Brooke M Feldman, MSW, is a social justice activist. Born and raised in Philadelphia, Brooke openly identifies as a member of the LGBTQ+ communities; she’s also a person in long-term recovery.

After spending her adolescent years in and out of behavioral health institutions and the juvenile justice system, Brooke began her recovery at the age of 24. Since that time, much of Brooke’s energy and efforts have gone into making wellness and recovery accessible to all.

The Interview

Liv: In your work, you advocate for equal access to treatment. Why do you believe oppressed and marginalized groups have reduced access to treatment?

Brooke: Well, oppressed and marginalized groups have reduced access to all resources, supports, services, and privileges. Just as equity does not exist in other areas, equity does not exist in access to treatment and recovery.

There’s a ton of research that demonstrates the lack of equity in access to quality healthcare, and that disparity also includes access to quality behavioral healthcare. Furthermore, sustained wellness and recovery is far more about having access to social determinants of good health than it is about access to treatment and abstinence from substance use.  For instance, if somebody does not have access to safe, affordable housing, good social supports, healthy communities, meaningful employment, etc., we know that negatively impacts their chances of sustaining recovery.  This is an important point because oppressed and marginalized groups have historically had lower access to social determinants of good health.

And lastly, we know that, despite using and selling drugs at the same rate as white people, people of color are disproportionately more likely to be arrested and more harshly punished for their drug use than white people.  To that end, many people of color are shuttered off to jails and prisons rather than into treatment.

Liv: In a recent talk you gave, you mentioned that people of color are less likely to successfully complete drug court programs, along with outpatient and residential substance use disorder treatment, when compared to white people. Why do you think that is?

Brooke: In addition to the role of social determinants of health already mentioned, I think there are several factors. First, we still have systems that lack diversity in positions of power. While the term “institutionalized racism” can cause discomfort among some of us white folks, there is really no denying that it exists.  For example, when we look at the current Congress, it is 81% White, 80% male, and 80% Christian-identified.  It would be easy to assume that the representation in Congress is irrelevant to addiction treatment, but Congress is responsible for writing legislation and approving or denying taxpayer dollars that go to states and trickle down through counties and cities to communities and individuals. To think this doesn’t have an impact on what drug policy and treatment looks like would be foolish.

The lack of diversity in positions of power also can be found in who leads treatment programs and who provides clinical services. There continues to be a disparity in leadership positions and counseling roles. When people don’t receive services that are designed and provided by people like them, it is no wonder that we see such poor outcomes.

So far as drug court programs are concerned, the reality is that we have an unfair criminal justice system. We see black and brown people not only arrested at higher rates and punished more harshly but also violated for probation and parole at higher rates than white people. To that end, it shouldn’t be surprising that black and brown people fare worse in drug court systems functioning on a sanction-based philosophy.

The tendency to more harshly punish black and brown people mirrors what we see in other institutions. For example, black children are more likely to be disciplined in public schools and receive harsher punishment than their white peers. At the end of the day, any intervention that includes a system that has systematically treated people of color worse than white people is unlikely to benefit people of color in the same way as it does white people. There is good research in this area, and I believe anybody advocating for drug courts must first educate themselves on that research.

Liv: We talked briefly about the war on drugs and its impact on people of color. How might
we better understand the impact racism has on drug policy, and how might that inform those advocating in the recovery community?

Brooke: I think it goes back to education. Never in any of the professional trainings I participated in (and facilitated, for that matter), nor in any of the conferences I attended was there ever any education about the “war on drugs” and its inherent racism. I think it is imperative that treatment, recovery community, and recovery advocacy organizations prioritize educating their constituency about the war on drugs.

For individuals looking for that education, I personally find Michelle Alexander’s The New Jim Crow: Mass Incarceration in the Age of Colorblindness and Johann Hari’s Chasing the Scream books to be instrumental readings. For those who aren’t inclined to read books, the movie Thirteenth on Netflix is a great start and there’s an abundance of YouTube videos, including videos of Michelle Alexander, that explain the war on drugs.

For the recovery advocacy community, being informed about the war on drugs is critically important.  Without understanding the war on drugs happened and how people and communities of color and poor people have been ravaged by it, it is impossible to do recovery advocacy that centers those most impacted by drug policy in America. To be frank, when white recovery advocates are engaging in advocacy without first having a deep understanding of the racist war on drugs, what we see is white-centered advocacy that harms people of color.

If we are colorblind in our advocacy; if we “don’t see color” and fail to consider, listen to, understand, and ultimately center people of color, the things we advocate for will only compound harm for people of color.  What we currently have nationally is a very white-centered recovery advocacy movement, and it is of my opinion that there must be a deep reckoning with that reality.

Liv: You’re known for writing about the false narrative around the opioid epidemic – that the reality is many of those who develop an opioid use disorder used prescription opioids illicitly, and that for most, it is not the common tale of people being directly prescribed opioids for pain and then oops, becoming hooked. Why do you think that is?

Brooke: Well, much of this ties into the racism inherent in the war on drugs, which makes it even more important that the recovery advocacy world understands how that played out.  The stigma surrounding people who use drugs, historically reserved for people of color, is pervasive.

In the 1980’s, we had the “crack epidemic,” with crack cocaine flooding communities of color and poverty, much like how opioids flooded middle to upper class white communities. What we saw back then was a very different response, one of locking up and locking out of civil society those “bad people” who use drugs.  With the “opioid epidemic,” while the original source of prescription opioids was “legal,” the widespread misuse of opioids was not legal. Most people who developed an opioid use disorder were, like me, not the people who were directly prescribed opioids for chronic pain conditions. We were the people who got our hands on diverted opioids. We stole them from family, bought them off the street, intentionally duped doctors into prescribing them, and used other substances often long before and alongside opioids.

In short, most of us who developed an opioid use disorder (not to be conflated with physical dependence) used prescription opioids because they made us feel good, because they numbed our psychological and emotional pain, because we wanted to “get high” – which makes us no different than those who used crack cocaine to “get high.” But that’s a hefty admission for white America to make after decades of punishing, stigmatizing and discriminating against people of color for their drug use.

It is easier to paint ourselves as innocent victims of nefarious pharmaceutical companies (who did operate as a legal drug cartel of sorts) and doctors (of which there were some bad apples) than it is to admit that we are just like “those people.” And so, we have this false narrative playing out, and it is one that is causing great harm to not only people of color but also people who benefit from prescription opioids for pain conditions.  I’ve have written a good deal on that subject and one of those articles can be referenced here.

Liv: Lastly, how can we – the recovery communities and treatment providers – make sure we are not contributing to the marginalization or oppression of people of color?

Brooke: Well, I’m going to pull out a reference to Michael Jackson’s “Man in the Mirror” song here. “If you want to make the world a better place, take a look at yourself and make a change.”

I think the first and most important step is to start with oneself. It is critical that people become aware of the fact that gross disparities do exist for people of color. This sounds easy to do, but if it were easy, we wouldn’t be where we are.

It is difficult for many of us to challenge all that we “know” and rigorously investigate how all we “know” may not be true. For me, education served as the key and all I learned in my recovery journey served as the roadmap for what to do with that information. Having an open-mind, willingness to look at and be honest with myself, willingness to consider a perspective different than my own, etc. are all things I picked up in recovery – and one does not have be in recovery to do those things.

My experience has been that, once your eyes are opened, they stay opened. And once you’ve committed to changing yourself, you then know how to make changes in the world around you. I believe if people first take time to learn about the reality of racism, oppression, and marginalization, learn about the disparities that result from it, then take an honest look inside themselves, they will then see how to make changes inside themselves and in turn in the world around them.

The most powerful way to change the world is to change how we walk through it, and the only way to change how we walk through it is to change ourselves. I happen to believe that people in recovery are some of the most well-equipped people in the world to do that. It is time that we do that en masse.