Impact of multiple levels of racism on polysubstance use

Racism-related experiences are well-supported risk factors for substance use among members of Black communities. Research examining the mental health effects of racism-related experiences has largely explored present-day racial discrimination, or contemporary experiences of racism within an individual’s own lifetime. This conceptualization of racism omits the influence of responses to historical racist events, like slavery and other colonial practices. Consideration of historical trauma may help explain observed disparities in substance use among members of Black communities and aid in tailoring prevention and intervention strategies to be more culturally responsive. To address this gap, Ebrahimi et al. investigated the differential influences of historical trauma (i.e., historical loss thinking) and contemporary racism-related experiences (i.e., major discriminatory events, racial microaggressions, and internalized racism) on past-year polysubstance use among Black young adults.

Data were drawn from questionnaire responses from 163 Black young adults between 18 and 35 years of age who took part in an online study examining the impact of historical trauma on the Black American community. Ebrahimi et al. found that more than half of the participants were individuals who engaged in polysubstance use monthly in the past year. All levels of racism-related experiences were each independently associated with past-year polysubstance use. The authors found that when combined, only contemporary racism-related experiences significantly predicted past-year polysubstance use, and historical trauma was not a significant predictor. In other words, thinking about historical trauma and the losses associated with it was less of a risk factor for polysubstance use than contemporary racism-related experiences were, perhaps because contemporary experiences were more salient . The authors did not find a moderative effect of contemporary forms of racism in the association between historical loss thinking and polysubstance use. This may suggest an alternative psychological response to both historical and contemporary forms of racism that warrants further attention.

This study is novel, as it extends the extant literature on racism and polysubstance use by investigating the role of historical trauma as a contextual factor among Black young adults. This study also offers new knowledge to help disentangle the ways in which descendants of historical trauma associate with the legacies of violence and oppression and how these associations influence their substance use behaviors. Major discriminatory events were the most relevant predictor of polysubstance use among young Black adults in this study, highlighting the psychological and physical vulnerability to racist events of members of this age group while also showing the effect of racial microaggressions and internalized racism on polysubstance use.

This article is in the Health Psychology and Medicine topic area.

Ebrahimi, C. T., Polanco-Roman, L., Saraiya, T. C., Bauer, A. G., & Hien, D. (2024). Historical trauma and polysubstance use in Black young adults: The role of contemporary racism. Psychological Trauma: Theory, Research, Practice, and Policy, 16(6), 922–929. https://doi.org/10.1037/tra0001652

Chantel T. Ebrahimi, MA, is a doctoral candidate in the Department of Psychology at The New School for Social Research in New York City. With her research, she works to identify sociocultural risk factors for substance use with a focus on race, racism, and trauma among ethnoracially minoritized communities. Contact Ebrahimi.

Lillian Polanco-Roman, PhD, is an assistant professor and the director of the Mental Health Equity Lab in the Department of Psychology at The New School in New York City. She is a licensed clinical psychologist and health equity scholar who studies the mental health and developmental consequences of racism-related experiences. With her research, she also aims to identify culture-specific processes that may buffer the harmful effects of experiences of racism among ethnoracially minoritized and immigrant youth, particularly in relation to health risk behaviors like suicide.

Tanya C. Saraiya, PhD, is an assistant professor, licensed clinical psychologist, and director of the Pursuing Addiction and Trauma Healing Lab in the Department of Psychiatry at the Medical University of South Carolina in Charleston, South Carolina. Broadly, her research aims to understand and attend to underlying trauma, traumatic stress, and posttraumatic stress disorder in individuals struggling with substance use. Across this work, she strives to focus on health disparities and ongoing inequities that present based on individual and collective identity, culture, race, and context.

Alexandria G. Bauer, PhD, is an assistant professor in the Center of Alcohol and Substance Use Studies and in the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. She is also the director of the university’s Racial Equity, Advocacy, and Community Health Alliance lab. Her research interests include understanding and addressing health inequities that burden Black, African American, and other minoritized populations, particularly using community-based participatory research strategies. Her work focuses on improving health and well-being, addressing social determinants of health, and improving access to culturally sensitive support.

Denise Hien, PhD, ABPP, is senior vice provost of research, director, and Helen E. Chaney Endowed Chair in Alcohol Studies at the Center of Alcohol & Substance Use Studies and distinguished professor at the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. She has been considered a leader in the field for over 30 years, and her research, which has involved conducting clinical trials in community-based substance use treatment settings, has contributed to the evidence base on the treatment of individuals with trauma-related psychiatric disorders and substance addictions. She is board certified in clinical psychology and serves on numerous national scientific advisory boards to support diversity and equity in research training.