It is widely known that Substance Use Disorder transcends culture, class, gender, and national origin, yet access to treatment and recovery resources are not equitable in the USA. In recent years the mainstream recovery movement in the United States has been under scrutiny for being Euro-centric and excluding communities of color. While the recovery community is beginning to look within and beginning to recognize that Black, Indigenous and People of Color (BIPOC) have been excluded from recovery narrative, Angelo Lagares, founder of Latino Recovery Advocacy (LARA) is beating the drum reminding those with access to resources, power, and privilege that the Latinx* community lacks access to treatment as well as recovery supports.
The lack of formal SUD treatment and recovery supports are not new to the Latinx community. Piri Thomas, wrote about detoxing from heroin in his book “Down These Mean Streets” in 1967, describing a neighborhood woman who was known to care and protect people in withdrawal in Spanish Harlem. In 2019, the Latinx communities continues to lack access to formal systems of care for Substance Use Disorder. The narrative of Opioid Use Disorder being an issue for White, middle class, suburban communities in conjunction with the Latinx mistrust of the medical establishment has made it even more complicated than it was in the last century. Latinx communities disengagement from medical systems are grounded in experiences of prejudice from medical providers, concern about legal issues, and fear of falling victim to unethical practices (like forced sterilization programs in the 1950’s and 1960’s), yet there remains a need for treatment and recovery support services.
Systems of care in the USA, are not equipped to deal with the cultural and linguistic needs of Latinx people, especially in Substance Use Disorder treatment. Most states do not have facilities that offer detox or treatment services in Spanish, and those who provide treatment grounded in a Euro-centric ideas of healthcare (outcome oriented, limited access to medical providers, and only offered in Engish). Those who provide treatment and recovery support services acknowledge the importance of culturally competent services and the importance of providing care for diverse communities, but when designing systems of care and support Latinx folx are excluded from the conversation. The common rally cry from the recovery community is “nothing for us, without us”, yet that sentiment is quickly forgotten when it comes to the Latinx community. Advocates for equity in treatment and recovery resources like Lagares, are creating a groundswell demanding that services providers and recovery communities step up to meet the need of Latinx communities and reduce health disparities.
The need for Substance Use Disorder services across the continuum are severely lacking. Culturally relevant prevention efforts for the Latinx community are limited at best. Access to Narcan and training to use it abysmally low in the Latinx community which is saw a surge in overdose deaths in 2018. Detox and treatment services in Spanish are almost non-existent in the United States, and recovery movement is centered in serving those who fund it and do not recognize the implicit bias that informs program development. The time has come to move from intention to action. Prevention, treatment and recovery support service providers have a moral and ethical responsibility to create culturally responsive services for Latinx communities (and other marginalized folx) to reduce harm and prevent unintentional deaths.
To create culturally informed treatment and recovery support services those who manage and work within these systems need to recognize there is a need that is not being addressed and reflect on why Latinx communities (and other marginalized groups) are not accessing services.
Once there is an awareness, the work towards creating culturally responsive services can truly begin. Those with access must widen their net, engender the cultural humility to engage leaders in Latinx communities to begin the conversations necessary to save lives, reduce health disparities, and increase access to the hope that recovery inspires. It is only when this occurs that inclusive systems of care can be created and Latinx communities will benefit from the resources dedicated to the recovery of people with Substance Use Disorder.
*Latinx is a gender inclusive term used to refer to people of Latin American identities in the United States.