Racism-Based Police Violence As a Structural Driver of Substance Use: Implications for Trauma-Informed Policy and Social Work Practice

Background and Purpose:
Structural racism continues to shape health disparities in the United States, with Black and Latinx emerging adults (ages 18–29) disproportionately affected by police violence. Racism-based police violence (RPV) exposure—defined as exposure to actual or perceived harm by law enforcement that is believed to be racially motivated—is a particularly salient manifestation of structural oppression and a growing concern among social workers addressing trauma and health equity. Prior research has linked RPV exposure to psychological distress and trauma symptoms, but few studies have explored its association with substance use behaviors, especially across multiple forms of exposure. This study addresses these gaps by examining whether RPV exposure as a victim, witness, or via media is associated with alcohol and illicit substance use outcomes among a national sample of Black and Latinx emerging adults, while adjusting for sociodemographic characteristics and broader experiences of racial discrimination.

Methods:
Data were drawn from a national, cross-sectional online survey of 936 Black and Latinx emerging adults. Participants were recruited through Qualtrics Panels using quota sampling to approximate the ethnic and gender distributions of the U.S. emerging adult population. Measures included three validated subscales capturing lifetime exposure to RPV (victimization, witnessing, and media), frequency and misuse of alcohol and illicit substance use, and the 9-item Everyday Discrimination Scale to control for general racial discrimination. Sociodemographic variables included gender, ethnicity, nativity, income, employment, and region. Generalized Poisson, ordinal logistic, and linear regression models were used based on model fit, with fully adjusted models controlling for all covariates.

Results:
RPV exposure was common and varied significantly across sociodemographic groups. Transgender, full-time employed, U.S.-born, and higher-income participants reported higher levels of RPV across one or more domains. In adjusted models, RPV-victimization emerged as the strongest and most consistent predictor of substance use. Specifically, RPV-victim exposure was associated with higher past 30-day alcohol use (IRR = 1.02; 95% CI, 1.00–1.03), 12-month alcohol use (OR = 1.04; 95% CI, 1.01–1.07), alcohol misuse (β = 0.24; 95% CI, 0.17–0.30), and both 30-day (OR = 1.11; 95% CI, 1.07–1.14) and 12-month (OR = 1.08; 95% CI, 1.05–1.11) illicit substance use. All three RPV dimensions were significantly associated with lower scores on the illicit substance misuse scale, highlighting a potential distinction between frequency and severity of use.

Conclusions and Implications:
Findings underscore the role of RPV exposure as a trauma-inducing structural determinant of health for Black and Latinx emerging adults. For social work practitioners, researchers, and educators, this study highlights the urgent need to integrate anti-racist, trauma-informed approaches into substance use prevention and intervention frameworks. Social workers must also advocate for systemic policy changes to reduce police violence and mitigate its long-term health consequences.