At the intersection of mental health and drug abuse

By Nyla Adams
AFRO Intern

Take a good look around any major urban area– and now, many rural spaces too– and you’ll see signs of drug abuse and addiction. 

The Baltimore City Department of Health reports that “In 2023, Baltimore City saw 1,043 drug and alcohol-related deaths, 921 of which were Fentanyl related.” 

What can’t be seen? The mental health issues that often come before or accompany the deep, dark hole of addiction. 

“In many Black communities, people struggling with addiction are also often dealing with depression, anxiety, PTSD (post-traumatic stress disorder) and sometimes bipolar disorder or schizophrenia,”  said Akos Antwi, APRN, PMHNP and co-founder of Revive Therapeutic Services. “A lot of times, these mental health issues go undiagnosed or ignored, and people end up using drugs or alcohol just to cope with the pain or stress they’re carrying every day.”

Revive Therapeutic Services provide comprehensive mental health services across Rhode Island, Massachusetts, Connecticut and Maryland. Revive Therapeutic Services has a selection of licensed therapists and psychiatrists to support people and their families through medical management and therapy. 

Alexandria D’Angelo is the community engagement manager at Revive Therapeutic Services. 

“We offer talk therapy in multiple languages. We offer medication management and we do TMS,” explained D’Angelo. 

Transcranimal Magnetic Stimulation (TMS) is a noninvasive procedure that uses a magnetic field to stimulate nerve cells in the brain to improve symptoms of major depression. It is approved by The FDA and the U.S. Food and Drug Administration. 

“It really helps reverse suicidal ideation. And we’ve had great, great results with it in our practice,” said D’Angelo. 

According to the National Alliance on Mental Health, Black adults living under the poverty line are twice as likely to report serious psychological distress.

Growing research now highlights a link between mental health struggles in the Black community and increased substance use as a means of coping with stress and trauma. As a result of their addiction, many often find themselves coming into contact with the criminal justice system, which can further exacerbate mental health issues.

Black Americans make up 13 percent of the U.S. population, but roughly make up 25 percent of all drug related arrests, reports the National Institute on Drug Abuse (NIDA). 

“It usually starts with trying to deal with something: stress, trauma, heartbreak, anxiety or just feeling stuck. If someone doesn’t have support or access to mental health care, they might turn to drugs or alcohol to numb those feelings. That’s what people mean when they talk about ‘self-medicating.’ And once that cycle starts, it’s hard to break without help, especially if the root issue, the mental health part, never gets addressed,” said Antwi. “There’s still this belief in some families and communities that you’re supposed to “tough it out” or pray it away — that going to therapy is only for ‘crazy’ people.” 

Antwi said that the issues of mental health and addiction are often compounded by other challenges. 

“Add the fear of being judged or misunderstood by a mostly White medical system, and it’s no surprise people hesitate to get help,” said Antwi. “Racism doesn’t just show up in the streets — it’s in healthcare too, where Black people are often dismissed, over policed, or not taken seriously. That kind of environment makes it hard to trust or even reach out for support.”

D’Angelo said that many times Black people hold back when seeking mental health support because they fear being labeled. Sixty-three percent of Black Americans reported experiencing stigma when seeking mental health care, a study by the American Psychiatric Association concluded. 

D’Angelo recalled a time during her community engagement events she heard stories confirming the existence of stigma. 

“I heard a lot of different stories that touched me deeply. One of the things that happens to women in this space–in health care in general– is they’re often gaslit, especially women of color and told, ‘Oh, it’s not that bad or that’s not what’s happening to you,’” reports D’Angelo. 

She opened up about a personal experience that shapes her perspective.

“Culturally, the prejudice that still exists could be a huge influence in trauma. My son is biracial and we moved to the midwest for a little while. I was shocked at how many racial slurs were still being thrown around in certain communities. I’m from the Northeast. Obviously, racism still exists everywhere, but that’s not happening so much.” 

A study conducted by the American Addiction Center found that 9.1 percent of Black Americans are in need of treatment for drug or alcohol abuse. 

“If you grow up in an environment where trauma is constant, substance use can start to feel normal, even expected as a way to survive,” said Antwi, who encourages those in need to seek help with a different view of their situation.

“It’s not weakness,” she said. “It’s pain that hasn’t had a chance to heal.”