Good. Good. Okay. So, thank you for joining us for addressing recovery support service equity in the African-American community. We're going to be talking about the history, landscape, and the future. My name is Anita Bradley. I sound like I'm loud. And I'm the chairperson who's going to be with you this afternoon. And I have the honor of introducing my two colleagues, Dr. Jonathan Lofgren and Andre Johnson. So, I'm going to, what we're going to do is I'm going to introduce them both. And then I'm going to turn over the presentation to them. But this is an interactive presentation, so we're not just going to sit and listen to a didactic presentation. We're going to interact. And if you have questions, give me a little nudge. I'll bring the microphone to you, because if we don't have the mic in front of you, you won't be recorded. So, this is being recorded, just so you know. But I had the pleasure of meeting Dr. Lofgren a couple of years ago. We founded together, the three of us, along with some other members, the Center for African-American Recovery Development. And each of us are in recovery, and we're all involved with recovery community organizations across the United States. And so, when we looked at the landscape of recovery, we learned that there are a lot of African-American communities that are disenfranchised, and many people that are suffering from social determinants across the country. And we wanted to make sure that there were recovery communities in each of the communities that were in need. And so, Dr. Lofgren, again, is a person in recovery. He received his Bachelor of Arts from South Florida in Interdisciplinary Social Science. He received his Master's Degree in Psychology from Springfield College in Massachusetts, and his Doctoral Degree in Education from Capella. He is a published author, and currently working as a professor in Addiction Studies at Minneapolis College in Minnesota. Dr. Johnson, Dr. Andre Johnson, is in Detroit, Michigan, and is the founder of the Detroit Recovery Project. When I founded my organization, he was one of the first people that I reached out to. He is a founding member of the Center for African-American Recovery Development as well. He took a sabbatical so that he could finish his degree, and I'll go through them. So he's a Bachelor's from Morehouse in Psychology. He also has a Master of Arts in Organizational Management from Phoenix University. And most recently, he received his Psychology Degree. He is a author, and again, the founder of the Detroit Recovery Project. So I'm introducing both of them. Their information is there as well on the slides. But today, we're going to be talking about, well, first of all, let's give the disclosure that the information presented here is strictly from those of us that are going to be presenting. And so, in all disclosures, it's been reviewed and vetted through the committee. I don't want to move too quickly. I want to be able to see the slides. So after the conclusion of our workshop, you will have an understanding of the evolution of recovery community organizations in the United States, a specific focus on the development of minority organizations. We're going to be identifying some of the barriers and success factors that were involved in the establishment and growth of these RCOs in various cities across the country, particularly within the black, indigenous, and people of color communities. And then we will be analyzing the current landscape for BIPOC-led RCOs, highlighting the critical role in addressing racial disparities among recovery community and health services in the country. And then we will be exploring future recommendations in terms of strengthening the administration, clinical practices to serve minority populations across the country. And so, I'll turn it over to Dr. Lofgren. You want me to take these? Take this? Or you want to... I'll try to turn it. I'll try to turn it. All right. Thank you for that introduction, Anita. Anita is the... I'm sorry. President of CARD, she didn't tell you that. She's a founding board member, but she is the current president of our board and doing tremendous work on a voluntary basis to advance recovery support in African-American communities all across the country. I'm a person in long-term recovery. What that means to me is I haven't used any drugs or alcohol since Labor Day 1987. I've been in recovery about 37 years. And more than just not using substances, recovery has afforded me an awful lot more than I once could ever have imagined. And what I mean by that is it gave me a chance to restore my relationship with my family. I was broken by my addiction. And it gave me a chance to go to school and learn a couple of things about myself. And it just so happened that I took an interest in the field of addictionology. I was a cabinetmaker in my early recovery. I wasn't thinking about going to be no counselor or anything. I was just happy to be making cabinets and not getting high. And I was at a self-help group. Somebody came up to me, and they said, boy, I wish I could talk to people like you talk to people. It shook me. I didn't think I talked to people in any kind of special way. I just talked to people, trying to work my little recovery program. And about four months later, I was signed up to go to the University of Minnesota for my first class in counseling, because somebody gave me an affirmation like that. Changed my life and the direction that I took in my own recovery. We're just going to talk a little bit about this notion of changing the paradigm of, from just treatment for substance use disorder, that's where the professionals work, people. Once upon a time, treatment was delivered by people in recovery, right, 60s, 70s, maybe even approaching the 80s. Treatment was delivered by people in recovery. But we got fancy, and all these doctors and stuff running around with mental health and health care and stuff looking at us like we didn't know nothing. That's what happened. They said we didn't know anything, so we all went back to school. Started getting some degrees and some certificates and stuff, they started making credential requirements and standards of care and all these things, right? But before that, it was really literally one drug addict trying to help the next drug addict, and anyway, so all these standards came into play. Treatment got a little more defined, and who could deliver treatment got more defined, so people in recovery started getting pushed to the sideline. They couldn't have that direct care role like they did in the 70s, 60s, 70s, and maybe even early 80s. So anyways, that was working pretty good to help people interrupt their substance use disorder. And, but we know access to education has disparities. And so, then as the profession got smarter, got more educated, there was less diverse providers giving the services to the people that needed it. So in certain diverse communities, they have a cultural care models within those communities. People still talk to people, but it wasn't a professional treatment. And anyways, so then as we kind of started wiggling our way through the 80s as a discipline, we noticed something was missing, that the people in recovery couldn't help the people trying to find recovery. And so, the paradigm shift maybe from this old school nature of helping people abstain from drug use and then giving them a dose of treatment and sending them on their way with a coin. You give them a coin for making it through the program, right, a recognition coin. And telling them to go to AA and wishing them good luck, right. We didn't have a continuum, especially in that transition. Like, how are we going to help people after we give them a good dose of treatment? So things started shifting a little bit, and then treatment centers were expected to do it all. You give primary care, step-down model care, and aftercare, and continuing care, and try to hold on people as long as you can. But we still hadn't quite figured out how to engage people in recovery. So this paradigm shift was to re-engage people in recovery so that they could help support people in recovery. And now we see this practice spreading throughout health care, mental health care, right. So when somebody has a chronic health condition, some health care systems will assign them to talk to somebody else that has that health care problem, that same chronic condition. Like, they surviving with that condition, so I'm going to hook you up with that person so you could talk to that person about how they manage it. And then mental health, they took that note. So now we see peer mental health specialists getting certified, and we're starting to add standards again. Now we're adding standards to peers. So hopefully we won't lose them as we continue this process of the evolution of a peer recovery specialist, being able to help somebody in their recovery journey from the foundation of that helper's recovery journey. So around the end of the 1980s, there was this guy named William White. Not was. He still is. William White. Some people give him credit for starting this kind of paradigm shift in developing programs that will support people in recovery after treatment, or maybe without treatment at all. You just go and get you somebody to talk to that's in recovery, right. And also to fight the tremendous amount of stigma about addiction, right. They had more than one mission. Around the end of the 1980s, I was in Washington, D.C. with William White, pioneering the field of addictions. And I didn't know him. I just had met him. That was my first time meeting him. I was living in Florida. My first time meeting William White. And he was telling me and this other guy from Florida, what do you think about this idea of us trying to start a peer recovery type of a program to support people when they get their treatment and after treatment. And I was like, well, that sounds cool, you know. It wasn't going yet. And a year later, he convened about 40 people, 25 people up in Minneapolis, Minnesota. That's where I'm from. I'm a native Minnesotan. And they started talking about this notion of peer recovery and developing organizations that provide peer recovery support. So this paradigm shift of just delivering a dose of treatment to somebody with a substance use disorder started shifting to we're going to also deliver peer recovery support to those people. So now throughout the nation, we've seen growth in the model of community recovery organizations or recovery community organizations, RCOs. And that really started transforming at the end of the 90s and through 2000, right? And so now there's several hundred RCOs across the country. Around 2014 or so, I started to ask myself, where is that community recovery support in my community? I ain't see none in north side Minneapolis where all the black people live and south side Minneapolis where the other black people live. I just saw some on the east side and the west side where the white people live. There was really only one or two at that time. So I started calling around people around the country saying, y'all got one in your community? You got one in your community? Then I called SAMHSA because they put this, the organization that launched, let me just go back, is called Faces and Voices of Recovery. So if you're looking to kind of see this organization that blossomed in the new paradigm shift at the federal level under SAMHSA, the Substance Abuse and Mental Health Services Administration, it's called Faces and Voices of Recovery. And the work of William White and all those folks that came up to Minneapolis and then working with SAMHSA, they launched this organization that really supports recovery, not just treatment. And out of that, these community recovery organizations emerge and emerge and emerge. Anyways, so we know treatment works, it's effective, just like the treatment of other health, chronic health conditions. It's good, it's not perfect. The outcomes, we all want to be better. Lots of people get a dose of treatment, change their substance use behavior, go on to lead great lives in absence of the problematic substance abuse. Other people struggle, they go to treatment a few times, just like for any other chronic health condition. They go back for more care. So people thought layering some recovery support might have an influence or an impact on that, recidivism, improving and enhancing on what people get in their primary dose of treatment, all that sort of stuff. So that's kind of the paradigm shift we're talking about in terms of bringing recovery support to the continuum of care. It didn't move, did it? Yeah, you put some, there you go. All right. How many people already know components of recovery? I'm not trying to bore anybody. Components of recovery? You think of somebody's trying to improve their situation from a chronic substance use disorder where it's had a bad impact on health and social conditions and criminal justice and family, right? When their health, your own physical health is impacted from chronic substance use and you get dental problems, you get all kinds of stuff, right? Cardiovascular problems, all kinds of health conditions. So when you're thinking about components of recovery, it might be after those things are intervened on a little bit or in support of intervening on those effects of the chronic health condition of substance use disorder. But in recovery, people would like to say that they instill hope in people, right? Like even me saying, you know, that the name of that organization, Faces and Voices of Recovery, right? When I said I'm a person in long-term recovery, maybe somebody got a little hope. Now other people might be judging me, like who's this old drug addict talking to me, right? But other people are like, oh, that person got better. So much better that he could talk to me about the problem. So and then to meet people where they're at and respect them and you know, the counseling skills, bunch of psychologists in the room, psychiatrists, helping professionals, any direct care providers in here? You talk to people with problems? Okay, so you know all about that counseling stuff, right? You try to build people up, right? And you wanna help them take responsibility so that they could rely on the things that they put in place from talking to you, right? All that good stuff. I think there's been a good advent or a resurgence of a focus on person-centered caregiving, humanistic approaches like that. Because we got a little bossy for a while, didn't we? You just do what I say and you'll be better, right? And I think a lot of healthcare professions did that. And then we've all been encouraged to see what the client thinks about stuff and ask them what they're willing to do, right? There was probably a good 20 years we wasn't doing that. I write somebody's treatment plan and say, here, you do this and then just do what I say and you're gonna be all right, right? People was doing that. Maybe nobody in here. Everybody's new to the field in here. Y'all didn't know about that stuff, right? But we- Can I say something? Yeah. He said, anybody else do that? This is not what you would like. Can you please explain to me what your thoughts are about this? And if we disagree, like, okay, if we don't do this, this is what may happen. However, you still have that autonomy and that choice, and I will work with you whichever way we can. But I still see it, even from younger generations, new, older ones, mid, we just also have to be open and just take that, sometimes that God-like ego and tone it down. Thank you for that. Sure. Yeah, I was just going to say, we came a long way, and I see that a lot still in community mental health, where no offense if there's any community mental health workers here, but it's just that the treatment plan is prescribed. And so unfortunately, a lot of providers are confined by that. You can be creative and using your own ethics, but a lot of time, providers don't have a whole lot of leeway to really tweak that. That's unfortunate, but definitely, I hear you. In terms of autonomy, we came a long way. Thank you. Yeah. Anyways, I think that sort of care, maybe we aspire to, or we proclaim that we're moving towards, is a little bit more collaborative, right? A little bit more collaborative. Anyway, so these are some of the elements, components of recovery. And we know recovery's not in a straight line. Recovery's not in a straight line, so when I'm working with somebody in recovery, their line goes something like this. Right? And then it goes back a little, and it goes, right? And sometimes it's a spiral, right? But anyways, so when we're working with people and we know the old notion of one strike, or two strikes, or three strikes and you out, that's just not how recovery works. That's not how change works. It doesn't matter if it's substance use, is it? Some of y'all stage of change experts? Seven tries, that's the average, to sustain the change. Seven tries. But a lot of treatments, it's like, okay, you get two tries, maybe three tries. But we don't design our programs for seven tries, right? The payer mix, they don't have a seven-try payer mix. Right? We had legislation in the state of Minnesota that says somebody can't get treatment after four treatments. And four treatments, somebody went to detox four times in the same month, right? And then that's it, that's all you get, right? Well, that legislation didn't pass, but some smart congressperson said that's what we should do. And people considered it. All right. There's about 17,000 treatment centers in the United States, give or take. 200, 300 RCOs? It's growing. And there's more RCOs than what's on some roster, right? There's more community organizations emerging all the time. But there's not as many RCOs as there are treatments. In the state of Minnesota, they developed some legislation. They said, if you provide direct care, you have to also offer peer recovery support. So it made it into our law. So now a treatment center, they can't just give you a coin at the end and say, good luck. They have to connect you to a peer recovery specialist. That's the rule. But that's not, it's not that way everywhere, is it? Is it like that in your state? Anybody have that rule as part of the treatment? No? Right. Well, the treatment people, all those smart people that went to school, they was like, well, these guys, they're not trained. They're going to take my job and my money, you know? So they was getting some pushback even from the people giving help, right? It's like we've had that tension with mental health and substance abuse, right? We don't want them in our money. We want them to talk to our people about drugs, but we don't want them in our money, and vice versa, right? Anyways, so as these RCOs emerged, we saw this gap in diverse communities. And so I got with one of the Addiction Technology Transfer Center leaders, the ATTC Network, in case you haven't heard of that, the ATTC Network. Their job is to bring science to practice. So Dr. J writes a book, maybe has something in it about transforming community organizations. The ATTC takes that research and makes it practical so you or I could go start an RCO based on Andre's research. That's what the ATTCs do, right? And well, that's what they're supposed to do. And they do a lot of training and technical assistance and stuff. Anyways, I got with one of the ATTCs. I said, we need to get some RCOs into some black communities around this country. You know, there's several hundred in white communities. We only have like two, maybe three, maybe four, right? And we know the disparities about treatment access. Well, the same thing happens with recovery access. And then when we come up with some fancy new scientific method, it doesn't reach all the people, right? It reaches people with resources first, right? And it reaches people where the money is disseminated first, which is almost never in the black and brown communities. I know we in Florida. Y'all ain't probably ain't even supposed to be talking like this. They might come get me. They got rules about that stuff in Florida, don't they? I'm going to say D-E-I and see, I hope nobody comes and gets me because I don't think he's supposed to. You ain't supposed to say stuff like that here. You ain't supposed to say diversity, equity, and inclusion in Florida too much. You definitely can't be teaching about it no more, right? They got some rules about that here in Florida. I lived in Florida for 15 years. They had put me out around 2005, right? Anyway, so I wrote a short paper called The Black Paper. In that paper, I said, all this stuff that's affecting black communities and substance use disorder, and y'all ain't putting no resources for recovery support into our communities, and we need to do that. I didn't say it just like that, but that's what I was trying to tell them. Sent it off to the ATTC people, a couple people at SAMHSA. I ain't hear nothing for about five, six, seven years, right? We got a group of people together about five, six, seven years later, 2019, something like that, 2018, right? I wrote the paper in 2014. We got a group of people together. They said, we need to do something about this. We need to get some RCOs in black and brown communities, right? I was like, they're going to do something with my paper. They're going to do something with my paper. I was so excited. So that's where, that's kind of the origins of how we started this organization, the Center for African American Recovery Development, to bring RCOs into black and then black and brown communities. But our first emphasis was on black communities. And anyways, so they can blame me, but guess how much money they gave us? Any guess? Say it out loud. Zero. Zero. They ain't give us no money. We had to go fight for some money. We had to go beg for some money. We got a couple dollars here and a couple dollars there, right? Just enough to not do that much, right? But we did enough to launch an RCO in New Orleans, Louisiana. They didn't have one. You're talking about a black community in a certain ward in New Orleans we all seen on the TV screen when the hurricane hit. We saw a black community in New Orleans, didn't we? They didn't have no recovery support. They have a vibrant RCO. And I'm not saying we get all the credit, because we just connect with the people and they do it. They make their RCO. But anyways, that's kind of our mission out of there. All right. How am I doing on time? Next one. Okay. All right. Go back once. Just once. Real quick. All right. All right. You go ahead. So we know that the kind of history, early support models, well, let's just say after the 40s. Does anybody want to go back before the 1940s? Legends and Dragon Days, Psychiatric Wards. We don't want to go all the way back there, right? We'll say after AA started, Alcoholics Anonymous, right? And they had this notion of sponsorship that emerged throughout the evolution of Alcoholics Anonymous. You go to AA and you find somebody that'll help you at AA. And you had to ask them to be your sponsor. And some people, they sponsee shoppers, so they all in recovery real good and stuff like that. They go to the meetings looking for a sponsee. But most of the time, the person comes to AA, finds somebody they like, and ask them, would you be my sponsor, right? Early peer support models. In the community, if the church wasn't too judgmental, sometimes people would get some help at the church. Somebody else's church had a drinking problem, they done found Jesus, or Allah, or any number of higher powers, right? And then they helped that person at church, right? So we know there's other peer support models besides AA. But the big one, the most famous one, for the duration of the, is that 20th century? The 1900s? Right. Right? Was AA. And NA, and CA, and AA, and AA, and AA. Built on, at least in part, on this model of one person helping the next person. Giving back, because you got your recovery and you give it back to the other people. They had this condition of anonymity, though. So it kind of reinforced stigma a little bit. And that's something that the RCO movement really worked hard to shatter. Faces and voices of recovery. Somebody needs to tell somebody that they're in recovery and doing okay. Because society thinks people with drug problems, they're not doing okay. And they're still not trustworthy when they're in recovery. Right? So there's still a lot of that in our society. Unless somebody goes, my name is Jonathan, and I'm a person in long-term recovery. So part of this recovery movement was also to put a face and a voice on that. Not to say AA and NA, and the notion of anonymity is bad. But it, I think, was misconstrued for a while there. Don't tell nobody you're in recovery. Right? All right. And hopefully we're influencing a shift of inclusion, but we know that's a slow boat. Right? When we would see equity in representation of community recovery organizations, that's going to take a while. I'm just talking about the black community. But there's like one RCO in the whole country serving Somali people. Well, they black. Right? But then what about in the Latin, is Latin X okay even today? Right? Hispanic and Latino community. Right? How many RCOs are spread out across that community? And what about in the indigenous communities of all the different nations? Right? There's some. They're growing. We're starting to shift towards inclusion. But look, we two decades in, just like the advent of almost every other evidence-based practice that emerges, it does not hit those black and brown communities for some period of time. When everybody else is looking in the rear view mirror going, why aren't they where we are? The sustaining majority looking back saying, why aren't they where we are? Right? And we know the answers, but pretty soon it might be against the law to say the answer out loud. Right? We know the answer. I'm going to let Dr. Jay hit on ecosystem because he done wrote a whole book about recovery ecosystems. That man right there, Dr. Andre Johnson, you look him up, he's got a nice book out there. And you can understand it. You can read it and understand it. You know how some of us, we get our little PhD and we write something and can't nobody understand it? Not him. He done put it in words we can understand. And I mentioned the disparities. I hit on this in that little short paper, trying to compel our great nation to invest resources in communities of color to build recovery support infrastructure. We know the disparities. Does anybody not know some of the disparities, socioeconomic, education, health care, quality of health care? Everybody knows all that. Y'all done went to school and stuff, you done read this stuff? You know, may or may not have talked about it that much. But it was in there. It was in that book, wasn't it? They was talking about it. But doing something, writing it down and doing something, that takes a lot, a lot more intentionality, doesn't it? A lot more determination to see legislation passed that makes our system do something. That's going to take a lot of heaving and hoeing. All right. All right. What number slide is this? Does anybody have a number? I don't want to go too far because Dr. Andre is almost ready to get up. I'll just tell you that over... That's number seven. That's number seven. All right. Got a couple more minutes. How we doing on time? I don't want it too long. A couple more minutes? About two more minutes? Okay. We got 20 minutes left. All right. We only got 20 minutes left? Yeah. For the whole thing? Yeah, it's over 415. Or is it 445? 445? 445. You know why he said that, right? He wants this mic so bad. He's back there. Y'all see him how his foot started shaking? Because when he gets up here, y'all getting ready to go. I'm just getting you warmed up. When he gets up here, y'all getting ready to go. All right. There's a few black-led, black-run recovery community organizations in the country serving the black community. And Dr. Andre, he runs one. And they serve diverse communities. You know when it says it's an African-American organization, it doesn't mean other people can't go. Just like if you have a Eurocentric organization, other people can go. It's not just for the white people. It's for whoever wants to go there, right? We all have rules about that. We can't just turn people away. I worked at this agency, the first treatment center in the whole country that was designed to provide substance use disorder treatment for African-Americans. Y'all know it was in Minneapolis? Did anybody already know the name of the organization? African-American Family Services. The first treatment center in the whole country designed by black people serving the black community. I worked there. I told you I'm in long-term recovery. I'm going to just go back. I went to a treatment center serving the majority population. I was the only black client. They served other people. A little hospital-based clinic, right? At the time, 1987, it was $3,000, y'all. $3,000 out of pocket. I don't know where the $3,000 came from, but somebody got it in there and got me in there. I was looking around in there, and I feel like I belong there. Then my counselor told me, you're never going to make it. That's what my counselor told me on discharge. You are not going to make it. They used to use tactics like that. They used to come at you, right? My counselor said, I'm not going to make it. I'm walking down the street. I got a crack pipe in one hand and a bus ticket in the other. I'm like, which one should I do, right? I don't know what compelled me to break that little crack pipe. But I got on the bus, and I went to this little halfway house. Went to the little halfway house, and right across the street was African American Family Services. They were like, go over there. I got into this black men's support group, right? I never been around a bunch of black guys that was doing anything too much good. They was all on the road to recovery and doing their treatment and stuff like that. Giving me support and all this kind of stuff. Anyways, I saw that counselor that told me I was never going to make it. When I was the president of our state association of addiction professionals, and we were having a conference. Here she come. She looked at me, and I looked at her. In my head, I was going, I was saying some cuss words in my head. I was like, how you doing? She's like, don't I know you from somewhere? I didn't say, yeah, you said I was never going to make it, and I'm president of March right now. I didn't tell her that. I said, yeah, we met back at Fairview. That was it. She knew who I was. I had a little badge on and a little tag that said president. She looked at my badge. You know what I mean? It's almost like she had a look of shame on her face. I think she remembered. She told me I wasn't going to make it. Anyways, we try not to do that to people these days. Right? Anyways, I had made this slide. There's a few organizations. There's a black-led RCO in Minneapolis called the Twin City Recovery Project modeled after Dr. Andre's program. That's how bad he is. People want to copy his program. When I say bad, I mean good. Y'all know that, right? That kind of bad, right? That's how bad he is. He can set up RCOs or inspire people to set up RCOs based on his work around the whole wide world, not just in the United States. Right? Anyways, there's a few. Our goal, hopefully, as a discipline of helping professionals is to bring equity so that the kinds of supports that we want to see in our communities, we want to see in everybody's communities. That's what our goal is. We want the same kind of supports in every community. Does that make sense? One more time. Everybody knows about the opioid epidemic? There's a workshop going on. We don't want you to leave, though. There's a workshop about the opioid epidemic. They're talking about changing the criteria of opioid use disorder because it's so out of control. Everybody's getting all kinds of mixed drugs, trying to get a little heroin or take a pill, and the pill's laced with all kinds of stuff don't nobody even know about. We were sitting out with scientists out there in the hallway just now You know how they used to say about marijuana? There's like 78 chemicals in marijuana nobody knows about. Everybody just wants the THC. Well, now they're saying that about the little pills. They got some words in there. I can't even say the whole word, but it sounds like a bad chemical. But there was a period where people didn't think this was a black people's problem. The overdose deaths. Y'all know when the pill emergence happened and then they was like, well, mostly the white people can get the pills. The black and brown people, they don't have access. Well, then they started shutting down those pill mills and getting after a few of them doctors. And then all of a sudden it shifted back. Now people are looking at it like, oh, it's a black and brown problem. Right? The white access changed a little bit. So all of a sudden we had an inversion of the overdose deaths. White people was overdosing like crazy. We need to get them in treatment. We need to get interventions from medical people like y'all. Do you think they're using that same language? In the black and brown communities and indigenous communities around the country right now? Some people are. But it's not the same level of urgency I heard 15 years ago. It's just not the same level of urgency. And you think they're moving the money out to those communities. We all got another thing coming. Now we're getting the fentanyl out there. Naloxone out there. I got three kids in my bag right there and a test strip in case anybody's thinking about getting high. I got a test strip. Right? But anyways, it started hitting different black and brown populations' overdose deaths over this last 10-year period. Inversion. So I don't know if that's a precipitating factor of RCOs but it might be another rationality. We need to get recovery support out there but we also need to get other stuff out there into the communities, right? All right. All right. This last thing I'm going to say recovery movement exclusion Dr. Jay's response. That's the black paper I already mentioned. Oh, okay. I want to read this one little quote to you about trauma. I didn't mention trauma in the recovery support. Trauma is another recovery support principle if you will addressing trauma. Anybody ever read the book My Grandmother's Hands? My Grandmother's Hands. Res Momenicam, right? Res Momenicam. Right? Somatic abolitionism. Somatic abolitionism. And the notion of somehow addressing the trauma that gets stored in our DNA. Epigenetics. Any of those scientists in here? Neuroscientists? Anybody heard the term epigenetics before? When stuff gets passed on a few generations all of a sudden it's just inside you. Like I don't know how that got in there. Right? I'm seven generations removed from a freed great, great, great, great from Texas. A freed slave. Just saying that makes my skin go right. They all went up to Omaha and sharecropped and then they spread out. But that's seven generations. But somehow it's still in my memory. That's the kind of notion behind it, I think, epigenetics. Trauma gets passed on and woven into your DNA. And so Res Momenicam came up with this idea in the book My Grandmother's Hands called somatic abolitionism. That we don't have to treat everything with medication. That you got to do that you got to do that body work. Right? You got to heal the body. Right? And anyways, his quote his quote, I just want to leave it with you. And just ask you what you think about it. And we're passing on. I need my glasses? I had to slide right up. All right, we know there's all kinds of trauma, right? Some of it's intergenerational and historic and all that stuff, and then stuff be happening to people, right? And then there's persistent trauma that's still going on, that people deal with. Some people, they'll put poverty in there, like living in poverty is traumatic, and they're still in poverty. So it's not PTSD, right, unless it's present-day trauma. Anyways, Resmaa wrote, trauma decontextualized in a person over time can look like personality. There's some psychiatrists and psychologists in here, right? And you look at people that have been suffering trauma for a long time and over generations, and you could just think that that's their personality and might not even ever inquire about the trauma. And then he said, trauma decontextualized over time in a family can look like a family trait. So when I start assessing what's going on in a family, all of a sudden, the trauma is just a trait of that family. That's how that family is. And then trauma decontextualized in a people over time could look like culture. That's a quote from Resmaa. My grandmother's hands. Or in a couple of his lectures afterwards, right? But I was just wondering if anybody has a response, like what does that quote mean to you? I'll say it one more time. Trauma decontextualized in a person over time can look like personality. Trauma decontextualized over time in a family can look like family traits. And trauma decontextualized in a people over time can look like culture. What does that quote mean to you? Because we're supposed to have interaction. I've been up here lecturing and talking. Well, to me, it feels like discrimination in the sense that something has happened to you, like Oprah Winfrey says, in the book about trauma, what happened to you? Something happens to you, it impacts you, and then you get labeled that that's just your personality or that's part of your culture. That's what it means to me. I just want to comment that this generational trauma that you're talking about, how it affects families, and you look at some families that they do crazy things, crazy behaviors, so people coming up in the family get re-traumatized from the things that their ancestors and their parents went through, and what is the number one way that people deal with trauma is drugs and alcohol, because it quiets it down temporarily. So, you know, when you open up a drug treatment center, and you don't have anybody there that's really skilled in dealing with the trauma, all we want to do is send you to groups and give you a standardized treatment like from the Matrix or the Hazelden Program, but nobody's dealing with the underlying trauma, and then you send them out without recovery support, so they just recycle. Now, the sad part about that recycling, I'm an addiction psychiatrist, but I also work in managed care, and we don't have outcome measures to say how this treatment is doing versus how that treatment center is doing, and so when you have a fee-for-service, no matter how your patient does, you just bring them back and recycle them through, and so some of these community organizations are making money just simply recycling people, but nobody's dealing with the trauma. There's no real skilled person to do EMDR or anything definitive. There's no psychiatrist to prescribe SSRIs, there's nothing. I'm gonna say something real quick, if we could. Okay, so I did some research in my family, and I used to try to figure out, like I felt like my father was abusive when we were growing up, like spanking us. You ever hear about, we're gonna spank these kids, we're gonna spank these kids, and I thought spanking is like, it just seems so abnormal to me, and especially the way that it was in our family, so as I began to talk to my cousins that are older than me, and I was a kid that did a lot of research, biographies and reading stuff about slavery, but the question he asked was about like culture, like how does these things affect our culture, and what I came up with is that the spankings that the children receive from where we were from in Alabama was a way to discipline the children, because if you don't discipline your child, the child needs to listen to the parent, and so they overly disciplined the children the same way that the slave master overly disciplined the slave, because they needed to listen, and I just was like, it just didn't sit well with me, but, and they gave an example of one of my aunts who was, they call it hard-headed, she was hard-headed, she didn't listen, right, and the grandfather just would spank her, spank her, but he needed her to listen, because if she didn't listen, they were gonna take her from the family, so what he's talking about is the cultural things that are brought up from all those generations about how do we make these people behave the way we want, and so we overly conditioned them to spankings, and so nobody wanted that, right, and so this is just me doing my own research. Yes, I just want to respond to what you said about discipline in African-American families. Being from the South, before I landed in Detroit, Michigan, keeping Wayne State University, by the way, keep in mind that Emmett Till, who was raised in the North, when he came down South, he was considered disrespectful and got killed. So a lot of that discipline from Southern families was to teach kids how to behave outside of the home so that they wouldn't get killed. That's what I'm saying. All right, y'all. Hopefully, you're not totally bored out of your minds yet, because we've got a treat for you now, Dr. Andre Johnson, coming on up. All right, thank you. Thank you. All right. Well, talked about so much. I'm happy to be here. I'm thrilled to be here with you all. I really want to just dive into some of the slides, but also really get an understanding of what drove you to this workshop. Why are you here? What are some of the things you hope to gain and learn at this workshop? Excellent job by Jonathan. Excellent introduction by Anita. We were planning to have our executive director of CARD, Nyla, here, but she's stuck in Los Angeles taking care of some personal matters. But I just want to scan the room right quick and say, what made some of you all come here, since you're smiling? And I'd like to know, where are you from? What area? Anybody else? Y'all know it's late. I ain't letting y'all go to sleep on me this last 30 minutes. It's less than 30 minutes. Because I work. Thank you. Thank you. Excellent. A couple more. action at this time, but also I'm about to start. Thank you, thank you, thank you very much. One more. Hi, I'm Brenda. I currently live here in Florida. educate ourselves because me, I identify as an Afro-Latina, and I get hit from many different ways. And even as a professional, I will experience the stigma, the stereotyping, and the discrimination. And then another whammy, I'm a female. So it just keeps adding and adding. I came recently to the west side of Florida, and even though I was on the east side, culture does change, even within the state. And the reason I'm here is just to see what other people in other areas are doing for our minority communities. One of the reasons I came to this side was to serve underserved communities, including people from all over that don't look like the mainstream and do not get the services that they deserve because they don't look a certain way or come from certain areas. But with my background, this is my second career. I was in the military and saw the stigma in our community wanting us to be well, but if we sought help, then that pretty much ended our career. So after I retired, this is where my passion came, and this is what I continue to do because I think when it comes to the quote that you had mentioned, is that even though we specifically now are not living the same experiences our ancestors lived in the past, these are learned experiences that we come through generations, and the trauma's there, the trauma forms, the trauma becomes ingrained in us, and some of us will act and behave and think a certain way, and sometimes we don't even realize it's because of this trauma that has been coming from different generations. And with me, even though some people will talk and they're like, oh, I've never had any trauma or anything, and then they tell me this story. I'm like, this is trauma. I'm like, so we need to all understand this trauma so then we can start peeling these layers of the onion so we can understand why we're doing things a certain way so then we can take care of everything else. But this is why I'm here, because we need a lot of work within our community still. All right, now, let's give her a hand. That was, yeah, yeah, no, you unpacked a lot. And really, we can go so deep when it comes to trauma and unpacking it. I mean, a whole book that the lady talked about earlier around what happened to you that was written by Dr. Bruce Perry and Oprah Winfrey, incredible book. But there's so many other books out there as well, Body Keeps Score, Bessel has done a lot of work in trauma, and we just started really talking about trauma and addiction space in the last 10, 15 years. We're about 50 years late to that discussion, and let alone really trained in that space, really understand the depths of trauma. We go to, it's easy to go through online and complete a trauma-informed care tip on SAMHSA's website, but really, really going deep and going on a deeper level and bringing that into the space with your clients takes a certain level of expertise. But one of the beauties of what we're doing and part of what we're doing as it relates to developing this CARD national initiative is really to take what we've learned in black recovery community organizations throughout the country and help other black organizations develop, because we know there's a disparity of recovery community organizations in the black community, and we wanna be able to just be black. We don't have to say it's black, but we are black, right? So we want to just ensure that we can bring some of our principles and we can bring some of our experiences. So we talk about costly understanding, culturally tailored, embracing community-centered values of family, faith, and I'm drawing a blank. What's the blank? What's the, you know, round, what is it, Christmas? There's something called the seven principles of Kwanzaa. We can bring those seven principles of Kwanzaa into our recovery community organization. We can bring, right, Black History Month into our organizations. You know, when I worked, I worked in Los Angeles doing my clinical internship, worked predominantly with Latino, Hispanic community. You know, I would celebrate more holidays than I knew about during that year. But nobody brought up Black History Month. You know what I mean? Nobody brought up the seven principles of Kwanzaa. It was like, and nothing, you know, nothing personal against the Latino or the Hispanic community because they were the majority. But it's just being mindful about other aspects of other communities. And I think we all have to be mindful of that and be able to bring that cultural awareness, bring that cultural humiliation, bring that cultural understanding that, you know, I really don't know shit about some of these other you know, cultures. And how can I engage other cultures to teach me? Because our clients are our best teachers, quite frankly. 2020, that was a year. I mean, 2020, the beginning of a new decade. 2020, George Floyd. 2020, was that the pandemic too, right? The pandemic. And so there was a lot going on in our country. And just think, you know, there's still a hand, maybe two, three, really fully functional handful of recovery community organizations in the United States that's fighting to help people change, fighting to help people instill the hope, instill the components of recovery that say you can do this, you know. That's peer led, peer ran, and peer driven. That was a hard year. I remember I was doing my clinical and my supervisor said, hey, Andre, I got a client for you who asked specifically for a person of color. And I was like, yes, cool, I'm about to work with a young black man. Because I've been working, all of my interns and practicums, I work predominantly with white people. Ain't nothing against white people or any other culture, but my supervisor, I was like, cool, I'm about to finally get the time to do some work. And then a Hispanic guy showed up. Because my supervisor, the way he framed it, he said, yeah, he asked for a person of color and that he may have experienced some racial discrimination. And I was like, damn, for real? People gonna treat me for that? So the guy shows up, he's a 27 year old Hispanic who grew up in a rural part of Michigan, predominantly white, where he was the minority. And he was working at like a CVS or something. And he said, which I didn't know, I gotta say, I learned so much from the clients, but he said, certain parts of the year, they think I'm white, and then other parts of the year, they think I'm black. And then they start disrespecting me while I'm working in the store. And the slurs and the negative names and stuff like that. And so it was at that time when I started really diving more deep into the trauma and seeing how, was that somehow part of his upbringing and life? And he talked about how he experienced the bullying as a young kid. He talked about how him and his family, three sisters, mother and father, both parents were active alcoholics, but they were also Catholics deep into the church. And daddy used to beat the shit out of him every day. And he slept on the floor growing up. You know what I mean? So you got the trauma, the childhood, the historical family trauma, and then you got the trauma in the community, and then he had this trauma from the workplace, and then he was obsessed with CNN, Fox News, watching Trump during that time. And just how all that psychologically contributed to a significant amount of depression and anxiety. And he was trying to marry a white girl who was two years younger than him, and her parents didn't really care for Latino family. Now you see all these dynamics going on that we had to flush through and work with this psychiatrist and make sure he was taking his medication and giving him his treatment and giving him his one-on-one therapy in order to help him get better. And that was a nine-month process where he was able to turn around and we were able to really work through a lot of this. Now we talking about, and not minimizing nobody, but I can tell you all these stories that's like, damn, especially when it come to black men. You know what I mean? It's because I do forensic psychology, got a young black man, 31, no, 26 years old, shot and killed his 25-year-old pregnant girlfriend. They both was living in a hotel, smoking cocaine, doing meth, doing alcohol, doing weed, for two weeks straight, no sleep. And he shot and killed his pregnant girlfriend and couldn't even tell you why. And now he's on a death penalty. And I started investigating his background. Poverty, trauma, mama, active drug user, daddy murdered, selling drugs at 13 years old. Just a psycho. And he lived in a predominantly white neighborhood. But in that predominantly white neighborhood, there's a small, marginalized community. And most of them live in the homes of seven, eight generations of their family members where they never really leave. You know, you're talking about the socioeconomic disparity, the physical health disparity. And those are the people, people say, you just need to kill that motherfucker. But the truth is, we gotta treat people. I graduated from a humanistic psychology program. And the way I was trained is we gotta bring empathy. We gotta bring compassion. And we gotta be able to admit when we have ruptures. Because we have ruptures as professionals. And we don't know everything, as Dr. Jonathan has already said. So yeah, I think 2020 was a part of this history that's gonna change our paradigm. It's impacted our paradigm. And I think we've made a little progress. And as long as we can make a little progress, that's better than no progress at all. But we got a long way to go. We talk about commitment to equity, that's a whole gamut of things that need to happen. And I think it has to happen with us being able to advocate that we need to make sure we got more black people or more Latino people or more people of color that's working in our field to make sure that when people come into our field that they can see people that look like them. That's an intentional, it has to be intentional. And everybody has to take that intentionality approach. I run an organization, we got 95 employees and we probably got 70% blacks and the other 30% are whites and it's every age range. And we got a Latino person, you know what I mean? Why? It's because I'm the president and CEO so I can be very intentional with making sure that our team is multicultural because we live in a multicultural community. Although Detroit is predominant blacks, but it's not just blacks coming through our doors. So it's important to me that we have peers that can speak the language, peers that can make the connection and peers that's been educated, that's been fully trained. And if we're not bringing that piece together, if you're not advocating to bring that together in your community, then you're not really ready to be a catalyst for change. Because catalyst for change requires all of us to change and it also requires us to be committed to the equity. I think John has already done a great job talking about the components of recovery. I'm sure most of you are very familiar with various aspects of this. But again, I think it's important that we recognize that cultural expressions is important. You know, I always like to ask y'all, when y'all think about Detroit, what do y'all think about? Motown. Motown. And what's some of y'all favorite Motown music? What songs? Can anybody give me some Motown songs in here? Don't smile. Say it. Come on. You ain't stop talking, don't get shy now. Give me a song. Well, for me, it's the Jackson 5 at that point. What song? I don't know titles, but I could hear them in my head. You wanna sing it? No, not really. Oh, now she Googled it over there. Come on, can somebody give me a Motown song? House House. Temptations, my girl. My girl. Do y'all know about my girl? I know you a Gen X back there, ain't you? You know about that song? He's like, nah. What else? Who else? What's going on? Who made that? Marvin Gaye. You hear that? Marvin Gaye. Well, I'm not gonna sing, but under cultural expressions, also a dress, fashion, appearance, those are also symbols of cultural expression. That can count. That's right. I'm into that. All right, all right. Y'all hear what she into? Fashion, design. So we heard, what did you say? What's going on? What's going on? You know, that song was made, I believe, Marvin Gaye, he was writing that song in relation to what, the riots and stuff that was going on in the late 60s. And it's just interesting. I always love to ask people, what are they thoughts around Motown music and how Motown music shaped America and the world as it relates to music, inspiration, and definitely fashion, culture, but also the music and the songs around the meanies. My Girl, you know, you had them three guys start doing like this and they start saying, come on, y'all wanna do it? My Girl, oh my God. But it's important to somehow infuse the music into what you do as a therapist. So even if you a therapist and you facilitating a group, you can tell your clients to close their eyes for five minutes and be in the here and now and play some Stevie Wonder. That's what was my experience when I was in treatment in 1988. And I remember 15 of us, we closed our eyes and when it was over, everybody was crying. I didn't know what the fuck I was crying for, but I was crying. And it was just, you know, really, truly getting into the music, right? And sometimes, you know, as people use drugs and alcohol, don't always know how to get into stuff like that. We know how to escape and run from our feelings and our emotions. But really to like sit still, being in here now, I think it's a good strategy. So putting it on this line. It's a little different than this one. So I just wanted to point that out. We talked about those recovery principles earlier, but not specifically for African-Americans. So a few subject matter experts drafted a definition and then bounced it off about 500 black people about what they thought about this definition. And that's how we arrived at this definition. We tweaked it, got the feedback, and kind of tweaked it based on that feedback. So you'll see the principles here. If you look at the principles of recovery by SAMHSA and the definition of recovery by SAMHSA, that language is a little different. This language is tailored to the African-American experience about recovery. Go on and keep it. Keep it. OK, thank you. Thank you very much. And that's excellent. And so here, we just talk about some of the other aspects related to the position statement in terms that we recognize there's financial hardships that exist. We recognize the social disparity around education and social disruption, the confusion around COVID and what that brought, and how religious disassociation and addiction and uncertainty. There's so many aspects that we had to really try our best to really educate and empower others. Because now, over the past year, we spent time in New Orleans helping that crew down there to develop a day recovery community organization. And New Orleans still haven't, at least the black community, still haven't fully bounced back since Hurricane Katrina. But there is a sense of unity and a sense of connectedness that just made things kind of work out to be very cohesive. So we're developing a strong recovery community organization. Ms. Bradley has a strong communication, I mean, a recovery community organization in the heart of Cleveland, Ohio, Cuyahoga County. Dr. Laughlin sits on one of the largest black recovery community organizations in Twin Cities, which is a Twin Cities community project in the Minnesota area. I'm in Detroit. We have colleagues in Atlanta, Georgia, Dallas, Texas. And again, it's just a handful of us in these major states. Dallas, Texas, all the people in Texas, Cleveland, Ohio, not a clue. What happened to Columbus? What happened to Dayton? What happened to Cincinnati? And obviously, Dr. Laughlin talks already a lot about the disparity in the black community and why. And that really just feeds the fuel why it's important to have recovery community organizations. But also just some of the financial aspects, a lot of average budgets of some of these communities of some of these RCOs range around $700,000 to $800,000 a year, not even a million dollar budget. And some are less than that. They've been operating five and 10 years. They haven't even seen a million dollars. And the only way it's going to work and we'd be effective is when there's a team approach and we start coming together. So when you represent universities, you represent hospitals, you want to start bringing those institutions to partner with the recovery community organization. And that's how we have a greater impact because we know at the end of the day, there's physical health disparities, behavioral health disparities. But when we can all work together, speak together, I mean, we know mental health has worked historically in a silo situation. And SUD has worked historically in a silo situation. But now it's all about integration and certified. How many of y'all heard of CCBHC? Nobody heard? Just one person? Two? Oh, my god. Where y'all been? Well, CCBHC stands for Certified Community Behavioral Health Clinic. And that's the funding that SAMHSA has been pushing over the last five or six years, really since the pandemic, around including resources under one roof where we develop and build one-stop shops where people can get their mental health and SUD treatment in one shot. And they can also get their physical health services as well under one shot. So now we have a multi-team approach where everybody's talking. We have a psychiatrist talking to our medical doctor, our nurse practitioner, our peer in recovery, as well as our master-level social therapy for the greater good of one person. That way, all the weight doesn't fall on one person. But we got to talk about it. We know this person has taken some SSRIs, and they also have diabetes and high blood pressure. We need to know how this medicine is perhaps creating some challenges with the patient. And we're talking about a patient that's continuously sleeping in group or falling asleep during an individual session. But nobody knows what type of medication and how that can impact one's health. So again, increased provider diversity. We want to promote MAT. Dr. Lofkin already said very eloquently, black overdose deaths has continuously risen, while white overdose deaths have continuously declined. So we want to make sure everybody has that access to MAT. We also want to be mindful of the youth programs, collaborations, and then develop and build these community-driven models for the greater good of the community. So now I want to take these last few minutes to say, hey, do y'all have any questions for me and my dynamic presenter, Dr. Lofkin? No questions? Y'all just came for the CEUs. Y'all ain't got nothing to say, right? I have a question. OK. Right now, here we go. Yeah, there you go. She's next. OK. Hey. Sorry. My name is Matt Stose. I'm an addiction psychiatrist in Milwaukee. He has a lot of segregation. I work at the VA, and we have a lot of diversity in our patient population. There's also a lot of diversity overall in the staff, but the providers themselves, the physicians and pharmacists are predominantly white, and we've just been starting to get some more diversity in the group that we have. And it's just causing, you know, I think some of my colleagues are coming in with their own trauma and cultural trauma and generational trauma. And I'm working with them to kind of integrate well into kind of the system while the system's kind of adjusting to kind of integrating. It's taken like 150 years or something. But any advice for kind of helping, you know, bringing in African-American colleagues into kind of a predominantly kind of white work environment? How do you kind of work with that? Any advice to help that go over better? It's challenging, and I'm in it for the long run. And so anything you have would be helpful. Sure. Great question. Did you want to take a stab? of course, is having equity in your then not put all the pressure on them to represent the culture. So when you do diversity training across the system, don't put it on the new culture, the diverse people, to train the people that are already there. And then sometimes coaching, getting a little support from somebody that has a little expertise in organization development around diversity, equity, and inclusion, and stuff like that can be really helpful when you kind of bringing on diverse staff. Excellent. And I'll tell you some more afterwards. I want to get her. Go ahead. I mean, we're out of time. First of all, I have to say that you guys did an excellent job. I love the laid-back modality of this training. It's not a lecture-based. We really learned a lot from you. So thank you so much for this presentation today. My name is Farrah. I'm a licensed clinical social worker out of Florida. Thank you. God bless you. Yeah, a lot of challenges here, for sure. But I work for an FQHC. We just recently launched an MAT program within the primary care setting, which we call primary care addiction treatment. We recently also received a grant from Central Florida Behavioral Health to provide peer recovery services. One of the criteria is that previously, they required that the peers have to be certified. But then with this new grant, they do not have to be certified. However, here in you, and we know that, of course, all peers have to be well-trained in order for them to be able to provide services to others. Even though they've already worked at work, they have a lot of wisdom and a lot of knowledge. But do you provide, first of all, do you have any recommendations for maybe peer recovery support, if that makes any sense? I got something for you. Yeah, I mean, we have some trainings that we do around how to provide supervision for peer support. And we also have some basic trainings around. So Dr. Lofgren mentioned my book earlier, Recovery Ecosystem. And there's about 15 chapters. And I'm not self-promoting, but if you do want the book, you can get it. But no, it's a good roadmap to really give insight, a framework, because the lived experience is important. But we also want to make sure and ensure that we're teaching people the real process of the recovery process. Thank you. Yeah, the other thing I would add, I've been going to a few RCOs around the country doing some motivational interviewing training with peers, because they get a little introduction to motivational interviewing counseling skills during peer recovery training. But they don't get enough to where they could practice it and then use that when they're talking to their peers. I will take one more comment. Are you familiar with the opioid response network? So if you submit a request to them looking for that, that's something they can certainly help you with as far as peer support support. Mark Howley Benjamin. Thank you.

Recovery Support Services

African-American Community

Recovery Community Organizations

Equitable Recovery Networks

Culturally Adapted Models

Peer Support

Cultural Influences

Trauma

Diversity in Providers

Culturally-Informed Care

Creative Arts Therapy

Systemic Changes

Equitable Access