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Understanding Barriers and Decision-Making Pathways in Drug Addiction Treatment: A Community-Based Study on Black/African Americans in Miami-Dade County
Dissertation

Understanding Barriers and Decision-Making Pathways in Drug Addiction Treatment: A Community-Based Study on Black/African Americans in Miami-Dade County

Michele Serita Mayne
Doctor of Philosophy (PhD), University of Miami
2025-11

Abstract

Black/African American communities Substance use and addiction Treatment decision-making pathways Interpretive phenomenology Addict identity Community-based research

Drug addiction remains a significant public health concern, especially within Black communities in Miami-Dade County. Yet limited understanding of how individuals recognize addiction and decide to seek treatment restricts the development of culturally relevant interventions. This dissertation examines how Black adults in Miami-Dade County understand addiction, interpret their treatment experiences, and navigate pathways to recovery. Using a community-based and interpretive phenomenological approach, twenty-five participants were recruited through community and faith-based organizations in Liberty City and completed in-depth narrative interviews.

Findings show that decisions to seek help were shaped by identity, family influence, spirituality, and experiences of stigma. Participants described addiction recognition as a personal and relational process that involved shifts in self-perception rather than clinical diagnoses. Treatment experiences varied widely. Some found support through compassionate, nonjudgmental relationships, while others encountered systems that felt impersonal, inflexible, or focused on insurance rather than care. Seven themes highlight the importance of belonging, trust, dignity, and active listening in supporting recovery.

This study contributes to medical sociology by situating addiction within cultural and community contexts rather than viewing it solely as an individual or biomedical issue. It underscores the need for culturally responsive and community-driven approaches that center Black voices and experiences. By framing recovery as a lifelong and relational process, the study offers insight into how empathy, cultural understanding, and meaningful connections can strengthen pathways to treatment for marginalized populations.

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Embargoed Access, Embargo ends: 2027-11-17

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