Transcript African American Women and Cocaine

African American Women
Trauma/Addiction and
Treatment
Objectives
1. Relationship between early trauma and substance use and abuse
2. Recognizing treatment challenges and barriers
3. Treatment strategies
Important Development
• Trauma plays a role and is a risk factor
for substance abuse.
• Studies have found that trauma
exposure is one of the pathways to
substance use.
What is Trauma?
• What makes something traumatic?
• Trauma is the persons’ unique experience of an event or condition in
which:
“The person is unable to integrate their emotional
experience and it becomes over whelming.”
(Pearlman & Saakvitine, 1995)
Data on Childhood Trauma
• Data from the National Survey of
Adolescents and other studies indicate
“One in four children and adolescents
in the United States experiences at
least one traumatic event even before
age 16.”
When Karen was 7, her parents would go to church at least 2 times
a week. She was left in the care an elder brother, John to babysit.
John would sexually and physically assault her. The abuse was
repeated weekly until age 14. After that happened, I began stealing
and using drugs. I became violent and was arrested for domestic
violence. My drug use increased as I stopped caring. “I hated the
world.”
The Impact of Trauma on African American Women
• Childhood sexual abuse
• Initiated partner abuse
• Exposure to community violence
• Family and social Problems
• Lower levels of education
• High rates of unemployment
(Boyd, et al., 2003; West, 2002).
Why is this an urgent matter for African American Women?
• There is high rate of untreated trauma among African
American women.
• Untreated trauma can lead to substance use and abuse
• Addiction is traumatic
• Addiction can result in death
• In some studies, African American women have higher rates
of trauma compared to similar women from other racial
groups.
African American Women and Cocaine
• African American women are at a
greater risk than women of any
other racial or ethnic group for
initiating use and becoming
dependent on crack cocaine
(SAMHSA,2006b).
Data from SAMHSA
• Using data from SAMHSA, OSA 2008 African American women admitted to
public treatment most were:
• Crack/cocaine 35%
• Alcohol 24.8%
• Heroin 18%
• Marijuana 15%
• One study suggested that as the
level of alcohol consumption
increases among African
American women the severity of
other risk factors such as risky
sexual behaviors and use of
crack/cocaine increase.
What are the Challenges of Treatment ?
• African American women are less likely to seek treatment for
substance abuse.
• African American women have lower treatment completion
rates.
• African American women are more likely to terminate
treatment early.
What Barriers are associated with entering treatment
• Popular Misconception: African American women are thought to
be strong.
• Manage things on their own to include not disclosing trauma
events
• Can endure any pain and keep on going
• Sacrifice self and care for others
• Stigma and Discrimination
Barriers associated with treatment completion
• Relapse
• Lack of motivation
• I can manage on my own
• I no longer have a problem
Engagement Strategies Motivational Interviewing
• Asking Permission
• More likely to open up when there is respect.
• Affirmation
• Can be used to recognize strength.
example: you are not responsible for being
down but you are responsible for getting up.
(Seeking Safety)
• Feedback
• Provide feedback on the courage to open up
and share their experience.
Engagement Strategies (cont’d)
• Readiness for change
• Can vary for each individual.
• Change Talk can be difficult
• How to help get past some of the pain.
• Provide feedback on the courage to
open up and share their experience.
• Normalizing
• Helps the client understand there are
others who have experienced similar
trauma
Making the Connection
• The connection between African
American women, trauma, and
substance abuse often was never
made.
Key Points
• A traumatic experience can be the pathway into substance abuse.
• African American women …..
• Have never made the connection between their trauma and substance use.
• Use substances as an attempt to manage psychological distress
• Continue to be underrepresented in treatment
• Encounter treatment barriers
• Have lower treatment completion rates.
References
• Najavitis, L. (2001). Seeking Safety. A Treatment Manual for PTSD and Substance Abuse. Guilford Press.
• Sobell L., Sobell M. (2008). Motivational Interviewing Strategies and Techniques. Rationales and Eamples.
Retrieved from www.nova.edu/gsc/forms/mi_rationale_techniques.pdf
• Substance Abuse and Mental Health Services Administration (2006a). Treatment Episode Data Set (TEDS):
1994-2004. National Admissions to substance treatment services.(DASIS Series S-33, (DHHS Publication No.
SMA 06-4180). Rockville, MD: Office of Applied Studies.
• Substance Abuse and Mental Health Services Administration (2006b). Results from the 2005 National Survey
on Drug Use and Health: National Findings. (NSDUH Series H-12, DHHS Publication No. SMA 428. Rockville,
MD: Office of Applied Studies.