The Hidden Legacy: How Intergenerational Subjugation Fuels Mental Health Struggles and Substance Use Disorders

Intergenerational subjugation refers to the persistent oppression and marginalization experienced by certain communities across multiple generations. This enduring cycle of disadvantage profoundly affects mental health and significantly contributes to the prevalence of substance use disorders (SUDs) in affected populations.

Understanding Intergenerational Subjugation

Intergenerational subjugation encompasses the transmission of trauma, systemic inequities, and chronic stress from one generation to the next. It is seen across various groups, including Indigenous populations affected by colonization, African American communities grappling with the aftermath of slavery and systemic racism, refugees fleeing war and oppression, and families trapped in chronic poverty or cycles of abuse.

Rather than being isolated historical events, these patterns become embedded in family systems, cultural practices, educational access, economic opportunity, and healthcare disparities.

The Psychological Toll

The psychological impact of intergenerational subjugation is profound. Research on Adverse Childhood Experiences (ACEs) has shown that exposure to abuse, neglect, violence, and instability is closely associated with increased risks of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation.

Individuals with higher ACE scores are exponentially more likely to experience mental health issues and to engage in substance use as a coping mechanism.

Historical trauma research, especially within Indigenous and African American communities, shows how collective grief, unresolved historical injustices, and ongoing discrimination lead to elevated rates of mental illness across generations.

Substance Use as a Coping Mechanism

 The relentless stress associated with systemic oppression often drives individuals toward substance use as a form of emotional regulation or escape. Over time, reliance on substances becomes embedded within family and community systems, further perpetuating the cycle.

Studies show that trauma increases the risk of early initiation of substance use and ongoing patterns of abuse. Marginalized groups often experience higher rates of co-occurring disorders—when mental illness and substance use disorder appear together—creating more complex treatment needs.

Trauma exposure not only leads to individual vulnerability but also increases intergenerational transmission of substance use behaviors, with children raised in high-stress, substance-using households more likely to mirror these patterns in adulthood.

Contemporary Contributors to Racialized Trauma

Weaponization of DEI

In recent years, Diversity, Equity, and Inclusion (DEI) initiatives have faced backlash, with terms like “DEI hire” being weaponized to undermine the qualifications and achievements of Black and other POC professionals. This rhetoric not only discredits individual accomplishments but also reinforces harmful stereotypes, leading to feelings of isolation, imposter syndrome, and increased pressure to prove oneself.

The dismantling of DEI programs further exacerbates these issues, removing vital support structures and advocacy platforms for marginalized groups.

Race-Baiting and Public Hostility

The media’s portrayal of crimes involving people of color, especially when the victim is white, can incite racial hostility and perpetuate stereotypes. Such narratives contribute to a hostile environment, increasing the psychological burden on communities of color.

 This environment fosters hypervigilance and chronic stress, leading to a range of mental health issues, including anxiety, depression, and PTSD.

Barriers to Accessing Care: What Gets in the Way 

Despite the urgent need for mental health and substance use disorder treatment, individuals from historically subjugated populations often face numerous obstacles that limit access to care. These include:

Structural Barriers

  • Economic Insecurity: Lack of insurance, inability to afford treatment, and limited paid time off, make accessing care challenging.
  • Geographic Isolation: Rural areas and reservations often have fewer mental health providers or culturally appropriate treatment centers.
  • Underfunded Services: Public health systems serving marginalized groups are often under-resourced and overstretched.

Cultural and Historical Mistrust

  • Distrust of Institutions: Historical abuses (such as unethical medical experiments or coercive government programs) have fostered deep mistrust toward healthcare providers, particularly among Indigenous, African American, and immigrant communities.
  • Cultural Incompetence: Many clinicians lack the training to understand culturally specific expressions of trauma, healing traditions, and worldviews, leading to misdiagnosis or ineffective treatment.

Stigma and Shame

  • Internalized Stigma: Individuals may feel shame about needing mental health care, viewing it as a weakness, especially in communities where resilience is highly valued.
  • Community-Level Stigma: Seeking help can be seen as betraying the family or community norms, further isolating those in need.

Policy Failures

  • Systemic Racism in Healthcare: Evidence shows that racial and ethnic minorities often receive lower-quality mental health and substance use disorder care compared to white patients.
  • Criminalization over Treatment: People of color are more likely to be incarcerated for substance use rather than diverted into treatment programs, perpetuating cycles of trauma and disconnection from needed services.

Pathways Toward Healing

Breaking the cycle of intergenerational subjugation requires:

  • Trauma-Informed and Trauma-Responsive Care: Services must recognize the widespread impact of trauma and actively resist re-traumatization).
  • Culturally Grounded Healing: Incorporating Indigenous, African American, and other community-specific healing traditions into treatment models enhances engagement and recovery.
  • Policy Advocacy: Expanding access to Medicaid, funding community mental health centers, and supporting diversion programs that prioritize treatment over incarceration are needed.
  • Community-Led Initiatives: Empowering communities allows people to lead their own healing processes and paves the way for resilience, cultural identity, and collective action.

Sources:

Brave Heart, M. Y. H. (2003). The historical trauma response among natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35(1), 7–13.

Centers for Disease Control and Prevention (CDC). (2021). Preventing Adverse Childhood Experiences (ACEs): Leveraging the best available evidence. Retrieved from https://www.cdc.gov/violenceprevention/pdf/preventingACES.pdf

Dube, S. R., Anda, R. F., Felitti, V. J., et al. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experiences Study. Pediatrics, 111(3), 564–572.

Felitti, V. J., Anda, R. F., Nordenberg, D., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245

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