In 2020, accelerated by the COVID-19 pandemic, Black Americans and Native Americans died of substance overdoses at higher rates than White Americans, and Latinx overdose deaths increased at record rates.1,2 These deaths were closely linked to inequalities in employment, housing conditions, targeted law enforcement, and disproportionate exposure to unregulated illicit drug supplies3-5-making overdose prevention an urgent racial justice issue. In keeping with Chandra Ford's application of critical race theory to public health,6 we illustrate the unique contributions of Black and Latinx practitioners who (1) center the perspectives of racialized groups to inform harm reduction and substance use disorders (SUD) treatment initiatives;(2) use personal, experiential knowledge to relate and build trust with service users;and (3) inform research and practice with their own lived experiences as part of racialized populations. The impact of family members' roles in providing community members with food (P. G-Z.);growing up in communities where heroin use was rampant and witnessing drug-related deaths unfold in 1970s Brownsville Brooklyn, New York (J. T.);and being influenced by the political awakening of the civil rights movement and the response to the war in Vietnam (J. T.) propelled us into harm reduction and grassroots organizing work. The experiences of working under majority White leadership of a public clinic serving a predominantly Black and Latinx population who resisted engaging community leaders to improve services and did not act on innovative proposals (A. J.) and difficulties implementing evidenced-based interventions in Mexico (P. G-Z.)-where there is much stigma surrounding HIV and substance use-are examples of inadequate institutional support.
The Crucial Role of Black, Latinx, and Indigenous Leadership in Harm Reduction and Addiction Treatment