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Choi S, Hong S, Gatanaga OS, Yum AJ, Lim S, Neighbors CJ, Yi SS. Substance use and treatment disparities among Asian Americans, Native Hawaiians, and Pacific Islanders: A systematic review. Drug Alcohol Depend 2024; 256:111088. [PMID: 38262197 PMCID: PMC10922506 DOI: 10.1016/j.drugalcdep.2024.111088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/30/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The increasing relevance of substance use disorder (SUD) within the Asian American, Native Hawaiian, and Pacific Islander (AA&NH/PI) communities, particularly amidst rising anti-Asian hate incidents and the disproportionate health and economic challenges faced by the NH/PI community during the COVID-19 pandemic, underscores the urgency of understanding substance use patterns, treatment disparities, and outcomes. METHODS Following PRISMA guidelines, 37 out of 231 studies met the search criteria. Study characteristics, study datasets, substance use rates, SUD rates, treatment disparities, treatment quality, completion rates, and analyses disaggregated by the most specific AA&NH/PI ethnic group reported were examined. RESULTS Despite increased treatment admissions over the past two decades, AA&NH/PI remain underrepresented in treatment facilities and underutilize SUD care services. Treatment quality and completion rates are also lower among AA&NH/PI. Analyses that did not disaggregate AA and NHPI as distinct groups from each other or that presented aggregate data only within AA or NHPI as a whole were common, but available disaggregated analyses reveal variations in substance use and treatment disparities among ethnic groups. There is also a lack of research in exploring within-group disparities, including specific case of older adults and substance use. CONCLUSION To address disparities in access to substance use treatment and improve outcomes for AA&NH/PI populations, targeted interventions and strategic data collection methods that capture diverse ethnic groups and languages are crucial. Acknowledging data bias and expanding data collection to encompass multiple languages are essential for fostering a more inclusive approach to addressing SUD among AA&NH/PI populations.
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Affiliation(s)
- Sugy Choi
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America.
| | - Sueun Hong
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America; New York University Wagner School of Public Policy, New York, NY, United States of America
| | - Ohshue S Gatanaga
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Alexander J Yum
- University of Pennsylvania College of Arts and Sciences, Philadelphia, PA, United States of America
| | - Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Charles J Neighbors
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Stella S Yi
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
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Wang CL, Kanamori M, Moreland-Capuia A, Greenfield SF, Sugarman DE. Substance use disorders and treatment in Asian American and Pacific Islander women: A scoping review. Am J Addict 2023; 32:231-243. [PMID: 36573305 PMCID: PMC10121752 DOI: 10.1111/ajad.13372] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/15/2022] [Accepted: 12/11/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Asian American Pacific Islanders (AAPIs) face unique barriers in seeking treatment for substance use disorders (SUD) and are less likely than the general population to receive treatment. Barriers specific to AAPI women may be especially significant given identified gender and racial differences in SUD prevalence and treatment. This review examines rates of SUD in AAPI women and summarizes the literature on SUD treatment for AAPI women. METHODS Data from 2016 to 2019 National Survey on Drug Use and Health (NSDUH) surveys were extracted to summarize rates of SUD. A scoping review of the literature on AAPI women and SUD treatment was conducted; eight articles published from 2010 to present were reviewed. RESULTS The prevalence of SUDs among AAPI women increased overall, although rates of SUDs were generally lower in AAPI women compared to their male counterparts. Patterns of gender differences in SUDs varied for subpopulations of AAPI women. There is limited research on treatment utilization and access for AAPI women. The few studies that examined treatment outcomes found favorable outcomes for AAPI women; research on culturally adapted interventions was promising but nascent. DISCUSSION AND CONCLUSIONS Literature on SUD treatment for AAPI women is limited. The availability of more culturally tailored treatments addressing the specific needs of AAPI women may lead to more acceptability and treatment utilization for this group. Additional research is needed to elucidate the unique barriers to treatment AAPI women face. SCIENTIFIC SIGNIFICANCE With rising rates of substance use in AAPI women, there is a need to develop and test effective SUD treatments adapted for AAPI women.
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Affiliation(s)
| | | | - Alisha Moreland-Capuia
- McLean Hospital, Belmont MA 02478
- Harvard Medical School, Department of Psychiatry, Boston, MA 02115
| | - Shelly F. Greenfield
- McLean Hospital, Belmont MA 02478
- Harvard Medical School, Department of Psychiatry, Boston, MA 02115
| | - Dawn E. Sugarman
- McLean Hospital, Belmont MA 02478
- Harvard Medical School, Department of Psychiatry, Boston, MA 02115
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Bersamira CS, Macaraeg J. Advocacy and Community Building to Address Filipino Behavioral Health. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:338-340. [PMID: 36504502 PMCID: PMC9727704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Clifford S Bersamira
- Department of Social Work, Thompson School of Social Work and Public Health, University of Hawai'i at Manoa, Honolulu, HI
| | - Jethro Macaraeg
- Department of Social Work, Thompson School of Social Work and Public Health, University of Hawai'i at Manoa, Honolulu, HI
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Park D. Profiles of social disadvantage and their associations with alcohol use disorder criteria among Asian Americans and Pacific Islanders. Alcohol 2022; 102:43-49. [PMID: 35636650 DOI: 10.1016/j.alcohol.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The relationship between social disadvantage and alcohol use disorder (AUD) among Asian American and Pacific Islander (AAPI) people is poorly understood. The study explores the patterns of social disadvantage and their associations with the AUD criteria in this population. METHODS This study used data from the National Epidemiologic Survey of Alcohol and Related Conditions-III on AAPI people's (N = 1801) social disadvantage, adverse childhood experiences (ACEs), racial discrimination, and AUD. A three-step latent class analysis (LCA) using the Bolck, Croon, and Hagenaars (BCH) method was conducted to examine the heterogeneity within response patterns to items that describe social disadvantage among AAPI people. In addition, the relationship between classes and the AUD criteria was examined. RESULTS Three classes were identified: Class 1, labeled "High Adversity" (8.2%); Class 2, labeled "High Discrimination" (9.7%); and Class 3, labeled "Low Disadvantage" (82.2%). Results from the analyses of a multiple regression model suggest that Class 1 (High Adversity; B = 1.049, SE = 0.27, p < 0.001) is more susceptible to AUD compared to Class 3 (Low Disadvantage). CONCLUSIONS The average number of AUD criteria among AAPI people who had experienced high levels of adversity was 2.2. Latent class models demonstrate how social disadvantage is distributed across classes and illustrate its associations with the AUD criteria. Tailored interventions for AAPI people are required. Further studies are also necessary to more effectively understand social disadvantage in AAPI populations.
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Affiliation(s)
- Daejun Park
- Department of Social Work, Ohio University, Athens, OH, United States.
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Endogenous endophthalmitis in patients with intravenous opioid use: demographics and associated comorbidities. Int Ophthalmol 2021; 41:1513-1520. [PMID: 33506370 DOI: 10.1007/s10792-021-01709-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/09/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE To identify risk factors for endogenous endophthalmitis (EE) in hospitalized adults, under 65 years of age, with a history of intravenous opioid use and non-ocular infection. METHODS The National Inpatient Sample Database was used to identify cases of EE with a recent history of intravenous opioid use disorder with associated non-ocular infection. Systemic and ocular comorbidities were identified using codes from the International Classification of Diseases, Ninth Revision (ICD-9). Descriptive and regression analyses were performed to evaluate the risk factors for EE using IBM SPSS 23. RESULTS Of the 605,859 inpatients, 21-65 years age, who had a history of recent opioid-IVDU and an associated IVDU-associated systemic infection, 363 (0.1%) had EE. Systemic comorbidities such as diabetes mellitus, mitral valve disease, aortic valve disease, history of cardiac valve transplantation, chronic kidney disease/renal failure, cirrhosis, active or previous radiation therapy, and history of solid organ transplantation were significantly more prevalent in patients with EE. A significantly increased risk of EE in intravenous opioid users was noted if they were of male gender (OR = 1.84), Asian/Pacific Islander ethnicity (OR = 4.41), had history of cirrhosis (OR = 2.33), active or history of radiation therapy (OR = 14.74), history of solid organ transplantation (OR = 5.91), candidemia (OR = 15.22), and infectious endocarditis (OR = 4.83). Conversely, concurrent alcohol use disorder (OR = 0.35) decreased the risk of EE. CONCLUSION Various demographic variables and systemic comorbidities increased the risk of developing EE in inpatients with a history of intravenous opioid use with associated non-ocular infection.
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Godinet MT, McGlinn L, Nelson D, Vakalahi HO. Factors Contributing to Substance Misuse Treatment Completion among Native Hawaiians, Other Pacific Islanders, and Asian Americans. Subst Use Misuse 2020; 55:133-146. [PMID: 31846599 DOI: 10.1080/10826084.2019.1657896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Research on substance abuse treatment completion (SATC) among Asian Americans and Native Hawaiian and Other Pacific Islanders (NHOPIs) is extremely limited despite growing concern of SA among these groups. Objectives: This study examined predictors of SATC among and within Asian, NHOPI, and White racial groups. Methods: 129,939 cases from the SA and Mental Health Services, Treatment Episode Data Set-Discharges-2016 were used in this study. Logistic regressions were employed to examine the differential impact of race on SATC and to investigate the moderating effect of race on the relationship between socioeconomic factors, type of substance used, and type of treatment setting on SATC. Results: NHOPIs were less likely to complete SA treatment than Whites. Within-group analysis indicated that NHOPIs who were in outpatient non-intensive treatment were more likely to complete treatment compared to ones in inpatient (more than 30 days), and outpatient intensive settings. In contrast, Asians and Whites in outpatient non-intensive treatment settings were less likely to complete compared to all other types of treatment settings. Older adults for Whites were more likely to complete treatment compared with younger adults. Age was not a significant predictor of SATC for Asians and NHOPIs. Asian and NHOPI methamphetamine users were less likely to complete treatment compared with White users. Conclusion/Importance: Findings highlight the importance of disaggregating Asians and NHOPIs in future SA studies to better understand how specific factors are relevant to each group, and to guide the development of cultural and race-informed treatments for these groups.
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Affiliation(s)
- Meripa T Godinet
- Myron B. Thompson School of Social Work, University of Hawaìi, Honolulu, HI, USA
| | - Lindsey McGlinn
- Myron B. Thompson School of Social Work, University of Hawaìi, Honolulu, HI, USA
| | - Dawna Nelson
- Department of Social Work, Alabama State University, Montgomery, AL, USA
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Chang JS, Sorensen JL, Masson CL, Shopshire MS, Hoffman K, McCarty D, Iguchi M. Structural factors affecting Asians and Pacific Islanders in community-based substance use treatment: Treatment provider perspectives. J Ethn Subst Abuse 2017; 16:479-494. [PMID: 29236627 DOI: 10.1080/15332640.2017.1395384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Asians and Pacific Islanders (API) have large disparities in utilization of substance use treatment compared to other racial groups. In this study, we analyzed factors that shape API experiences accessing and engaging in community-based treatment from the perspective of treatment providers. We conducted semi-structured interviews with 40 treatment providers who work with API clients in treatment programs in San Francisco and Los Angeles. We analyzed the transcribed interview data in ATLAS.ti using a content analysis approach. There were three main findings. First, treatment providers found the API category itself is too broad and heterogeneous to meaningfully explain substance use patterns. Second, beyond race/ethnicity, structural factors such as poverty, neighborhood, housing, and age had an impact on API substance use. Third, factors such as family, immigration status, religion, language, stigma played complex roles in API treatment experiences, contingent on how client, programs, and providers attended to differences in these categories.
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Affiliation(s)
- Jamie Suki Chang
- a U.C. San Francisco , San Francisco , California , USA.,b Santa Clara University , Public Health Science , Santa Clara , CA , USA
| | | | | | | | - Kim Hoffman
- c Oregon Health and Science University , Portland , OR , USA
| | - Dennis McCarty
- c Oregon Health and Science University , Portland , OR , USA
| | - Martin Iguchi
- d RAND Corporation , Santa Monica , California , USA
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Bersamira CS, Lin YA, Park K, Marsh JC. Drug use among Asian Americans: Differentiating use by acculturation status and gender. J Subst Abuse Treat 2017; 79:76-81. [PMID: 28673532 PMCID: PMC9084395 DOI: 10.1016/j.jsat.2017.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
This study examined past-year drug use among Asian Americans with respect to ethnic subgroup, acculturation, and gender differences. Survey data were collected during the National Latino and Asian American Survey, a national epidemiological household survey of behavioral health prevalence and service utilization rates. The analytical sample consisted of 505 Filipino, 598 Chinese, 518 Vietnamese, and 466 other Asian respondents. Results indicated that among ethnic subgroups, Filipinos had the highest rates of drug use. Among all Asian Americans, those who were born in the United States, those with higher levels of English proficiency, males, those who were younger, those with lifetime prevalence of a major depressive episode, and those who were frequent drinkers were all more likely to have reported past-year drug use. Findings suggest the need to better understand the heterogeneous character of Asian American drug use when considering the provision of culturally competent and linguistically appropriate prevention and treatment services.
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Affiliation(s)
- Clifford S Bersamira
- The University of Chicago School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Yu-An Lin
- The University of Chicago School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Keunhye Park
- The University of Chicago School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States
| | - Jeanne C Marsh
- The University of Chicago School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, United States.
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Asian American and Pacific Islander substance use treatment admission trends. Drug Alcohol Depend 2017; 171:1-8. [PMID: 27988403 DOI: 10.1016/j.drugalcdep.2016.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/14/2016] [Accepted: 11/19/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND A national analysis of Asian Americans and Pacific Islanders (AAPI) substance use treatment admissions has yet to be studied. We sought to explore admission trends for AAPI, demographic and treatment variable change, and individual state admission change over time. METHODS We used retrospective time-series logistic regression treating year as a predictor of yearly treatment admission trends, between-state test for heterogeneity of treatment effects among states' AAPI admissions, and percent-changes of AAPI demographic and treatment characteristics. Participants included AAPI (n=135,356) and comparison non-AAPI (n=8,938,982) treatment groups' first-time admissions (N=9,074,338) in United States treatment centers receiving public funding from 2000 to 2012. RESULTS AAPI demonstrated a greater increase in admissions than non-AAPI from 2000 to 2012 (p<0.0001; OR=1.02, 95% CI=1.019-1.022). Large percent increases were demonstrated in multiple demographic and treatment characteristic, most notably in prescription opioids as a problem substance, age of first use for the oldest and youngest groups, and homelessness. In addition, trends are provided for individual states to help prioritize resource need. CONCLUSIONS The present demographic and treatment characteristics revealed specific variables that may help to improve a culturally competent understanding of increasing risk factors among AAPI clients. The present findings may help to demonstrate which states may need to increase AAPI-specific resources and interventions.
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