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White People Go to Rehab, Black People Go to Jail

Amy Dresner and Joe Schrank explore the systemic racism of the treatment industry and the recovery community.

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In this article

Amy Dresner and Joe Schrank explore the systemic racism of the treatment industry and the recovery community.

The death of George Floyd ignited another fever spike of the endlessly unhealed race issues in America. These issues long preceded the drug war, but made the racial disparities in rates of incarceration and who pays the price for drug use abundantly clear.

The vilification of black people and the narrative of urban decay offers shallow justification for many of the incidents with police. Some in conservative media tried to explain the Michael Brown killing by saying “He smoked weed.” (Is there anything more docile than a stoned doughy kid looking for snacks?) With Trayvon Martin, “He looked like a drug dealer,” was another tale told. But the data and metrics are clear. And the unfortunate conclusion is this: white people go to rehab and black people go to prison. Is that the case in the liberal bastion of Los Angeles? Turns out, it is.

If You’re White, You’re Sick, If You’re Black, You’re a Criminal

Jeff Ball, founder and clinical director of PCH treatment center told us: “We have made strong efforts to engage African American clients but our population doesn’t have the representation it should.”

Interventionist Tim Harrington put it pretty bluntly, saying, “If you’re white, you’re sick; if you’re black, you’re a criminal”.

Financial barriers seem to be a logical reason why there aren’t more black people in rehab, but upon closer look, that doesn’t hold up either. City, state, and county employees have a fair number of black employees and all are eligible for mental health services benefits with their insurance. Still, random site visits to LA rehabs will produce few, if any African American clients. Sure there are some county-owned, court-ordered rehabs that can boast more black clients, but the mid and upper level rehabs don’t have many black clients, nor do they have many black counselors or administrators.

“In my career as a clinical interventionist and sober companion, I have had exactly one black client, a notorious diva pop star,“ Joe Schrank said. “In my years at Promises, Malibu there were never any black people there. During my time running a transition program in Brooklyn, we had one black client. Something is wrong.”

Part of this could be long-standing cultural issues. According to the various black men and women in recovery we spoke with, there is still a stigma in the black community regarding seeking help for mental health or addiction problems. Ruben, 49, a New Yorker now sober thanks to a DUI and court-ordered outpatient treatment told me, “In our community, mental health treatment is a 40 and a blunt.” He and others do see this changing, slowly, with the younger generations.

“In the black community, recovery isn’t a thing. There’s no treatment. There’s jail or church”

Malik Pointer, eldest son of Ruth Pointer of the Pointer Sisters explained it this way, “Black people are not allowed to be weak. For years we haven’t talked about our pain and our feelings. You don’t get therapy. It’s changing now.”

“In general, black people don’t go to rehab. That’s why it wasn’t the solution for Prince or Michael, Marvin, Rick James, Whitney,” Malik continued. “You’re either strong or you’re not. Black people don’t collectively come together and say ‘whoa we just lost some of our dopest musicians. What are we going to do about it?’ But white people do that about everything.”

Nyla Christian, a black recovery advocate and a woman in long term recovery, reiterated the same sentiment. “In the black community, recovery isn’t a thing. There’s no treatment. There’s jail or church. Black Americans are just starting to address mental health as a challenge and a disease and not as moral or philosophical failing.”

Okay, but the onus doesn’t just lie in the black community.

“The training in social work is to see and respect the inherent worth and value of all humans, serve the most marginalized class, respect the diversity an individual brings,” Joe Schrank explains. But are we doing this? Not according to the number of black people in treatment.

Malik, who’s been to a staggering 25 plus treatment centers, now 3.5 years sober, said “In terms of black clients at all the rehabs, it was me and 2 girls… Maybe one or two black counselors. But 99% of the times I went to treatment, I was the only black person there.”

“I can’t tell you the times I’ve been told ‘Ooh you’re so articulate’. What the fuck were you expecting me to be?!”

Nyla’s experience was similar, especially at the upscale treatment centers. “When I went to the white treatment centers, they’re expecting a low bottom crackhead if you’re black. But I was a high bottom alcoholic. The counselors were surprised and the clients were resentful because that wasn’t their expectation. I’m supposed to fit a category: lost my kids, sold my body… When my story doesn’t fit their ‘story’, I’m either embraced or shunned. They’re more comfortable with the typical Shaniqua with long nails and gold teeth. I can’t tell you the times I’ve been told ‘Ooh you’re so articulate’. What the fuck were you expecting me to be?!”

“They were fine about talking about poverty or incest or whatever,” Nyla said, “but when I wanted to discuss my trauma of being a black woman in America, they told me it was not relevant to my alcoholism.”

So she finally decided to go to a black treatment center, The House of Uhuru, which means “freedom” in Swahili. All the counselors and founders were black, the directors were black, most clients were black but for an upper middle class black woman like Nyla, the experience was quite startling and more lowbrow than she’d expected.

“When I wanted to discuss my trauma of being a black woman in America, they told me it was not relevant to my alcoholism.”

DH Peligro, the black drummer from the Dead Kennedys, has been to 32 rehabs. In all of them all, he was the only black person there… “aside from a light skinned dude from Malibu.” He noted that “10 or 12 times there have been people of color that worked there. One was a counselor but the rest were drivers and techs.”

When he went to an all black rehab in St. Louis where he’s originally from, it was, he says, “Straight ghetto. All food was donated. You lived with the roaches.”

When black people end up in all white treatment facilities, we’ve got another problem. “A lot of black people feel uncomfortable talking about their problems to somebody who’s usually white,” DH said.

“At one rehab they were giving me therapy for PTSD, which I didn’t even know I had from being pulled over by the cops all the time… I was like, ‘Oh is that why I’m terrified every time I see the police?’”

 The Staffing Gap: Where are the Minority Counselors and Case Managers?

Isaac Reddick, a black man in long term recovery who’s worked at Promises, Wonderland, The Hills, and is now the Alumni Coordinator at Westwind, disagrees. “I really haven’t experienced racism in the treatment industry unless you’re talking about my having to be nice to and treat racist clients.”

He had a few horrific stories to tell about that. Here’s one: “I had a client at The Hills who refused to make his bed and felt housekeeping should do it. I explained to him it was about empowerment. Things escalated and he wound up shouting, “What do you know? You just some dumb nigger! I could buy your family ten times over!” Howard Samuels, the owner, kicked him out on the spot. I had no say in it. A few months later, that guy came back with 2 months of sobriety and made amends to me.”

“Why are people of color mostly techs or drivers instead of counselors, rehab owners or case managers?”

Isaac wanted it noted that, “I treat the racists with the same pity and compassion that I would cheerfully grant a sick friend,” which for those of you unfamiliar is something from the Big Book of Alcoholics Anonymous. “The last thing I want is for some KKK member to feel he can’t come get clean at Westwind because he read an article.”

When pried about the limited number of black clients he said, “That doesn’t FEEL like racism, it’s socio-economic geography.” Isaac said there are “Plenty of black folk at Cri-Help and Tarzana Treatment Center.” When he worked at Promises years ago, almost every tech was black, Hispanic or Middle Eastern… but “only because we had cars and could afford the gas money to drive to Malibu.”

Why are people of color mostly techs or drivers instead of counselors, rehab owners or case managers?

Here’s the deal. “White people and black people use drugs at roughly the same rate,” Joe Schrank told me, “but black people are overwhelmingly incarcerated for the same behavior as white people.” Findings from the 2018 National Survey on Drug Use and Health show that “6.9% of African Americans have a substance use disorder, compared to 7.4% of the total population, and 3.4% of African Americans have an illicit drug use disorder compared to 3% of the population.” However, the rate of heavy drinking among African Americans (4.3%) is much less than the general population (61%) and Caucasians (7.2%). And so is the rate of cocaine use with “African Americans reporting lower lifetime use of cocaine (8.5%) compared to Caucasians (17.6%) and Hispanics (11.1%).”

Different Treatment, Same Disease

The stats don’t show a huge discrepancy in substance use. But what about the startling difference in incarceration rates for black people vs. white people?

According to, “Nearly 80% of people in federal prison and almost 60% in state prison for drug offenses are black or Latino.” In addition, “Research shows that prosecutors are twice as likely to pursue a mandatory minimum sentence for black people as for white people charged with the same offense.” Finally, “People of color experience discrimination at every stage of the criminal justice system are more likely to be stopped, searched, arrested, convicted and harshly sentenced…This is particularly the case for drug law violations.”

All white drug addicts have experienced white privilege in regard to the cops, treatment centers, and meetings. I am a white Jewish woman and a 25 year veteran of rehabs — an Olympic athlete, if you will, of relapse. Of the seven treatment centers I’ve been to, there was not one black client. There were two black techs and Isaac, the black Alumni coordinator. I never had a black counselor or case manager.

I recall the time I blew a red light, shitfaced, with open bottles in the car and the police let me go because I was young, blonde, white, and wearing an extremely tight t-shirt. They hypocritically warned me, “Don’t think you can get out of tickets because you’re cute.” I think about the years I drove around snorting rails of meth off the console of my ‘67 Thunderbird and never got pulled over. Or the years I drove around in my PT Cruiser, high on cocaine with loaded syringes in the glove box and, again, never got pulled over. When did I get pulled over? When my Hispanic drug dealer was driving. So does racial profiling and police racism exist? Absolutely. I heard countless stories of white drug addicts who punched cops in the face and were taken to the psych ward instead of jail. Others were pulled over by the police, found with syringes and cotton in their car, and were offered, not handcuffs, but help to find a detox.

Where Does This Leave the Black Community?

But back to the main point. Where are all the black people in treatment?

Harold Owens is the Senior Director of the Musicares Foundation, the charitable arm of The Recording Academy. He is also a black man with 31 years clean and sober. He got his first job working in treatment in 1979. During the 90’s he eventually became the program director of Exodus Recovery Center in Marina Del Rey, CA, and made clear that it was a diverse staff. He reports starting as a tech and worked his way up to a counselor. However, he admitted, “I always had the sense that as a black man working in a predominantly white treatment center I had to work harder than my co-workers and prove that I had the ability to work with many of the white and entitled clients that came through. I was fortunate to be in a position where I had people who helped me up.”

He believes there are treatment centers within Los Angeles that are sensitive to race issues: “Cri Help and the Impact Treatment Centers as great examples,“ Harold told me. “We had cultural sensitivity training modules back in the 80’s. I don’t believe they have that now, which is why you’re finding that cultural bias to the black experience is such a problem.”

But there seems to be a gap between the massages, equine therapy and 5 star chefs at upper level, mostly white treatment centers, and Cri Help or Impact which are much more hardcore and certainly not as toney. He admitted, “I think it’s hard for middle class black Americans to find treatment that’s appropriate for them.”

“Treatment loves to talk about trauma and grief. Those are the new buzzwords,” he said. “But you take somebody like Nyla and they’re just not going to know how to address her issues.”

Harold told me that part of the problem is that white affluent treatment centers don’t get that there’s a poverty of mental health services in the black community. He made it clear that he hasn’t worked in a treatment center in 30 years, although he refers musicians to treatment centers he personally vets.

He felt hopeful that we are moving in the right direction in LA County though. “We do get funds for underserved populations, but there’s a waiting list. Hell, it’s hard for even white people to get into treatment if they don’t have money or the right insurance.”

Next I got on the phone with Franchesca Gordon, a black LMFT. Aside from the fact that she is not in recovery herself, what made Franchesca’s viewpoint so interesting is that she started in counseling in community health, then worked at two high-end, primarily white treatment centers, and now she’s at a nonprofit MediCal-based treatment center.

Growing up in Orange County, Franchesca is used to being the only black person in the room. So when she worked at one high-end treatment center primarily geared to the Jewish community, she was nonplussed at being the only black clinical team member for most of her employment, aside from a black psychiatrist, an outside contractor, now passed on. For the year and half that she worked at this particular facility, there were three black clients that she can remember.

When she worked at another now defunct high-end treatment center in West Hollywood, she was the only the black therapist. There were some black clients, mostly from out of state. In terms of racism she experienced, it was more insulting assumptions, not outright slurs.

She remembers clearly when a returning celebrity client arrived back at the rehab, her representative greeted her, and said to Franchesca “Are you a tech?” to which Franchesca replied, “No I’m a therapist… the onsite lead therapist to be precise.”

“I always had the sense that as a black man working in a predominantly white treatment center I had to work harder than my co-workers.”

Another strange comment was from a client who’d come from some small town in the Midwest. On Franchesca’s first day, he said to her, “Back home, I’d get drugs from…” he paused and looked at her…”no disrespect, black people.” I asked how she felt about that comment and she just thought it was odd, “They’re not my cousins… He thought all black people knew each other or something, or worse, all are involved in criminal activity.”

She admits that she’s a hot commodity in the treatment world because she understands the black experience. “Recovery at its core is about authenticity, but how can you find that if you don’t have anyone who understands your experience?”

Franchesca agreed with me and Harold that there isn’t really a model for the black middle class. “You’re either on GR and on MediCal or you’re a famous black musician and your roommate in rehab is the son of a white doctor.”

“Going to rehab is a privilege. You have to be able to stop working for 90-130 days. I don’t know many black people who can afford that, certainly not the working poor. And that’s aside from having the money or the right insurance,” she said.

When asked about a solution, Franchesca said, “The white recovery community needs to be more inclusive, but that means you need to change your whole medical model. Black and brown people don’t have the luxury of coming from years of wealthy generations. They can’t come in with lots of cash. You have to care about getting people into treatment and not just people with resources… because somebody’s lived experience can be a resource too.”

Before we got off the phone she said, “You know what I think is funny about recovery? Why is Whitney Houston demonized and Elvis Presley is a fucking god? They are both celebrities believed to be the best in the world… and both died in a bathroom.”

Bias in Alcoholics Anonymous

But the racism isn’t just among cops or upscale treatment centers. It has penetrated the entire recovery community, including Alcoholics Anonymous (AA) meetings.

In some ways, AA is the most egalitarian system in America. It’s readily available. It’s free and the only requirement for membership is “A desire to stop drinking.” But as Joe and I decided to dig a little deeper into the experiences of black people in recovery, we quickly realized that yes, recovery is a racist system.

Chris Marshall is a black man 13 years in recovery who has been both a client and counselor at treatment centers. He remembers very clearly when he was 24 years old, new in recovery in Houston, and an old timer in AA asked “Are you done yet, boy?” So this begs the question if this is a geographical or generational problem? Now living in Austin, Marshall finds it’s still quite segregated but the overt racism and sexism is gone.

“I just started to connect with the black community via Instagram after the George Floyd situation, “Marshall said. “And that’s damn sad that that’s what it took.”

Malik says he’s still usually one of five black people in AA meetings of 200 or more in Hollywood or Brentwood. He remembers being taken to NA meetings in the San Fernando Valley when he was at Cri Help years ago. Many members at the meeting were “gnarly Hells Angels racist fuckers and Aryan Nation.” He was getting vibed and he didn’t like it. When he proposed to the other clients at Cri Help, a pretty hardcore rehab populated by many that were just released from prison, that they go to meetings in Crenshaw, they were all too scared and I quote, “Too scared to be in a meeting that’s mostly black.”

Nyla told me bluntly, “I support AA but as we move forward we must incorporate. There seems to be a lack of representation of black people as speakers and attendees, especially on the Westside of Los Angeles. Race is considered an outside issue in AA but is it? If I want to get down with black people, I need to go to Crenshaw and that’s not necessarily my scene.”

When Ruben left outpatient treatment and sought out AA meetings, he had a similar experience. “The first meeting was overwhelmingly Jewish. The second one was quite blue collar, working class, regular white dudes but I was the only black guy there.” He concedes that if he went to meetings in predominantly black neighborhoods, they’d be more black, but they took his license away so he goes to meetings that are close to him.

For people like Malik, Nyla or DH who have been exposed to the program, the racism or dearth of black members is something they’ve learned to accept or overlook. But think about how much more challenging it is for black newcomers like Ruben. To explore this further, I spoke with “Layla,” a young black newcomer who lives in Northern Virginia in a primarily white county. “I was hesitant to talk to you since I’m pretty new but white privilege in recovery impacts nobody more than the newcomer,” she said.

Before the pandemic, her homegroup was all white. She went for a month and nobody introduced themselves to her. “Race is something that isn’t talked about… I didn’t bring it up. I felt like I had to accommodate white people and not make them uncomfortable,” she told me.

Part of her trauma that led to her alcoholism is the racism she experienced when she was young: being the only black person at her school, being bullied, constantly attacked. That’s when she started drinking, at 12 years old.

“White privilege in recovery impacts nobody more than the newcomer.”

She told me about an AA meeting in Maryland where some of the members started to say really racist things about Freddy Gray, a 25 year old black man who in 2015 sustained spinal cord injuries so severe while in police custody that he lapsed into a coma and died. Those comments alone sent another black woman to leave AA for two years. During that time she relapsed.

You can say those comments didn’t “make her relapse” but when you’re a black woman with alcoholism and you hear comments like this you are being retraumatized all over again. “I think the people who have dealt with the issues of racism in the rooms are probably like ‘fuck this, I’m not coming back’. They’re still out there,” Layla said.

At a Zoom meeting, all the members were talking about the coronavirus, Trump, the looting, the protests, even SLAA but when “Layla” brought up racism, she was shut down and shamed for “breaking the 10th tradition.”

“The last place I expected to be triggered was in a meeting,” she said. “I cried for hours, wanting to self-harm but instead I picked up the phone.”

When she experiences racial gaslighting, micro and macro aggressions and racial stereotypes in meetings she gets the program thrown in her face. Implying that she can only change her reaction, she can’t control other people, she must practice acceptance and my favorite…“we must love racists, too.”

But does she? Isn’t it the recovery community’s job to do the work and make the black newcomer feel welcome and safe? Isn’t it the recovery community’s job to look at their own racism and change it?

“Immigrants of color and black people don’t feel AA is an option for them because it’s been perpetuated by white people,” Layla said. “Plus in the black culture, addiction is still primarily looked at as a handicap and not a disease. I’m constantly asked ‘Why do you need to go to meetings every day? Why does recovery have to be a lifestyle?’”

I thought about my own experience. Personally, I don’t see many black people at the meetings I go to Echo Park, Silverlake, Hollywood, etc. However, years ago I had a black lesbian sponsor who took all her sponsees to black lesbian meetings in Crenshaw. Initially, I felt uncomfortable. I wasn’t used to being the only white person in the room. I sat in the back and my sponsor said, “What are you doing in the back?” And I admitted I was scared. And she said bluntly, ‘Be scared in the front!’ However, my experience at this, and all-black meetings, as an attendee and a speaker, is that they are extremely welcoming. Isaac has a white crackhead sponsee who “only goes to black meetings because he feels comfortable there because…well, crack”. However, it doesn’t sound like black people feel the same warmth and aren’t embraced in the same way at primarily white meetings.

Racism doesn’t just stop in meetings. Despite AA being founded by white Christian men in the 1930’s, it is really the fellowship, not the program, that propagates the racism we see now. It’s systemic in the culture, so of course, it can be found between sponsors and sponsees. Isaac told me a story of when he sponsored a white cop who called him during a relapse. “He called me, drunk, at 11:30 pm and asked me to come to pick him up. He’d eaten Taco Bell and vomited all over my car on the way home. Once there he asked me to come and straighten things out with his girlfriend. I refused, saying all I wanted to do was get my car cleaned. Enraged he shouted, ‘You’re just a nigger and I’m a cop! Do you know what I could do to you?!? I can END your fucking life!’ Bear in mind, this was a man who had wept in my arms during his fifth step. He stumbled out of my car and slammed the door. Later, I told him what he’d said and he seemed horrified. He remembered none of it. Shortly thereafter, he got a new sponsor.”

I spoke to a man who is 8.5 years in recovery. He is partly Dominican and partly Puerto Rican. He grew up in New York but now lives in Pittsburgh. His first sponsor used to say “Watch your wallets, everyone,” when he’d walk into a room. Another member absolutely insisted that he was a different black-bearded man he’d met. He was usually the only POC in meetings in New York and that didn’t really change when he moved. He talked to me of “the loneliness of not seeing anyone of color in the ruins, especially here in Pittsburgh.” He made it clear that he was never made to feel unwelcome due to his skin color in CMA or AA in either city but more that he has been fetishized in the gay 12 step community by white men because of the color of his skin.

Then the pandemic hit and all AA meetings went online. But why do I see so few black people in Zoom meetings?

Malik said “Zoom meetings…Well, the culture in regards to the internet, finances, computers, it’s a different thing. The majority of black people don’t have it and when you have a bunch of real life shit to deal with that’s first. People who have to make living just don’t make zoom meetings a priority.”

Thankfully, since the protests, POC meetings have been popping up like crazy. That’s where “Layla” goes now and intends to stay.

Ruben told me an interesting story. He was at a Zoom AA meeting, walking home, camera off, phone in his pocket, carrying groceries. After the meeting ended the members began “to chit chat about the George Floyd situation and why were black people so upset about shit that went down 400 years ago, yadda yadda yadda”. So Ruben turned his camera on and the faces in the meetings went white…. well, whiter than they already were. The presumption that there were no black people in the meeting and they were safe to reveal their own prejudice says everything.

Wrapping up, Joe Schrank says, “We will never heal the racial divide in America without truth and reconciliation and the truth is: drug policy is by design a system to control and subjugate black people. We are all guilty of letting this go on as long as it has. It is a human rights violation. Reframing drug policy as a public health issue will be a step toward reconciliation and an opportunity for restitution. We owe the black community a deep and heartfelt apology for centuries of racism but we owe them more than that. We owe them payment for the crime of the drug war. When black men try to sell weed they’re criminals, when white men do their entrepreneurs. All cannabis licenses should go to black men and women, the way gambling went to native people.”

I will close with this quote from Chris Marshall: “We all know what it’s like to be on the outside, whether you’re a woman, gay or black, and the last place that should be segregated is the recovery community.”

Amy Dresner is a journalist, author, and former comedian as well as a recovering addict and alcoholic. She has been a columnist for the addiction/recovery magazine since 2012 and has freelanced for, Psychology Today, and many other publications. Her first book, “My Fair Junkie: A Memoir of Getting Dirty and Staying Clean,” was published by Hachette in 2017 to rave reviews from critics and readers alike, and is currently in development for a TV series.

Joe Schrank is a clinical social worker and interventionist.  He is founder of and executive editor of the small bow.

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