As overdose deaths have spiked amid the pandemic, Congress has authorized billions of dollars in the fight against substance use disorder (SUD). While the funding has been lauded by many for its potential to improve treatment access, others argue the federal government still hasn’t done enough to help the minority communities hardest hit by SUDs.

“All of these dollars were allocated for opioid use disorder (OUD), but we’re not seeing the impact of the dollars reaching our communities,” Tanya Young Williams, a Black SUD treatment executive, told Behavioral Health Business. “What’s the good of [having] it, if the people who need it most can’t get it?”

Young Williams is the co-founder and CEO of Pivot Treatment & Wellness Centers in Lake Park, Florida, which provides medical detox, residential treatment, intensive outpatient programming (IOP) and partial hospitalization (PHP) programming for people with SUDs and dual diagnoses. As one of the few Black woman owners of a SUD treatment company, she started Pivot — located north of Miami on Florida’s Singer Island — in large part to address racial inequities in the industry.

Young Williams said that when it comes to SUD treatment, the recent funding oversight reflects a larger, long-time disregard of communities where the majority of residents are black, indigenous and people of color (BIPOC). That’s one of many reasons a large part of her business is focused on serving BIPOC individuals.

“I need more help than I can generate by myself to really fix the problem,” Young Williams said. “At the end of the day, addiction is a life and death disease.”

A former communications professional with a background in journalism and public relations, Young Williams was initially drawn to the addiction treatment industry because she wanted to improve patients’ outcomes and offer a more holistic approach to care.

“We wanted to approach treatment generally differently,” she said. “We really believe that people went into treatment and oftentimes came out sober, but they didn’t come out well.”

Young Williams estimates that she visited around a dozen detox programs in South Florida prior to establishing Pivot. One visit in particular stuck out for her.

“I saw [only] one African American man, and it was startling,” she recalled. “I took a step back and realized that no one’s hand I was shaking — [from] the ownership of any of the places — was Black or brown.”

Meanwhile, Young Williams was a Black woman entering into an industry overwhelmingly run by white men, an issue trade organizations like the National Association of Addiction Treatment Providers (NAATP) have called out in recent years, pointing to a lack of diversity among workforce and leadership.

“I had to show up because I had to be a voice that no one else was going to have,” she said.

And so Young Williams and her business partner founded Pivot — which advertises itself as a luxury rehab center — in 2018.

Pivot is built on pillars the pair deemed more necessary to a person’s wellbeing. Some of those pillars include social, physical, financial, vocational and spiritual concerns.

“We … created a 12-pillar wellness curriculum that would really deal with the total wellness of people, so that when they came out of Pivot, they would feel that they would be able to go back and contribute to society and work with their families,” she said.

Pivot serves a diverse clientele in South Florida, which Young Williams said is reflective of the diversity of her staff. Additionally, Pivot puts a significant focus on addressing the unique needs of BIPOC individuals seeking SUD treatment — needs that BIPOC leaders in SUD treatment, as well as across the behavioral health spectrum, say haven’t been met historically.

Pivot takes into account cultural concerns, with BIPOC and culturally-sensitive counselors and therapists to help patients on their recovery journey.

“We had to really let it be known that we’re open, we are going to cater to Black and brown people and our curriculum is going to have certain conversations that are going to be unique to this population,” Young Williams said.

Although rates of SUD are about equal for different races, BIPOC communities tend to have less than adequate access to treatment options compared to white communities.

Young Williams said that BIPOC-owned providers like Pivot are playing a critical role in making sure minority communities have access to sufficient SUD treatment services equal to whites. Given racial disparities to SUD treatment, she fears what the absence of providers like hers could mean for BIPOC individuals.

“If we’re not really treating people where they are because of the incapabilities of the … clinicians, we could be potentially killing and devastating people’s lives,” Young Williams said. “That’s why I’m so passionate about this.”

Working toward equitable treatment

While overdose deaths continue to reach new record highs, the SUD epidemic was already a big problem pre-pandemic. One of the more recent examples of that comes from 2016 data from the Substance Abuse and Mental Health Services Administration (SAMHSA), which shows that over 27 million Americans are either dependent or misusing illicit or prescription drugs.

For BIPOC individuals with SUD, the situation is especially dire.

“Despite relatively uniform rates of substance abuse among racial and ethnic populations …, members of minority groups are most likely to experience barriers that impede their ability to access substance abuse treatment,” states the American Psychological Association. One reason for that, experts say, is the federal response to the SUD epidemic.

Congress last year passed legislation authorizing $3.8 billion to be spent on SUD treatment, but much of that money went toward OUD, which largely impacts majority white, rural communities. In fact, OUD has been the major SUD priority for lawmakers at the Congressional and executive levels for the last several years. Meanwhile, SUDs impacting mostly BIPOC communities have not been equally prioritized, Young Williams said.

“The federal response, particularly to our demographic, has been non-existent,” she said. “The global response and the dollars … were allocated in ways that went to science, medication and research, which can take years to trickle down to people who are suffering right now with the disease of addiction. … The federal government has been lax and absent in providing help to our community and people of color generally.”

While Young Williams said she is hopeful that the Biden administration will change that, he has not yet unveiled any SUD funding or awareness initiatives specifically for communities of color. That’s one of the most effective means of improving SUD treatment for BIPOC communities — earmarking federal funds for BIPOC-owned treatment clinics — she said.

“At the end of the day, we don’t get the money,” Young Williams said. “The money that has been appropriated by the federal government, … that will not trickle down to the [minority] community, and none of it has been earmarked. Some of it should be earmarked to go directly to Black and brown communities.”

She said that a better federal response for BIPOC communities will help to make her job and the jobs of others like her much easier. That means promoting awareness, improving resources and increasing funding for BIPOC individuals with SUD.

“We’ve got to walk and chew gum at the same time,” she said. “We’ve got to be able to put forth strategies that teach people in our communities about the resources that should be available to them, and take away the barriers.”