American Society of Addiciton Medicine
May 30, 2024 Reporting from Rockville, MD
Addressing Inequalities: The Vital Role of DEI in Addiction Medicine
May 30, 2024
Avik Chatterjee, MD, MPH, has seen firsthand the鈥痟arms caused by structural and interpersonal racism, as well as鈥痶he benefits of incorporating DEI (diversity, equity, and inclusion) principles into society and societal institutions.

Addressing Inequalities: The Vital Role of DEI in Addiction Medicine.Substring(0, maxlength)

American Society of Addictin Medicine


Addressing Inequalities: The Vital Role of DEI in Addiction Medicine

Avik Chatterjee, MD, MPH

Avik Chatterjee, MD, MPH, has seen firsthand the鈥痟arms caused by structural and interpersonal racism, as well as鈥痶he benefits of incorporating DEI (diversity, equity, and inclusion) principles into society and societal institutions.鈥 

Dr. Chatterjee first realized the potential influence of DEI programs when he moved away from the progressive and diverse North Carolina school district in which he grew up. 

While attending college in Boston, he volunteered at a local public school and quickly noticed how the system segregated students by income and race.鈥 

“I realized how these practices shaped the school I鈥痺ent鈥痶o鈥痑nd the opportunities I had as I was growing up,”鈥痵aid Dr. Chatterjee, medical director of South Hampton Street Shelter Clinic in Boston. 

While Dr. Chatterjee said he has not experienced structural racism, he has experienced interpersonal racism.鈥 

“When I applied to medical school, I鈥痺as asked鈥痟ow I might distinguish myself from all the other Indian applicants who seemed to be the same to the interviewer,”鈥痟e said.鈥“I’ve鈥痟ad patients say,鈥‘Go back to your country’鈥痠f they鈥痙idn't鈥痑gree鈥痺ith the advice I was giving them.鈥疪ace is鈥痭ot something鈥痶hat's鈥痠nvisible.” 

DEI in Health Care 

In addition to his work at the shelter clinic, Dr. Chatterjee鈥痠s an assistant professor at鈥疊oston University Chobanian & Avedisian School of Medicine/Boston Medical Center; associate鈥痚pidemiologist鈥痠n the Division of Global Health Equity, Department of Medicine, Brigham and鈥疻omen's鈥疕ospital;鈥痑nd a part-time lecturer at Harvard Medical School,鈥痺ith a particular interest in institutional and structural racism in medicine and medical education.鈥 

As an addiction medicine specialist, Dr. Chatterjee became interested in DEI around 2017.鈥疶oday, he says this aspect of his work is as important as ever, especially at the shelter clinic. 

“Overdose is the leading cause of death in our patients,”鈥痟e said.鈥“Our patients are disproportionately Black, Native American, and Hispanic. So, when we talk about racialized inequities and addiction treatment and outcomes,鈥痺e're鈥痶alking about my patients having worse outcomes, overdosing more, and not being able to access treatment.鈥疌hanging these patterns is鈥痸ery important鈥痜or the people I see on a daily basis.” 

The concept of addiction鈥痠s commonly racialized鈥痠n society and the media; stories about minorities with a substance use disorder often include negative images and headlines. 

“But when鈥痠t's鈥疻hite people dealing with opioid addiction and overdose,鈥痺e see headlines that say,鈥‘Anyone Can鈥疭uffer from Opiate Addiction,’”鈥痟e said. “We need a more compassionate public health approach, especially when it comes to marginalized patients.”鈥 

Dr. Chatterjee notes a key component to changing the narrative is diversifying the health care field with increasing numbers of physicians and other practitioners who represent minority populations.鈥 

“There's鈥痳eally good鈥痙ata showing that physicians of color take care of more patients of color and that there are improved relationships, outcomes, and recommendations around racial concordance,” Dr. Chatterjee said.鈥“That says to me -- and I think it should be obvious -- that our physician and health care provider workforce should reflect the鈥痙iversity of the country, whether鈥痠t's鈥痓ased鈥痮n language, ability, or鈥痗ulture.” 

ASAM’s鈥疍EI Modules鈥 

SA国际传媒has taken steps to educate its members on systemic racism in addiction medicine through its new鈥. 

“In the modules, we deal with鈥痶he impact of racism and structural racism on鈥痑ddiction treatment, how to understand it, and how to work to improve outcomes for your patients of color,”鈥痵aid Dr. Chatterjee, who helped develop the courses.鈥 

ASAM’s鈥痜irst two DEI modules are鈥疭etting the Stage: Racism in the History of Substance Use and鈥疉ddiction鈥痑nd鈥疕ealth Disparities in Substance Use Disorder.鈥疶wo additional modules will be released in the near future. 

“I鈥痶hink modules 1 and 2 provide an excellent introduction to the history and epidemiology of racialized inequities and how they affect addiction treatment and outcomes,”鈥疍r. Chatterjee said,鈥“Modules 3 and 4 will then provide a framework to attempt to repair those historical inequities.” 

Dr. Chatterjee said the SA国际传媒modules, which take about an hour to complete, are鈥痠mportant鈥痓ecause physicians, including addiction medicine specialists, are not immune to racism and other social issues that shape society. 

He added that he is thankful that SA国际传媒helps its members focus on issues of diversity, equity, and inclusion in a sensitive yet practical way.鈥 

“This approach is鈥痥ey to thinking about the difference between interpersonal and structural racism. I think a lot of people are sensitive about these issues, (thinking) that鈥痺e're鈥痵aying that a certain person or a certain clinic, for example, is racist,”鈥疍r. Chatterjee said.鈥“That's鈥痭ot what鈥痺e’re鈥痵aying. These racialized differences exist just based on history and laws, so鈥疘'm鈥痸ery happy鈥痶hat SA国际传媒is continuing to support efforts surrounding this critical issue.”