towards reducing health disparity and equitable access to treatment for opioid impacted African Americans.

References

Gondré-Lewis, M. C., Abijo, T., & Gondré-Lewis, T. A. (2022). The opioid epidemic: A crisis disproportionately impacting Black Americans and urban communities. Journal of Racial and Ethnic Health Disparities, 10(4). https://doi.org/10.1007/s40615-022-01384-6

National Association of Social Workers. (2021). Code of ethics. National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Nicholson, H. L., Alawode, O. A., & Ford, J. A. (2024). Determinants of prescription opioid misuse among Black Americans: Evidence from the 2019 National Survey on Drug Use and Health [Review of Determinants of prescription opioid misuse among Black Americans: Evidence from the 2019 National Survey on Drug Use and Health]. Addictive Behaviors, 149, 107890. https://doi.org/10.1016/j.addbeh.2023.107890

Stevens-Watkins, D. (2020). Opioid-related overdose deaths among African Americans: Implications for research, practice and policy. Drug and Alcohol Review, 39(7). https://doi.org/10.1111/dar.13058