The Manifestation of Structural Oppression Through Racial Trauma: Implications for Substance Use Among Black Adults

J Psychoactive Drugs. 2026 Apr 22:1-10. doi: 10.1080/02791072.2026.2662462. Online ahead of print.

ABSTRACT

Systemic racism and structural oppression are key drivers of health inequities, shaping substance use patterns and contributing to disproportionate harms among Black communities. While racial discrimination has been recognized as a chronic psychosocial stressor, its impact on substance use has rarely been examined through the lens of racial trauma – a critical psychological embodiment of structural oppression. This study investigates whether racial trauma symptoms mediate the relationship between racial discrimination and substance use (alcohol, tobacco, and cannabis) among Black adults. A sample of 183 Black/African American adults completed an online survey assessing experiences of racial discrimination, racial trauma symptoms, and substance use frequency. Mediation analyses using the PROCESS macro tested the direct and indirect effects of racial discrimination on substance use. Results showed that racial discrimination was significantly associated with greater alcohol, tobacco, and cannabis use. Racial trauma symptoms fully mediated the relationship between discrimination and alcohol use and partially mediated the relationships with tobacco and cannabis use. These findings highlight racial trauma symptoms as a key psychological mechanism through which systemic racism influences substance use behaviors. Integrating trauma-informed, culturally responsive prevention and treatment strategies is critical for reducing substance use disparities and advancing health equity for Black communities.

PMID:42017833 | DOI:10.1080/02791072.2026.2662462