Chemical Dependency and Blacks

320 Review CHEMICAL DEPENDENCY AND BLACKS Chemical Dependency and the African-American: Counseling Strategies and Community Issues. By Peter Bell. 66 pp. Center City, MN: Hazelden Educational Materials,1990. $4.95 (paper). Black, Beautiful, and Recovering. By Gloria McGee and Leola Johnson with assistance from Peter Bell. 11 pp. Center City, MN: Hazelden Educational Materials, 1985. $1.05 (paper). THE literature addressing the needs of chemically dependent AfricanAmericans is very sparse. As concern mounts over chemical dependency in our communities, the need for such literature becomes increasingly critical. These two booklets aim to help meet that need. Each attempts to highlight cultural issues of great significance to African-Americans. Chemical Dependency and the African-American targets black leaders, students, policy makers, professionals in the field of chemical dependency and mental health treatment, and other human service professionals. Black, Beautiful, and Recovering is aimed toward recovering African-Americans themselves. Chemical Dependency and the African-American reflects the observations of an author who has worked in the field of chemical dependency treatment for over a decade. The booklet contains five chapters, plus endnotes. The first chapter covers two theories of addiction—disease theory and environmentalsecondary theory—and their cultural relevance. Disease theorists believe that chemically dependent persons can never learn to use mood-altering chemicals responsibly. Persons who adhere to the environmental-secondary theory of addiction believe that underlying causes (crime, poverty, etc.) are primary, and that the addiction itself is secondary. Bell describes disease theory as prevalent in the field of chemical dependency and as having received more acceptance among whites than among blacks. He criticizes disease theorists who do not acknowledge and address cultural issues. Bell describes environmental-secondary theory as having greater support among minorities because it is more responsive to cultural issues. But he takes the position that individuals or groups cannot make Journal of Health Care for the Poor and Underserved, Vol. 2, No. 2, Fall 1991 ___________________________________________________________321 significant progress in recovery from alcohol or other drug abuse while viewi ng the abuse only as a secondary problem. Bell believes it is difficult to make a strong case for racism as a major cause of addiction among black Americans or other oppressed groups, concluding that if the environmental-secondary theory were correct and racism were a primary factor in producing addiction, we would have seen much more alcohol and drug abuse among African-Americans when "racism was more evident." He does not see that racism and oppression are just as evident today as they were earlier in our history, and that what weakens over time may be one's ability to tolerate such abuse. This understanding allows us to predict that drug abuse will ever increase as long as the oppression continues. Bell also discusses methadone treatment programs and the challenge for counselors to address issues regarding racial identity and cultural differences, while not allowing those differences to be used as excuses to avoid treatment. He predicts that methadone maintenance programs will increase in number because they serve as a form of social control. He also acknowledges that the methadone approach is more likely to be used in the minority community than elsewhere. Chapter two raises six important factors affecting the incidence of alcohol and other drug problems: a breakdown in the rules regarding the use of alcohol and other drugs; the context for chemical use; the role of cultural institutions in determining rules for use; systems of accountability; functional tools for coping with stress; and functional rites of passage. Chapter three focuses on the relationship of alcohol and other drugs to other problems in the African-American community, including poor health, crime, family instability, unemployment and insufficient income, and lack of educational gains. Service implications for each of these problem areas are also presented. Chapter four explores ways to improve the capacity of the black church, along with civil rights, black advocacy, and human service organizations, to deal effectively with alcohol and other drug problems. The author also describes the establishment of goals for these organizations, plus client assistance programs and neighborhood drug-free zones. The final chapter explores the interfacings of race, culture, and class in work with chemically dependent African-Americans. Bell highlights the...