Alcohol and Drug Abuse Among African Americans

The U.S. Bureau of the Census estimates that there are 44 million people of African origin living in the country, comprising 13.4% of the total population.¹ African Americans are overrepresented among drug abusers in the United States, but they are also more likely to seek treatment for their drug addiction.

Unfortunately, studies show that this population experiences less favorable outcomes upon the completion of substance abuse treatment. Here we will discuss the statistics of substance abuse among African Americans and explore treatment options and outcomes.

Substance Abuse Among African Americans

The rates of substance abuse among African Americans are similar to those of the general population, although there are some slight differences. Findings from the 2018 National Survey on Drug Use and Health include:²

• 6.9% of African Americans have a substance use disorder compared to a rate of 7.4% among the total population.
• 3.4% of African Americans have an illicit drug use disorder compared to a rate of 3% among the total population.
• Past month illicit drug use among African Americans (13.7%) is more than Caucasians (12%) and Hispanics (9.7%).
• Past month marijuana use among African Americans (12.2%) is higher than the general population (10.1%).
• African Americans report lower lifetime use of cocaine (8.5%) compared to Caucasians (17.6%) and Hispanics (11.1%).
• Alcohol use disorders are less common among African Americans (4.5%) than the total population (5.4%).
• Binge drinking among African Americans (23%) is slightly less common than in Hispanics (24.6%) and Caucasians (25.7%).
• The rate of heavy drinking among African Americans (4.3%) is much less than the general population (6.1%) and Caucasians (7.2%).

Although the rate of cocaine use among the African American population is much lower than the rest of the country, it is important to note that this statistic includes the use of both powder and crack cocaine.

Studies examining the use of specific forms of cocaine show that African Americans are more likely to use crack than any other ethnic group in the United States. A recent study indicates a much higher rate of lifetime crack cocaine use among African Americans (4.6%) compared to Caucasians (3.7%) and Hispanics (2.3%).³

Differences in Substance Abuse Patterns Across the Black Population

Research on substance abuse among Black Americans often combines Caribbean Blacks and African Americans into a single population, which does not provide a true picture of the substance abuse among these populations.

A recent study determined that there are differences in the patterns of substance abuse and dependence between African America and Caribbean Blacks. Some of the findings from this analysis include:⁴

• Rates of substance abuse are slightly higher for African Americans (11.5%) than for Caribbean Blacks (9.6%).
• Rates of substance use disorders are slightly higher for African Americans (4.9%) than for Caribbean Blacks (4.1%).
• Rates of substance abuse are higher among African American women (6.3%) than Caribbean Black women (2.8%).
• First-generation Caribbean Blacks are significantly less likely than African Americans to have a substance use disorder.

Treatment Options and Outcomes Among African Americans

The Substance Abuse and Mental Health Services Administration reports that African Americans are just as likely to need substance abuse treatment as any other population. A recent study found that 9.1% of African Americans and 9.3% of persons from other racial and ethnic groups are in need of treatment for drug or alcohol use.⁵

African Americans are less likely to need treatment for alcohol use (6.8% vs. 7.8%), although they are more likely to need treatment for illicit drug use (4.1% vs. 3.0%).

Although the rate of illicit drug use is higher among African Americans, statistics show that African Americans seek and receive specialty treatment for substance abuse problems at a higher rate than the rest of the population. Among individuals in need of substance abuse treatment, African Americans are more likely to receive treatment at a specialty facility (15.2% vs. 9.6% for individuals from all other ethnic groups).⁵ African Americans are also more likely to recognize the need and seek treatment (2.8% vs. 1.4%).

Unfortunately, research also shows that African Americans have lower rates of recovery from drug addiction following treatment.⁶ To better meet the treatment needs of the African American community, there are several social and cultural factors that should be considered. These include:

Program Staff

Cultural differences between providers and program participants can easily undermine the reception of treatment. A multicultural staff is most effective in providing substance abuse treatment, and programs treating African Americans benefit from having someone of color represented on the treatment team.⁷

Location

Programs should be provided in facilities that are easily accessible to the client. Studies have found that lack of transportation is one of the top reported barriers to treatment for African Americans.⁷

Spirituality

Spirituality and religion are key sources of strength among the African American population, and spirituality should be emphasized as a potential coping mechanism during treatment for African Americans. Studies have shown that spirituality among African Americans in recovery from substance abuse is associated with more positive outcomes.⁸

Sources

1. United States Bureau of the Census. (2019). Quick Facts: Black or African American, percent.
2. Substance Abuse and Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and Health Detailed Tables.
3. Palamar, J.J., Davies, S., Ompad, D.C., Cleland, C.M., & Weitzman, M. (2015). Powder cocaine and crack use in the United States: an examination of risk for arrest and socioeconomic disparities in use. Drug Alcohol Dependence, 149, 108-116.
4. Broman, C.L., Neighbors, H.W., Delva, J., Torres, M., & Jackson, J.S. (2008). Prevalence of substance use disorders among African Americans and Caribbean Blacks in the National Survey of American Life. American Journal of Public Health, 98(6), 1107-1114.
5. Substance Abuse and Mental health Services Administration. (2013). The NSDUH Report: Need for and Receipt of Substance Use Treatment among Blacks.
6. Milligan, C.O., Nich, C., & Carroll, K.M. (2013.) Ethnic differences in substance abuse treatment retention, compliance, and outcome from two clinical trials. Psychiatric Services, 55(2), 167-173.
7. Williams, R. (2008). Cultural Considerations in AOD Treatment for African Americans.
8. Brome, D.R., Owens, M.D., Allen, K., and Vevaina, T. (2000). An Examination of Spirituality among African American Women in Recovery from Substance Abuse. Journal of Black Psychology, 26(4), 471-486.