or Latino community and are people with lived experience of SUD. Eligibility to be a peer recovery coach includes being in recovery for at least two years and completing an intensive five-day training that includes courses on motivational interviewing; ethical considerations; addiction 101; cultural awareness and responsiveness—knowing the “street” language used; wellness recovery plans; and linkages with community resources, such as housing and primary care to address related infectious diseases. The peer recovery coaches are required to complete 500 hours of recovery coach work with 35 hours under supervision from a peer recovery coach supervisor. Once eligibility is met, they are certified by the State and their services are billable. The peer recovery coaches are critical in outreach and engagement; they know the community, know the resources, and are able to communicate effectively, and are able to draw upon their own experiences with SUD and recovery. As one key informant noted, "The key strength is that we [recovery coaches] understand addiction, we went through the same stuff. Also not going to tell you what to do, it is self-directed…we don’t have a timeframe. Recovery coach is there to support and give guidance. We connect them with MAT, help with job seeking, housing applications; if relapse, recovery coach is there to help you pick up there all the time… sometimes can spend four hours in a day with getting them to appointments and assisting transportation…we can sit with you 3 hours in a courtroom. How many professionals can do that?” Recovery coaches develop a unique connection with the client and have said that the most difficult challenge is the family. Families often do not understand SUD, have seen their family member relapse repeatedly, and do not believe in the possibility of recovery. In cases where family members are using drugs, the peer recovery coach teaches refusal skills. Community Snapshot: Building and developing a culturally sensitive and diverse workforce—Detroit Recovery Project. DRP collaborates with local universities and Authority Health to establish DRP as a training facility for psychiatry and internal medicine interns and residents. 59 The partnership allows for mentoring the next generation of medical providers to be better equipped and experienced in working with low-income, Black/ African Americans with SUD.
Moving Forward Opioid misuse, OUD, and opioid-related overdoses have affected all population groups in the U.S. Strategies to address this issue need to be tailored to the diversity of the communities affected. Promoting a one-size-fits-all strategy may inhibit access to appropriate, quality prevention and treatment for culturally diverse populations. To reduce the impact of opioid misuse, OUD, and opioid-related overdoses on the Black/African American population, it is critical to understand the contextual issues, the treatment barriers, and the community-informed strategies that are working in these communities. Reducing opioid misuse and overdoses in Black/ African American communities requires an interdisciplinary, multi-level team approach. Collaboration among community leaders, associations, advocates and residents with policymakers, government agencies, educators, prevention specialists, and treatment and recovery providers is urgently needed. All must mobilize to educate and engage one another and identify and implement evidence-based and community-informed strategies that work best for this population and save lives.
THE OPIOID CRISIS AND THE BLACK/AFRICAN AMERICAN POPULATION: AN URGENT ISSUE
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