A 50-year View of Substance Use From the Ground Level and From 30,000 Feet

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When Dr. Westley Clark says, “Youth always threaten the status quo,” he’s not just talking about the undergraduate students he teaches in his Substance Abuse and Addiction, Public Health Ethics and the American Health System classes at Santa Clara University. He’s also talking about himself.

Growing up in Detroit in the 1950s and 60s, he has vivid memories of the week he spent in jail during the 1967 riots because he believed that it was important to challenge inequities and unjust policies.

And he still does, especially now with COVID-19 shining a bright light on years of health disparities. The difference is he’s a nationally respected leader in behavioral health who works within the system.

As the first person in his family to go to college, Clark earned doctorate and master’s of public health degrees from the University of Michigan and is a board-certified psychiatrist. He’s also a licensed attorney with a degree from Harvard University and has nearly 50 years of experience working at the federal and community levels, and on Capitol Hill, including three years of working on health policy for Senator Ted Kennedy.

“We’ve made incremental changes. People are suspicious of radical changes, but we can’t quit now. If we keep going, we will make changes.”

Throughout his career, Clark understood the importance of mobilizing communities to improve health, which is why he supports coalitions. “What coalitions do is show that everyone has a stake in the outcome.”

He adds, “There is a lot of mythology, stigma and prejudice that drives wedges within communities, but I believe that you can’t simply walk away from the issues, especially when it comes to substance use.“ We have to understand that substance use is a brain disease and look at what preceded the drug use. Some people are victims of trauma or discrimination or they have inherited a gene set that predisposes them to use substances.”

“When it was mostly African American and Hispanic children who were dying from overdoses, there was less interest, but when young white kids started dying, perceptions around drug use and overdoses changed.

”With all of today’s seemingly intractable racial, social, economic, justice and pandemic issues, what keeps him motivated?

“We’ve made incremental changes. People are suspicious of radical changes, but we can’t quit now. If we keep going, we will make changes.”

A more realistic metaphor of the change he advocates is a switchback road on a mountain that goes back and forth, not straight up, but definitely not straight down. With his focus on “one step at a time,” at age 74, this Detroit native is still stepping.

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