A recent study reports that treating substance abusers, especially African Americans, could save the nation billions of dollars at a time when it is crucial to reduce the nation’s national debt. The study by researchers at Meharry College School of Medicine in Nashville Tenn. linked the prevalence of substance abuse disorders to the high rates of incarceration among Black males. Published in the November 2012 edition of “Frontiers in Psychiatry,” the study also suggested that spending more money on community based- treatment programs and monitoring mental health care in the Black community could have an impact on substance abuse and crime among young Black males.

Substance Use Disorders (SUD) was associated with health problems, economic hardships, failed relationships, domestic violence and crime. If you struggled with drugs and lived in a major metropolitan area you were more likely to spend time behind bars. According to the Mcharry study 80 percent of adult U.S. prisoners used or abused alcohol or other drugs Although Blacks abstain from drugs and alcohol at higher rates than the national average, Blacks are disproportionately represented in drug arrests and prison sentences nationwide. Driven by draconian drug laws and mandatory minimum sentencing, the incarceration rates for blacks exploded by 500 percent between 1986 and 2004. In 2009, Blacks males were 6.7 times more likely to spend time in jail than their White counter parts. “This is high rate of incarceration has resulted in more African American males involved with the criminal justice system than with educational services” the report said.

When arrest records and visits to jail become more common than diplomas and college tours, educational values shift. It’s an unfortunate fact of life for young Black males said William Riche, assistant psychiatry professor at Mcharry Medical College and lead author of the study The Vera Institute of Justice an independent research organization found that states spend in 3 excess of $ 40 billion dollars annually house prisoners.

Historically, in the field of substance abuse treatment, counselors have rejected a client’s need to talk about race related issues. Counselors have often assumed that would claim uniqueness or use any difference as an excuse “cop out” in addressing his or her addiction. The reality is that many Black clients (like all other clients will sometimes use difference as an excuse for their addiction and other inappropriate behavior. This fact, however, does not invalidate the very feelings and conflicts many blacks have around racial and cultural issues. A client would not be allowed to go through a treatment or aftercare program without talking about issues such as sexuality, sexual orientation, the family, vocation, or even spirituality. This has come to known in various treatment professions as the “total person” concept. Unfortunately, issues of race, culture, social class have been exempted from the concept.

The income generated from the drug sells gave many African American males another avenue for becoming entrepreneurs: selling drugs became another source of income such as gambling. Today, onset of addiction for African American males appears to be getting younger and younger as crack cocaine has invaded central areas of America’s cities. Drug selling has increased which has contributed to the public school dropout rate as selling drugs offers a quicker rate of success than academic pursuit. Certainly, some of the renowned Hip Hop artists present their version of these factors with an emphasis on defiance of authority and decadence.

Saunders provides the Tip of the Iceberg Model in the treatment of African American males [1]. He claims that the presenting problem is often the tip of the iceberg. The factors underneath the presenting problem in the symptoms associated with substance abuse is some combination of these core issues: many loses, self-hate, bottled up emotions, pain caused by racism, feeling of helplessness, feelings of hopelessness, apathy, rage cultural shame, color consciousness and father/son issues manifesting considerable pain. I agree with Saunders that emotional and family/social abandonment has played a role in the self-hatred of African Americans males. John Bradshaw in a workshop entitled” Shame and Addiction” which aired on public television who points out that abandonment leads to toxic shame. A toxically, shamed person feels worthless and useless. They feel that they are a mistake and that they should not have been born. Bradshaw points out that since young children idealize their parents, when they are abandoned them blame themselves and begin to believe it happened because they are bad children. This is often the beginning of self-contempt and ultimately self-hate. I claim even when both parents are in the home, a child may experience emotional abandonment.

Fred Dyer has made an important contribution to the understanding of African American male substance abuse particularly its initiation during adolescence. He posits the following risk factors for adolescent substance abuse [2]:

1. Laws and norms favorable toward behavior

2. Availability

3. Extreme economic deprivation

4. Neighborhood disorganization

5. Physiologic effects

6. Family alcohol and drug use

7. Poor and inconsistent family management practices

8. Family conflict and low bonding to most family members

9. Early and persistent problem behavior

10. Academic failure

11. Low degree of commitment to schooling

12. Peer rejection

13. Association with drug-using peers

14. Alienation and rebelliousness

15. Early onset of drug use

Now as to effective treatment both Mark Sanders and Fred Dyer have join the chorus of those of those calling for evidence–based treatment [2]. The National Institute on Drug abuse in1999 conducted an extensive review of the treatment outcome research literature in the area of adolescent substance abuse as noted by Randall and colleagues [3]. These principles have important implications for conceptualizing the nature of effective services for substance abusing adolescents.

1. No single treatment is appropriate for all individuals.

2. Treatment needs to be readily available

3. Effective treatment attends to the multiple needs of the individual.

4. An individual’s treatment and service plan must be assessed continually.

5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness.

6. Counseling and other behavioral therapies are critical components of an effective treatment for addiction.

7. Medications are an important element of treatment for adolescent, especially when combined with counseling and other behavioral therapies.

8. Addicted or drug using adolescents with co-existing mental disorders should have both disorders treated in an integrated fashion.

9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change the long –term drug use.

10. Treatment does not need to be voluntary to be effective.

11. Possible drug use during treatment must be monitored continuously.

Some of the trends in the African American community have persisted over recent decades. Many inner-city communities have been further marginalized with few internal systems of accountability [4]. The role of black middle class people in the community has changed. In the past, poorer, less educated black who could benefit from their counsel and modeling of success, at least in theory. Today, middle class blacks often live apart from poor blacks At best they provide professional services (medical, educational, counseling and law enforcement) to poor blacks directly in inner-city locations or through mediated circumstances such as the media. The community-stabilizing and leadership roles do not exist in low income black neighbor hoods [5,6].

In addition, large segments of the black low income population question the legitimacy of middle class goals and aspirations. The influence of indigenous institution (such as the church which historically provided stability and counseling and a response to those in need have been undermined and made less relevant. Today, social services are provided by primarily by government and private agencies. The void created by the departure of the black middle class and reduced influence of the black, church is filled by drug dealers, gangs, and various aspect of the gambling. When an individual is concerned about the alcohol or other drug use of a family member, there is frequently little trust in outside resources available to the family. The family often views treatment as culturally insensitive and more important as generally ineffective.

Frequently, those who fail in treatment return to the community or those with other recidivist patterns (incarceration) serve as negative role models while criticizing the legitimacy of alcohol and drug treatment program. This often was the pattern for black veteran of the Viet Nam era affected by alcohol and drug use [7-9].

Certainly, it was Freud who made us realize that how one feels is important in describing a human experience as are facts of a person’s life. Starting in the1890s in an effort to cure “nervous disorders “Freud began describing what remains the most comprehensive and revolutionary theory of the mind ever proposed. At the core was Freud’s notion that the source of his patients’ ills lay in the unconscious-a shrouded realm of thoughts, fantasies, memories and dreams embedded in childhood and radiating control over one’s feelings and actions for life. Freud theorized that by identifying and exploring past experiences and accepting their sovereignty over one’s life, a person can gain relief from a wide range of emotional problems [10].

Although Freud did not discover the unconscious, his insight into a shadowy poetic notion, lend it precision and make it into the foundation of a psychology by specifying its origin and contents and its imperious ways of pressing toward expression,” writes Peter Coy in his 1988 biography Freud: A Life for Our Times

From what his patients were dragging up, Freud began piecing together the idea that a nervous disorder, a “neurosis” resulted from the bottling-up of traumatic thoughts too painful to acknowledge. The unconscious was something that had long been discussed. It was a common coin for philosophers and poets But Freud identified the existence of repression-the fact the human mind will forget, distort, or deny real experience in an effort to defend itself. Most of the controversial about Freud’s theory was that the unconscious was filled with repressed sexual wishes and fantasies’ that people experience when they are young children [11].

In 1989 with the publication of his book The Interpretation Of Dreams, Freud described exactly how the repressed impulses cause psychic damage He found it by studying his patients’ dreams which he called the “royal road to the unconscious” Freud explained that dreams are distorted images that result when repressed but powerful impulses—the mind’s id—surge toward consciousness only to be pushed back by the mind’s protective defense –the super ego or conscience; This conflict ,if never openly identified, can cause severe mental blocks—neurotic behavior such as the inability to form lasting relationship, difficulty succeeding at work, unexplained anxiety ,even physical illness.

By 1923 Freud had published The Ego and the id which fully explained his theory of the mind as divided into three forces-the id, ego and super-ego. It was Freud who explained why a young woman, ruled by a dominating father, would marry an abusive man. The woman says Freud, is destined to repeat bad relationships until the original experience with her father is dredged up from her unconscious Perhaps Freud’s greatest contribution is the convincing claim that we are not completely the masters of our psyches [12].

According to Amos N Wilson, criminality may heuristically be perceived as a sociological symptom of a society not unlike an obsessive-compulsive disorder discussed by Freud as a psychological symptom. He goes on to state, “it may furthermore be perceived, in the classical Freudian sense, as a maladaptive comprise between two or more conflicting forces with in a societal personality which have not yet been fully integrated……Symptomatic criminality while reflective of the societal, is incarnated and actualized in the minds and bodies of its individuals and group constituents. It is emblematic of the societal misallocation of power, energy, and resources; of societal hypocrisy; of as societal refusal to know itself and be true to its reality and possibilities. Criminality, as symptom, is inherently two- faced. It serves two masters.

It is a double-agent, both serving and betraying. Thus, according to, Wilson “Psychoanalytically speaking, criminality as a societal neurotic symptom does not necessarily affect all segments of a society in the same way. For some there are gains, both primary and secondary the criminal activities of one or more segments of a society may be used by other segments to achieve identity, dominance, wealth and prestige.

These dominant societal segments classes, or groups are often born and bred of the process of repression and impoverishment of the alienated, ‘criminal’ segments or constituents in their social domain. Addicted to the advantages derived from their oppression of the alienated groups, the dominant groups come to depend, whether consciously or unconsciously acknowledged, on such repressive process as necessary to their continuing relatively peaceful and profitable existence. Their dominance and advantages more often than not, rest on the derivational subordination of the other societal elements [13,14]. Solutions to the social problems: Empowering the young can be done through enhancement of the role of elderly African American Males.

Electronic monitoring for non-violence offenses with day reporting and other trade and school programs should be utilized. Local business should get tax breaks or grants to higher the individuals in the program. Furthermore, President Obama needs to pass a law giving our young defendants the option of enlisting in the military and doing their probation while in the military.

Federal prosecutors will no longer seek “mandatory minimum” sentences for many low-level non-violent drug offenders in a major policy shift aimed at turning around decades of explosive growth in the federal prison population. Too many Americans go to too many prisons for far too long and for no good law enforcement reasons. “While the aggressive enforcement of federal criminal statutes remains necessary, we cannot simply prosecute or incarcerate our way to becoming as safer nation” , Attorney General Holder Under new policy prosecutors would send fewer drug offenders to federal prisons for long terms, opting for drug treatment centers and community service. The change responds to major goal of civil rights groups, which say long prison sentences have disproportionately hurt low- income communities [4].

But what can elderly black American males do during this period of political, economic and social unrest in the black world and its way of life and the nation itself. After all are they not most of the elderly challenged by societal bias and barriers which affect the elderly regardless of race. The elderly have a meaningless role and are the victims of ageism. The elderly seem to encounter a number of problems in our society: low income and status, an emphasis on youth, health problems, inadequate housing, transportation problems, elder abuse, malnutrition, crime victimization, emotional problems (particularly depression), and concerns with circumstances surrounding dying). But what about those individuals with sounds minds and healthy bodies?

There are many who respond to life’s challenges in effective ways. They can be advocates when it comes to advancing social capital. Cities in the U.S with strong families, civic support groups, and a communityservice orientation do well on social and economic mobility [15-17].

The important role as an advocate for older black males includes the following:

• Identify environmental factors impinging on the quality of the community

• Provide and interpret data to show the urgency for change

• In collaboration with other stakeholders, develop a vision to guide change

• Analyze the sources of political power and social influence within the system

• Develop a step by step plan for implementing the change process

• With allies lobby legislators and other policy makers

• Recognize and deal with resistance

• Assess the effects of advocacy efforts on the system

All of this is done in the contest of the Appreciative Inquiry cycle-based on work by David Cooperrider, Case Western Reserve University, as indicated below:

1. Appreciative Inquiry “4-D” Cycle

2. Discovery

3. Our changing world

4. Organizational or community Positive Core

5. Opportunity context

6. Destiny

7. Initiatives

8. Pilots

9. Improvisation

1. Working Together to Create a Breakthrough Organizational or Community Design

2. Dream

3. Articulation of Vision & Future We Want

4. Design

• Principles

• Provocative Propositions

• Ideals

In conclusion, this not just a story of the relatively high levels of incarceration of African American males at most level of government prisons or jails in the states in which they reside nor the invisibility of old Black males in civic, private and public sector in the various regions of the nation [5,6]. The overall damaging consequence has been decline of opportunity to improve one’s status and a lack of African American social mobility. It also might mean that people in poor neighborhoods end up in a self-reinforcing cycle of under-funded schools, high crime and social breakdown [7-9]. It should not be surprising that places with high African American populations show low mobility for the white population living there as well.