CenterforSubstanceAbuse Prevention CSAP Monograph Drug-FreeCommunitiesbytheYear2000 CSAP Prevention Monograph-13 The Second National Conference on Preventing and Treating Alcohol and Other Drug Abuse, HIV Infection, and AIDS Black in Communities: From Advocacy to Action U.S. DEPARTMENTOFHEALTHANDHUMANSERVICES PublicHealthService SubstanceAbuseandMentalHealthServicesAdministration r CSAPPreventionMonographsarepreparedbythedivisionsoftheCenter for Substance Abuse Prevention (CSAP) and published by its Division of CommunicationPrograms.Theprimaryobjectiveofthisseriesistofacilitate thetransferofpreventionandinterventiontechnologybetweenandamong researchers, administrators, policymakers, educators, andproviders inthe publicandprivatesectors.Thecontentofstate-of-the-artconferences,reviews ofinnovativeorexemplaryprogrammingmodels,andreviewsofevaluative studiesareimportantelementsofCSAP’sinformationdisseminationmission. Thepresentationshereinarethoseoftheauthorsandmaynotnecessarily reflecttheopinions,officialpolicy,orpositionofCSAP;theSubstanceAbuse andMentalHealthServicesAdministration;thePublicHealthService;orthe U.S.DepartmentofHealthandHumanServices. All material in this volume, except quoted passages from copyrighted sources, is in the public domain and may be used or reproduced without permissionfromCSAPortheauthors.Citationofthesourceisappreciated. CSAPProductionOfficer:JoanQuinlan LibraryofCongressCatalogCardNumber:92-085148 DHHSPublicationNo.(ADM)93-1969 Printed1993 CSAPPreventionMonographSeries MSW VivianL.Smith, ActingDirector,CSAP RobertW.Denniston Director,DivisionofCommunicationPrograms,CSAP BernardR.McColgan Director,DivisionofDemonstrationsandEvaluation,CSAP AsofOctober1,1992,ADAMHAwasreor- ganized. The Office for Substance Abuse Prevention (OSAP) became the Center for SubstanceAbusePrevention(CSAP)andthe Alcohol,DrugAbuse,andMentalHealthAd- ministration (ADAMHA) became the Sub- stance Abuse and Mental Health Services Administration (SAMHSA). This document waswrittenbeforethechangestookeffect;to avoidconfusionandallowatimefortransi- tion, theformernames and acronyms have beenretained. CSAP Prevention Monograph-13 THE SECOND NATIONAL CONFERENCE ONPREVENTINGAND TREATING ALCOHOL AND OTHER DRUGABUSE, HIVINFECTION,ANDAIDS IN BLACK COMMUNITIES: FROM ADVOCACYTO ACTION 3* of S0 U.S.DEPARTMENTOFHEALTHANDHUMANSERVICES PublicHealthService SubstanceAbuseandMentalHealthServicesAdministration CenterforSubstanceAbusePrevention 5600FishersLane,RockwallII Rockville,Maryland20857 Foreword TheSecondNationalConferenceonPreventingandTreatingAlcoholand OtherDrugAbuse, HIVInfection, andAIDS in Black Communities was a naturalprogressionfromtheFirstNationalConferenceheldin1987.Thefirst conferencedefinedtheproblem:AfricanAmericanssuffermuchmorefroma varietyofdiseaseswhencomparedwiththeWhitepopulationofthiscountry, TheOfficeofMinorityHealth,apartoftheU.S. DepartmentofHealthand i Human Services and a sponsor ofthe conference, estimates that at least 60,000“excessdeaths”occurintheAfrican-Americanpopulationthanoccur in a comparable population ofWhites. The expected lifespan ofAfrican- Americanmalesisactuallydecreasing,duetoagreatextenttotheravagesof alcoholandotherdrug(AOD)abuse. Alcoholandotherdrugssometimeskilldirectly,throughthephysiological effectsofthesesubstancesonthebody.Moreoften,however,theykillindirect- ly.ThehomiciderateamongyoungAfrican-Americanmalesinourinnercities hasbeenskyrocketingforseveralyears;manyofthedeathsaredrug-related. In the last decade, another horrible killer has emerged from the use of drugs.ThenumberofdeathsfromAIDScontinuestoincrease,especiallyin our racial and ethnic communities, where drug abuse is prevalent. The tragedy ofHIVinfection and AIDS goes beyond its strikinginfected drug abusers,fortheirpartnersandunbornbabiesoftenbecomeinfectedaswell. TheFirstNationalConferencedocumentedtheseproblemsandmadean efforttoconveytheawfulstatisticstoaNationthatwasnotfullyawareofthe plightofAfricanAmericans.TheSecondConferencehadtogofurther.Four yearshadpassed,yearsinwhichtheproblemshadgottenworsewithtoolittle beingdonetocontrolthem.Still,therewerereasonsforoptimism:theNation hadbeguntointensifyitsefforttoconfrontthedrugproblemanddefeatit. The Federal Government has shown its commitment both through more fundingandbyestablishingtheOfficeforSubstanceAbusePreventionand theOfficeforTreatmentImprovement. Inthousandsofcommunitiesacross thecountry,grassrootseffortswereimplementedtofightagainstalcoholand otherdrugabuseanditsdeadlyeffects. ThesponsorsoftheSecondNationalConferencewantedtobuilduponthese activities.Theywantedtotakewhathadbeenlearnedinresearchprojects, localcommunityefforts, andfromothersources andapplyiton anational scale.Theconferencetitle,“FromAdvocacytoAction,”reflectedthefactthat theefforts ofthousandsofpeopleoverthelastfewyearshadproducedthe resourcestoconvertknowledgeofpreventingandtreatingtheseproblemsinto practicaleffortstoeradicatethemfromourcommunities. Theconferenceincludedpresentationsbysomeoftheleadingexpertsinthe struggle against health and social problems from universities, health programs,researchinstitutions,andtheAfrican-Americancommunity.These leadersspentlonghoursexchangingtheirtechnicalandacademicknowledge ofprevention and treatment and developing recommendations for future action. African-Americanmusic,food,religion, andotherculturalfeatureswere highlighted. Youngpeople attended meetings and sessions alongside their adultcolleagues,reaffirmingthetraditionalimportanceofthefamilyandthe community. TheseaspectsofAfrican-Americancultureweregivensuchanimportant roleintheconferencebecausetheyembodywhatwehavelearnediseffective in treating and preventing the abuse ofalcohol and other drugs. Family dysfunction,povertyandune—mployment,culturalalienation,pooreducation, lowcommunitycommitment allthesefactorsareassociatedwithhighrates ofalcoholandotherdrugabuse.IfAODpreventionandtreatmenteffortsare tobeeffective,allthesedifficultiesmustbealleviatedfirst. Thestruggleagainstdrugsisreallyastruggleforlife,family,community, andafairshareoftheAmericandream.IntheAfrican-Americancommunity, thismeansreturningtothetraditionalculturalvaluesofastrongfamily,a unitedcommunity,andacollectivecommitmenttoraisingchildrenwhoare equippedtomeetthechallengesoftoday’ssociety. Thisvolumecontainstheresultsoftheconference. Itincludes20papers thatattempttodelineatehowwecanbegintoturnadvocacytoaction.The papers fallwithinthetracks ofthe conference: BlackMales, Drug-Related HIVInfectionandAIDS,Prevention,Treatment,andYouth. This volume also contains summaries ofthe speeches delivered at the plenary sessions ofthe conference. The papers provide the technical ap- proaches; the speeches provide the intellectual, spiritual, and emotional energyweneedtokeepupthefightagainstthehealthandsocialproblems thatplagueoursociety. MSW VivianL.Smith, ActingDirector,CSAP IV Contents Foreword iii Acknowledgments vii 1. ConferenceSummaries i PlenarySessionSummaries 3 Workshop(Track)Summaries 19 2. African-AmericanMales Introduction WilliamM.Harvey 27 SocialConditionsThatContributetoorInhibitAlcohol andOtherDrugUseAmongBlackMaleYouth WilliamJ.Knox 29 TheCriminalJusticeSystemandAfrican-AmericanMales JesseE. Williams,Jr 37 TheAfrican-AmericanMaleandSpirituality WilliamM.Harvey 45 MakingPublicEducationWorkforAfrican-AmericanMales BelleS. Wheelan 67 3.Women,Drugs,andAIDS Drug-Exposedand-ImpairedBabies:DesigningPrevention/ InterventionProgramsfortheAfrican-AmericanCommunity IrisE.Smith 83 BabiesBomonCrackCocaine:MaternalDrugUsersUnderSiege MalaikaHorne 101 African-AmericanWomenandDrug-RelatedHIVInfection andAIDS AndreaBarthwell,M.D 113 4.YouthatRisk AlcoholandOtherDrugUseandAfrican-AmericanYouth: ADevelopmentalPerspective DrewW.Alexander 131 v TreatmentIssuesAssociatedWithAdolescentsWhoAbuse AlcoholandOtherDrugs ShirleyGross 147 5.Family TheRoleoftheFamilyinAlcoholandOtherDrugUsePrevention LawfordL.Goddard 161 StrengthsofBlackFamilies JaniceE.Stevenson 175 6.Community DrugAbuseandAIDS,OurCommunityatRisk:ChoicesforChange FlaviaR. Walton 181 ACommunity-OrganizationModelforthePreventionofAlcoholand OtherDrugAbuse,HIVTransmission,andAIDSAmongAfrican Americans JosephBouie,Jr 189 CommunityEmpowerment WadeW.Nobles 205 7.Voices Spirituality:TotalHealingWithinandWithout H.BeecherHicks,Jr 217 WhyMustTheyLabelUs? TmmbryHarris 225 WhichRoadDoITake? KeithL.Pettigrew 231 DotheRightThing! PhillWilson 241 8.FactsandFigures HealthandRelatedDataforRacial/EthnicPopulations intheUnitedStates:RealitiesandNeeds IreneJillson-Boostrom 247 FederalFundingOpportunities 265 vi Acknowledgments Theconferenceplanningcommitteewishestothankthefollowingfortheir invaluablecontributions: HonoraryChair TheHonorableLouisW.Sullivan,M.D.,Secretary,Departmentof HealthandHumanServices HonoraryCochair Elaine M. Johnson, Ph.D., Director, Office for Substance Abuse Prevention BenyJ.Primm,M.D.,Director,OfficeforTreatmentImprovement Charles R. Schuster, Ph.D., Director,NationalInstituteonDrug Abuse EnochGordis,M.D.,Director,NationalInstituteonAlcoholAbuse andAlcoholism William A. Robinson, M.D., M.P.H., Director, Office ofMinority Health CooperatingOrganizations’PlanningCommittee JosephineAlexander,ChiEtaPhiSorority,LosAngeles,CA LewisBingham,C.S.W.,AddictionResearchandTreatment Corporation,Brooklyn,NY JohnBland,ADASA,Pregnant,PostpartumWomenProject JacquelineButler,TheAlcoholismClinic,Cincinnati,OH RubyCallaway-Robinson,C.A.S.C.A.D.E.,Inc.,Atlanta,GA Charlene Day, National Association for Equal Opportunities in HigherEducation,Washington,DC WilliamHarvey,Ph.D.,NarcoticServiceCouncil,St.Louis,MO Mary Henry, Board ofTrustees Office, Compton Unified School District,Compton,CA AnneHill,NationalUrbanLeague,NewYork,NY WilliamJefferson,NationalPanHellenicCouncil,Prospect,KY LeonardLong,WestDallasCommunityCenters,Dallas,TX Alice Murray, Kenilworth Parkside Resident Management Corporation,Washington,DC Ruth Scoggins, Minnesota Institute on Black Chemical Abuse, MN Minneapolis, Abu-KarriemShabazz,PiggyBack,Inc.,NewYork,NY Gerald Smith, National Association of Black Social Workers, Atlanta,GA GraylingSmith,BEHASHI,Philadelphia,PA LynnetteTaylor,DeltaSigmaThetaSorority,Inc.,Washington,DC FlaviaWalton, Ph.D., Project LEAD, High Expectations (LINKS INC.),Washington,DC Leon West, M.A., Congress of National Black Churches, Washington,DC MarthaWilliams,ZetaPhiBetaSorority,Inc.,Washington,DC MaxineWomble,NationalBlackAlcoholismCouncil,Chicago,IL AtlantaPlanningCommittee The conference planningcommittee worked with a committee of citizensinandaroundAtlantawhosharedtheirideasandcommit- ment to the success ofthe conference. The local committee was cochairedbyDaisyL.HarrisandRubyCallaway-Robinson. DepartmentofHealthandHumanServicesConferencePlan- ningCommittee OfficeforSubstanceAbusePrevention Ms.KimberlyColeman Mr.FrancisC.Johnson ShakehJ.Kaftarian,Ph.D. Ms.AddieJ.Key Ms.RoseC.Kittrell Mr.BernardR.McColgan Mr.ArnoldR.Mills BettinaScott,Ph.D. viii