Case study:
In the example they use, Monique is poor and black; Becky is middle-class and white. Their different status of race and class influences (1) how potent the available drugs are (crack in poor inner cities versus powdered cocaine in affluent suburbs), (2) the relationship between sex and drugs in the particular social scene (Monique, who had to prostitute for money versus Becky, who had a well-paying job), (3) the ability of a person to maintain a “nondeviant” identity by being able to conceal drug use, (4) the availability of resources to cushion the consequences of using illegal drugs, and (5) the availability of options to leave the drug “scene” and move on to a different way of life (Monique, who went to a homeless shelter versus Becky, who went to Hawaii with her dad). Thus, the combination of racial oppression and economic class profoundly influences the context of drug initiation, drug use patterns, and the consequences of drug misuse and addiction. The Recovery Management model (RM) (see Chapter 1) is a new paradigm for addressing the differences so glaringly apparent in the stories of Becky and Monique. Recovery Management would be particularly helpful for someone like Monique, who had very few, if any, supports for recovery within her family (estranged and fractured) and social networks (fellow crack addicts). The RM model focuses on designing services based on the magnitude of the problem and the amount of “recovery capital” available to individual clients within their communities (White & Saunders, 2008; White & Kelly, 2010). Recovery capital is a concept that identifies strengths and resources within communities that have been overlooked in traditional acute care models. For example, the capacity for patience, compassion, and forgiveness within communities of color is viewed as a resource of hope, not a sign of codependency. The community eco- system itself is perceived as the source of healing, and thus the RM model seeks to enhance the recovery support of families, kinship networks, mutual-help groups, churches, and tribes. Indigenous healers in the community, such as the medicine man or woman, curandero, minister, shaman, or herbalist as well as relevant cultural rituals and ceremonies are sought out and included with the RM team approach. White and Sanders (2008) advocate for an assertive approach of community outreach because of several possible conditions of marginalized people that make engagement more difficult: 1. Lack of money, skills, and language to negotiate the treatment system. 2. High tolerance for pain and suffering. 4. Negative experiences in other service systems (courts, child welfare, 5. Cultural or religious beliefs that conflict with mainstream treatment 6. Fear of “losing face” or bringing shame on the family by disclosing personal problems.
Questions:
1) What does the story of Becky and Monique tell us about the path to addiction, the agent of addiction (drug used) and recovery options?
2) In your opinion, which of the above (race, ethnicity, culture, or class) has a greater affect on the path to addiction, the agent of addiction and recovery options and why?