Program Summary/Abstract
In 2020, over 85,000 people died from drug overdoses in the US, with mortality rates skyrocketing for Black and
Latinx people by 140% and 118%, respectively, given the presence of fentanyl (a manufactured opioid) in the
drug supply. While the national media has focused on opioid-involved deaths among White people, minimal
attention has been given to the disparate morbidity and mortality related to opioid use disorder (OUD) and alcohol
use disorder (AUD) among Black and Latinx people. Although overall prevalence of AUD is similar across racial
and ethnic groups, or in some cases, fewer than White people, there continues to be a disproportionate burden
of illness experienced among under-represented minority (URM) populations, complicated by a dearth of
culturally informed addiction treatment options. Further, with COVID-19, deaths continue to worsen for URM with
SUDs, making it more urgent than ever to study culturally informed treatment interventions for these populations.
This disproportionate illness burden and lack of access to the gold standard in addiction treatment—medication
for addiction treatment (MAT)—has been linked to a host of barriers, based in structural racism, including
inadequate access to technology (a point particularly underscored in the current COVID-19 pandemic), lack of
addiction providers from URM backgrounds, limited education about MAT in URM communities, and an absence
of robust culturally informed harm reduction services in these communities. To tackle the unique challenges of
decreased treatment initiation, engagement, and adherence to addiction treatment for Black and Latinx people
with SUDs, in collaboration with key stakeholders we developed Imani (meaning Faith in Swahili) Breakthrough
in 2017 through a community based participatory process. Imani Breakthrough is a faith-based, person-
centered, culturally informed harm reduction recovery program that takes place in churches. This
program provides an innovative approach to engaging vulnerable groups into SUD treatment, by focusing on the
8 dimensions of wellness (social determinants of health/ SDOH), 7 domains of citizenship, culturally informed
SUD education, and referral to MAT for any FDA-approved pharmacotherapy for treating a SUD. The main goal
of this current study is to develop and optimize methods for increasing access to, uptake of, and engagement in
MAT for AUD and OUD among communities of color. Through a multilevel CBPR initiative and a rigorous RCT
that incorporates elements of choice in participation, we will examine, among participants interested in MAT,
whether adding a Church-based Telehealth MAT option to Imani (Imani + CTM) will improve outcomes for Black
and Latinx people with AUD or OUD compared to Imani + traditional MAT Referral and Linkage (Imani + MAT
R&L) in the community. Individuals who do not choose to engage in MAT will continue in the Imani group program
as usual. Our CBPR process incorporates learning from and partnering with the church and larger community to
increase the community's understanding of AUD and OUD, tackle MAT misconceptions, optimize Imani
implementation, and establish policy recommendations to better serve Black and Latinx with SUDs.