Tag: healthcare access

  • Privilege Lurks at the Heart of Recovery Movements

    Privilege Lurks at the Heart of Recovery Movements

    Making blanket statements that “anyone can recover” whitewashes and overlooks the gross inequities that people of color and marginalized communities face.

    Recovery is possible for anyone, but it isn’t the reality for everyone. We may see an increasing number of people on social media proudly displaying their recovery as badges of honor — which in turn reduces stigma about addiction and a life in recovery — but it doesn’t accurately depict the true picture that recovery isn’t accessible to everyone, it heavily depends on your privilege.

    Recovering “out loud” has gained so much momentum that it’s now a social justice movement: we are now questioning advertisers who normalize the excessive use of alcohol, challenging the use of biased language, highlighting the inequity in authorities tackling opioids but overlooking alcohol as the leading cause of drug-related deaths, and advocating for policy changes that affect people with substance use disorders.

    While this recovery activism should be celebrated, we are still overlooking the inconvenient truth lurking beneath the surface: recovery is, unfortunately, still a privilege. Can we really be part of a social justice movement if we overlook the role privilege plays in the accessibility of recovery? 

    The Role of Privilege in Substance Use Disorders and Recovery

    Many people within the recovery movement believe that recovery is possible in spite of race, ethnicity, economic circumstances, nationality, sex, gender, access to health insurance, and a strong support system — in other words, privilege. This simply isn’t the reality. There are great disparities both in how addiction affects people and how much recovery capital is available to us based on privilege.

    Rates of addiction are higher in oppressed populations, especially among LGBTQ people and people of color. Black women over 45 are the fastest growing population with alcohol use disorder, and the risk of developing a substance use disorders is 20-30 percent higher for individuals who identify as LGBTQ+.

    We don’t hear about those statistics, though; we see an opioid epidemic that is largely affecting white people. When drugs have a detrimental impact on communities of color, the media is less interested in covering it. Advocate Shari Hampton explains “Nobody gave a damn when black lives were being ravaged by crack cocaine in the 80’s. Families were ripped apart; communities were literally destroyed. People were thrown in jail and some of them are still there.”

    She continues, “I’ve witnessed grandparents raise grandchildren right up to their grave while their grown children suffered from a crack addiction or a jail sentence that is so ridiculously long, it might as well be life. But now we have an opioid epidemic. It’s affecting a different demographic. And now, now it’s a treatment issue. This is disparaging and discouraging, especially to the black and brown folks that have never been treated with even a remote sense of compassion compared to what we see today.”

    This disparity continues in access to recovery. Recovery is vastly different for those who lack recovery capital — the resources that can be used to sustain recovery: financial security, education, health insurance, and a support system — which is heavily linked, again, to our privilege.

    Not all people who speak openly about their addiction and recovery are blind to the reality of the effects of privilege. In her recent book Strung Out, author Erin Khar unpacks the role of privilege in her own recovery: “Escaping addiction, and it truly does feel like an escape, requires protective layers of aftercare. I have been incredibly fortunate to have access to the support I’ve needed.”

    She continues, “We don’t have a system in place that makes it simple or easy for people to get help or support. There are financial, social, and racial barriers to getting help. If we are going to see a real downshift in the opiate crisis, support is what is needed — not just from peers and family members, but also the medical community and government.”

    Studies show that African American and Latinx individuals are far less likely than white people to complete outpatient and residential substance use disorder treatment.

    The inequity is also in access to medication. NPR highlighted a recent study by Dr. Pooja Lagisetty, an assistant professor of medicine at the University of Michigan, who stated that “this epidemic over the last few years has been framed by many as a largely white epidemic, but we know now that’s not true.”

    Lagisetty found that as overdose deaths rose between 2012 and 2015, so did though the number of medical visits where buprenorphine was prescribed. However, researchers found no increase in prescriptions for African Americans and other minorities. In fact, the study found that white populations are almost 35 times more likely to have a buprenorphine visit than African Americans even though death rates among people of color were rising faster than white people. Researchers also observed that these visits were paid for by cash (40 percent), or private insurance (35 percent) rather than with Medicaid (25 percent), suggesting inequalities in healthcare. 

    “We shouldn’t see differences this large, given that people of color have similar rates of opioid use disorder,” says Lagisetty. “As the number of Americans with opioid use disorder grows, we need to increase access to treatment for black and low-income populations, and be thoughtful about how we reach all those who could benefit from this treatment.” 

    People of color have less access to treatment not only due to socio-economic circumstances. There is also a disparity in how drug use is viewed in communities of color. Despite similar rates of drug use and sales, people of color are more likely than white people to be arrested and receive harsher punishments for drug-related offenses. 

    Khar reflects on the criminalization based on race: “Some might say it’s a miracle that I never got pulled over, never got caught with that briefcase of drugs. But I see it less as a miracle and more because I was a young woman with passing-white privilege in a Jetta.”

    She continues, “I’ve thought about this often, that had my skin been darker, had I come from less privilege, I have no doubt that I would have been arrested early on. I’ve thought about how that would have changed the trajectory of my life, how early arrests may have kept me forever trapped in a cycle of incarceration. Our drug laws are undeniably skewed to keep people of color and people of less privilege imprisoned and enslaved. And I’ve always been aware of that.”

    The true picture of addiction and recovery inequity are often ignored on social media because our privilege blinds us to these realities. But if we really want to create a social justice movement, we have to change how we relay what substance use disorders and recovery looks like for all.

    Creating a More Impactful Social Justice Movement

    Let me be clear: this article is not intended to shame anyone for their privilege; instead, I’m suggesting that we can’t ignore the true picture in favor of a prettier, more palatable version. Making blanket statements that “anyone can recover” whitewashes and overlooks the gross inequities that people of color and marginalized communities face. 

    Advocate Shari Hampton explains this discomfort that underlies many recovery advocacy conferences. “I went to a conference earlier in the year and the white fragility in the room was nauseating. I literally didn’t understand why even talking about inequality caused so much discomfort. Simply discussing the topic had white folk with pursed lips and clenched fists. White folks can’t bear to examine a system that has entitled them to more, as being broken. It’s like admitting that Jesus was black. It’s not going to happen. To do so would disrupt all things.”

    When asked how we can make a difference, Hampton responds: “America’s history teaches that black people are inferior to white people — that we don’t deserve the same treatment or opportunities. The mindset must shift. Because until we are seen, truly seen as magnificent beings, equal and worthy of the same quality of life and opportunities afforded to whites, very little will change.”

    If we really want to create a more impactful social justice movement, we need to get uncomfortable. We need to be more mindful in our social media posts and consider if what we are portraying is an accurate representation of recovery, and question if our privilege played a role in our access to resources. We need to consider if we are amplifying the voices of those marginalized and oppressed. If not, why not? And in creating events to address addiction, or in going to Washington, DC seeking policy changes, we need to stop and ask ourselves if we have invited the people who are most affected by these policies. If not, we need to ask ourselves why we aren’t amplifying the voices of the people who most need to be heard?

    We cannot divorce recovery from true social justice. Writer and sobriety coach Holly Whitaker says: “For those people who don’t want to ‘dirty up’ or confuse recovery spaces with talk of racism, classism, transphobia, homophobia, ableism, classism, etc. — remember that recovery is about awareness, and that this path is about inclusion, love, and acknowledging wrongs and injustices. If we aren’t talking about the way the system works, and who gets crushed by the system, we aren’t actually talking about recovery. We’re still just talking about our comfort zones, and using our privilege to deny other experiences.”

    View the original article at thefix.com

  • Access To Gun Shops Increases Suicide Risk For The Uninsured

    Access To Gun Shops Increases Suicide Risk For The Uninsured

    Over a 10-year period, suicide rates increased 41%.

    Having access to gun shops but lacking access to health care contributes to rising suicide rates among rural Americans, according to a new study. 

    The study, published in the journal JAMA Network Open, found that suicide rates are increasing for all Americans, especially those who live in rural areas. Between 1996 and 2016, suicides in the U.S. increased 41%.

    Suburbs vs Rural Areas

    There was a large difference in the risk of suicide in suburban versus rural areas. Between 2014 and 2016, metropolitan residents had a suicide rate of 17.6 deaths per 100,000, while rural residents had a much higher rate of 22 deaths per 100,000. 

    “While our findings are disheartening, we’re hopeful that they will help guide efforts to support Americans who are struggling, especially in rural areas where suicide has increased the most and the fastest,” lead researcher Danielle Steelesmith, a postdoctoral fellow at Ohio State’s Wexner Medical Center, said in a news release

    Counties with the highest suicide rates were found in Western states including Colorado, New Mexico, Utah and Wyoming; in Appalachian states including Kentucky, Virginia and West Virginia; and in the Ozarks, including Arkansas and Missouri.

    Researchers identified factors that contributed to increased risk for suicide. 

    “Suicide is so complex, and many factors contribute, but this research helps us understand the toll and some of the potential contributing influences based on geography, and that could drive better efforts to prevent these deaths,” Steelesmith said. 

    Suicide rates were higher where people had access to a gun store, said Cynthia Fontanella, a study co-author and associate professor of psychiatry and behavioral health at Ohio State. 

    “The data showing that suicides were higher in counties with more gun shops—specifically in urban areas—highlights the potential to reduce access to methods of suicide that can increase the chances an at-risk person will die,” she explained. 

    Service Members

    In addition, areas with more veterans had higher rates of suicide, highlighting the prevalence of mental health issues among former service members. People who had lower socioeconomic prospects and lack of access to resources were also more likely to die by suicide, a trend that was pronounced in rural areas. 

    “In cities, you have a core of services that are much easier to get to in many cases. You may have better access to job assistance, food banks and nonprofits that might all contribute to less desperation among residents,” Steelesmith said.

    The study authors point to ways that suicide risk could be reduced, including increasing social supports in rural areas and community engagement so that residents are aware of these resources. 

    “For example, all communities might benefit from strategies that enhance coping and problem-solving skills, strengthen economic support and identify and support those who are at risk for suicide,” Fontanella said.

    View the original article at thefix.com