11/23/2025
– Division of Mental Health and Addiction Services reports that in 2022 In New Jersey alone, there were over 85,000 admissions for substance use disorder treatment in 2022, yet entire Black and low-income communities remain trapped in ‘treatment deserts’ where access is severely limited. That means thousands of people who needed care had nowhere to turn not because of individual choices, but because of systems designed to fail them.
What we are seeing today is not a coincidence. It is not an accident. It is inequity by design. Poverty, racism, and criminal justice policies intersect in ways that determine who receives treatment, who gets incarcerated instead, and who is allowed a real chance at recovery.
In places like Newark, Irvington, and Trenton, we see the deepest overlap:
• High poverty,
• Racial segregation,
• Underfunded health services, and
• Aggressive criminal justice presence.
Together, they form conditions where substance use disorder isn’t treated as a health issue it’s treated as a legal problem. And the consequences are devastating.
This crisis isn’t caused by individual choices; it’s the result of systemic structures that block access at every step.
• Socioeconomic inequality creates drastically different starting points in life.
• Wealth disparities mean affluent areas have abundant mental health providers while poor neighborhoods have none.
• Racism and structural discrimination shape everything from hiring practices to school funding to who gets arrested versus who gets referred to treatment.
• Treatment deserts force people to rely on ERs, overwhelmed clinics, or nothing at all.
• Poverty combined with untreated SUD leads directly to increased criminal justice involvement.
We must name these barriers clearly to dismantle them.
here we confront one of the most disturbing realities: some treatment providers profit from patient suffering
• Patients become revenue streams
• Body brokering targets the most vulnerable
• Fraud replaces care
• The Florida ‘patient trafficking’ scandal exposed a national crisis
This is exploitation disguised as healthcare — and it hits minority and low-income populations the hardest.”
Equality is giving everyone the same resources. Equity is giving people what they need based on historic and structural disadvantage.
In a world where discrimination, poverty, and geography dictate access, identical treatment only perpetuates inequity.
Equity acknowledges harm, addresses barriers, and invests in communities proportionate to the challenges they face.
Here we see wealth’s direct impact:
• Wealth = faster care, private clinicians, shorter wait times
• Low-income families face Medicaid shortages and long delays
• Many NJ counties have worse mental-health access than the national average
• Black uninsured rates remain more than double White uninsured rates
These disparities aren’t accidental they stem from long-standing structural underinvestment
The data we’ve discussed makes one thing clear: we cannot punish our way out of addiction, nor can we rely on systems that have repeatedly failed communities of color.
First, reallocating funding toward evidence-based interventions is essential. That means prioritizing SUD treatment, supportive housing, mental health services, and prevention programs not incarceration. Research consistently shows that every dollar invested in addiction treatment yields $4–$7 in reduced crime and healthcare costs.
Second, strengthening community-based support systems is critical. Care must be culturally competent, affordable, and physically accessible, especially for cities like Newark, Irvington, and Trenton where treatment deserts persist.
Finally, we need structural policy reform. This includes addressing discriminatory policing, updating sentencing policies, and repairing the administrative barriers that keep Black and low-income residents from equitable diversion opportunities.
What They Took From Us, We Need To Reclaim Together.
We reclaim health by bringing SUD education, mental wellness, and literacy directly into underserved neighborhoods.
We reclaim strength through financial stability, job pathways, and local leadership.
We reclaim dignity through community programs that build pride, resilience, and economic mobility.
Recovery isn’t just clinical it’s collective.
To close, the message is simple: we do not live in a system where everyone starts equally. Wealth, race, and geography determine who gets care and who gets criminalized.
When treatment deserts meet systemic racism and chronic underfunding, communities are not just underserved they are structurally harmed.
In many Black and low income communities, treatment is scarce, trauma is untreated, and the criminal justice system steps in where the healthcare system should have been. These outcomes are not about individual failures; they are about systems designed to privilege some and control others. True equity means undoing the structural barriers created by racism, disinvestment, and neglect. It means redesigning policy, reallocating funding, and rebuilding care models so that healing is a right not a privilege reserved for certain zip codes or certain incomes. If we want different outcomes, we must demand different systems. And that begins with acknowledging the truth presented today and committing to action rooted in justice, compassion, and equity.
