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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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Nakajima M, Sero A, Jama S, Habte S, Taha S, Habte H, Mekonnen G, Geleto I, Bongard S, al'Absi M. Acculturation Style Is Associated with Stress and Tobacco Use among East African Immigrants. J Psychoactive Drugs 2023; 55:112-121. [PMID: 35196959 DOI: 10.1080/02791072.2022.2040659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
While tobacco use rates are relatively high among East African immigrants in the U.S., factors contributing to this high rate are largely unknown. Acculturation is associated with stress and substance use. Whether acculturation styles are related to stress and current tobacco use has not been tested among this population. We conducted a cross-sectional study that included 376 East African adults who provided information on demographic background, acculturation style, acculturative stress, depressive symptoms, and tobacco use. Multivariate analysis indicated that individuals who were distant to both the culture of the host country and the culture of origin (marginalization style) had greater levels of acculturative stress than those who adopted both cultures (integration style; p < .001). Marginalized people were four to eight times and assimilated people were three to four times more likely than integration people to be a current tobacco user (p < .04). This relationship did not change after controlling for demographic information and stress. In this study, acculturation style was associated with perceived stress and current tobacco use among East African immigrants. Research focused on characterizing integrated individuals may guide efforts to develop culturally-relevant strategies to reduce tobacco-related disparities among East African individuals.
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Affiliation(s)
- Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Abdul Sero
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Shamso Jama
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Sara Habte
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Sartu Taha
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Hileena Habte
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Gemechu Mekonnen
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Iman Geleto
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Stephan Bongard
- Department of Psychology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
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Laus V. Race and Filipina/o drug use: rethinking ethnicity among Filipina/o Americans through drug consumption, racial profiling, and the social construction of ethnicity. J Ethn Subst Abuse 2020; 21:1083-1103. [PMID: 33030414 DOI: 10.1080/15332640.2020.1829236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This research uses 23 in-depth interviews of Filipina/o Americans seeking out treatment for drug use to understand the role of ethnicity as they experience drug use, recovery, and attempts to integrate back into society. Past literature has focused on the role of ethnicity as a buffer against drug use in host societies, with highly acculturated groups more prone to at-risk behavior. Such scholarship usually relies on static notions of ethnic culture. By contrast, using a social constructionist approach to ethnicity, I argue that meanings of ethnicity to the users go beyond homeland traditions and, in this case, reflect racialized police profiling of users in their neighborhoods and also their understanding of the methamphetamine epidemic in the Philippines. The interviewees affiliate their ethnic experiences with larger social conditions that point to neocolonialism in the homeland, racialization in the host society, and the war on drugs in both countries. This has implications for treatment programs that use culturally-appropriate services for addiction programs, so that providers complicate acculturation and assimilation models of ethnicity to understand social factors that affect the meaning of ethnic identity for Filipina/os.
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Schumann M, Bug M, Kajikhina K, Koschollek C, Bartig S, Lampert T, Santos-Hövener C. The concept of acculturation in epidemiological research among migrant populations: A systematic review. SSM Popul Health 2020; 10:100539. [PMID: 32042888 PMCID: PMC6997899 DOI: 10.1016/j.ssmph.2020.100539] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 01/10/2023] Open
Abstract
•Acculturation is a widely used concept in epidemiological research.•There are various ways to measure acculturation using proxies or scales; often an acculturation score is calculated.•Studies often show inconsistencies in operationalization and measurement of the concept of acculturation.•The exact outcome is often unclear; this creates a lack of comparability, generalizability and transferability of the results.•Health relevant proxies such as language skills or feeling of belonging should be measured without calculating a score.
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Affiliation(s)
| | | | - Katja Kajikhina
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, FG28: Social Determinants of Health, General-Pape-Str. 62-66, 12101, Berlin, Germany
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Saraiya T, Smith KZ, Campbell ANC, Hien D. Posttraumatic stress symptoms, shame, and substance use among Asian Americans. J Subst Abuse Treat 2019; 96:1-11. [PMID: 30466541 PMCID: PMC7534512 DOI: 10.1016/j.jsat.2018.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/29/2018] [Accepted: 10/08/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND To examine the association between posttraumatic stress symptoms (PTSS) and substance use among Asian Americans and the influence of a culturally-relevant moderator, shame. METHODS From 2016 to 2017, 199 participants from Amazon Mechanical Turk and a university subject pool completed an online survey. Chi-square and Kruskal-Wallis tests explored demographic and clinical differences among three Asian American ethnic subgroups (East Asians, South Asians, and Southeast Asians). Generalized linear models assessed the association between PTSS and substance use (alcohol, tobacco, and other drugs) and the moderation of this relationship by shame. RESULTS Ethnic subgroups significantly differed on all three substance use variables. The severity in PTSS was significantly associated with hazardous drug use (IRR = 1.03, (1.01, 1.05), p = .003). The association between PTSS and days of tobacco use and binge drinking was significantly moderated by shame. Low levels of shame increased the effect of PTSS on binge drinking (IRR = 1.05, (1.00, 1.10), p = .035) and tobacco use (IRR = 1.15, (1.11, 1.19), p < .001). High levels of shame had no effect of PTSS on binge drinking (IRR = 1.01, (0.99, 1.03), p = .54) and a reduced effect on tobacco use (IRR = 1.07, (1.05, 1.09), p < .001). CONCLUSIONS Among Asian Americans, the association of PTSS and substance use depends on shame. Lower levels of shame are a risk factor, increasing the effect of PTSS on substance use. Culturally-modified addiction treatments should assess for shame among Asian Americans and attend to ethnic sub-group diversity in substance use.
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Affiliation(s)
- T Saraiya
- The City College of New York, The City University of New York, 160 Convent Avenue, New York, NY 10031, USA; Derner School of Psychology, Adelphi University, 158 Cambridge Avenue, Garden City, NY 11530, USA.
| | - K Z Smith
- Columbia University Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - A N C Campbell
- Columbia University Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - D Hien
- The City College of New York, The City University of New York, 160 Convent Avenue, New York, NY 10031, USA; Center of Alcohol Studies, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway Township, NJ 08854, USA.
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Bustamante LHU, Cerqueira RO, Leclerc E, Brietzke E. Stress, trauma, and posttraumatic stress disorder in migrants: a comprehensive review. ACTA ACUST UNITED AC 2017; 40:220-225. [PMID: 29069252 PMCID: PMC6900760 DOI: 10.1590/1516-4446-2017-2290] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/13/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE There is growing evidence supporting the association between migration and posttraumatic stress disorder (PTSD). Considering the growing population of migrants and the particularities of providing culturally sensitive mental health care for these persons, clinicians should be kept up to date with the latest information regarding this topic. The objective of this study was to critically review the literature regarding migration, trauma and PTSD, and mental health services. METHODS The PubMed, SciELO, LILACS, and ISI Web of Science databases were searched for articles published in Portuguese, English, Spanish, or French, and indexed from inception to 2017. The following keywords were used: migration, mental health, mental health services, stress, posttraumatic stress disorder, and trauma. RESULTS Migration is associated with specific stressors, mainly related to the migratory experience and to the necessary process of acculturation occurring in adaptation to the host country. These major stressors have potential consequences in many areas, including mental health. The prevalence of PTSD among migrants is very high (47%), especially among refugees, who experience it at nearly twice the rate of migrant workers. CONCLUSIONS Mental health professionals must be trained to recognize and provide appropriate care for posttraumatic and/or stress-related disorders among migrants.
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Affiliation(s)
- Lineth H U Bustamante
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Raphael O Cerqueira
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Emilie Leclerc
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elisa Brietzke
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Kane JC, Damian AJ, Fairman B, Bass JK, Iwamoto DK, Johnson RM. Differences in alcohol use patterns between adolescent Asian American ethnic groups: Representative estimates from the National Survey on Drug Use and Health 2002-2013. Addict Behav 2017; 64:154-158. [PMID: 27614054 PMCID: PMC5143158 DOI: 10.1016/j.addbeh.2016.08.045] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 08/28/2016] [Accepted: 08/31/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Studies have suggested that alcohol use prevalence is increasing among Asian American adolescents and there may be significant differences between specific adolescent Asian American ethnicities. METHOD Data from the National Survey on Drug Use and Health (2002-2013) were used to estimate prevalence of alcohol use (lifetime, past-month, past-year) and problem (binge drinking, alcohol use disorder [AUD], and early initiation of use) outcomes among adolescent Asian American ethnicities. RESULTS Filipino Americans had the highest prevalence of lifetime (29.3%) and past-month (10.3%) use; Korean Americans had the highest prevalence of past-year use (22.7%). Asian Indian Americans had the lowest prevalence of all three use indicators: 14.6%, 11.9%, and 4.9% for lifetime, past-year, and past-month, respectively. Korean Americans had the highest prevalence of binge drinking (5.4%), Filipino Americans had the highest prevalence of AUD (3.5%), and Vietnamese Americans had the highest prevalence of early initiation of use (13.5%). Asian Indian Americans had the lowest prevalence for all three alcohol problem indicators: 2.6%, 1.0%, and 4.9% for binge drinking, AUD, and early initiation of use, respectively. CONCLUSIONS Prevalence estimates of alcohol outcomes among Korean, Japanese, and Filipino American adolescents were high and similar to other racial groups that are often considered higher risk racial groups. Estimates among large subgroups with low alcohol use prevalence, Chinese and Asian Indian Americans, may mask high rates among other Asian ethnicities when alcohol use estimates are presented among Asians overall. When feasible, researchers should present alcohol use estimates disaggregated by specific Asian American ethnicities and investigate differences in risk factors across groups.
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Affiliation(s)
- Jeremy C Kane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States.
| | - April Joy Damian
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Brian Fairman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Judith K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Derek K Iwamoto
- Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD 20742, United States
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
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