Addiction is a disease that crosses all boundaries. Statistics show that this chronic, progressive condition affects individuals from all walks of life, regardless of their gender, age, race, socioeconomic status, or occupation. Yet within these demographic groups, it is possible to discover patterns of substance use and abuse that affect the lives and health of these individuals. In the admission stage of rehab, and throughout the rehab process, an evaluation of the client’s needs can make the difference between effective, individualized care and a cookie-cutter approach to rehab.
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The compulsive actions and thoughts associated with addiction vary from one individual to another, yet there are neurological and behavioral patterns that make this disease truly universal. No matter what the individual’s background may be, addiction has the following characteristics:
In spite of social advances and efforts to combat racist stereotypes, African Americans still feel the repercussions of slavery, segregation, and racial profiling. Members of this group — which include Americans who can trace their heritage to Africa — generally are exposed to higher rates of poverty and violence, combined with fewer opportunities for education and professional advancement.
Contrary to cultural misconceptions about drug and alcohol use among African Americans, substance abuse rates in this racial group are similar to rates of drug and alcohol abuse among Caucasians or Hispanics. However, the impact of substance abuse on the physical health and socioeconomic status of African Americans is greater than that of other groups.
Tamika C.B. Zapolski, PhD, proposes in Psychological Bulletin that low-income African American men, in particular, experience the negative effects of substance abuse, including alcoholism and alcohol-related crime and disease, at a disproportionately high rate: “We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability).”
Culturally competent treatment for African American clients reflects the values and experiences of this group. Family engagement is important in rehab, as are spiritual development, education on relapse prevention, and strong aftercare programs to help these clients successfully transition back to the community after rehab.
The Hispanic/Latino population now represents 17.4 percent of the US population, or approximately 54 million people, according to the U.S. Census. This group includes immigrants and their descendants from numerous Spanish-speaking countries in Mexico, Central America, South America, Spain, and other regions. The most rapidly growing Hispanic subgroups are from Puerto Rico, El Salvador, Cuba, the Dominican Republic, and Guatemala, notes the Centers for Disease Control and Prevention.
The cultural and linguistic diversity of these subgroups makes it difficult to generalize about the substance abuse treatment needs of Hispanic/Latino Americans. However, there are certain values and perspectives that these groups have in common, such as a strong emphasis on the importance of family and the role of religion and spirituality in issues affecting health. When faced with a substance abuse problem, Hispanic Americans may be more likely to seek help from a family member or close friend, or to consult a spiritual leader than to enroll in a rehab program.
Although Latinos generally have lower rates of substance abuse than other racial groups, those who do enter treatment generally have poorer outcomes, according to the Journal of Ethnicity and Substance Abuse. Treatment can be made more effective by accommodating Hispanic cultural values, by providing bilingual services, and by taking into account the ethnic and cultural differences that exist among the many Hispanic subgroups.
Among the major racial groups that make up the melting pot of the US, Asian Americans have the lowest rates of drug and alcohol abuse. The 2013 NSDUH reports that 3.1 percent of Asian Americans — a group that includes people of Chinese, Japanese, Vietnamese, Korean, Cambodian, and Laotian descent, among others — were current users of illicit drugs, and that 34.5 percent were current users of alcohol.
However, drug use is increasing among younger generations of Asian Americans, who are more likely to experiment with hallucinogenic drugs, marijuana, and stimulants as part of the club scene. According to the Journal of Drug Education, substance abuse is increasing among Asian American adolescents and has been associated with depression and low self-esteem, especially among females. Similarly, the rates of mental illness and emotional disorders appear to be increasing among younger generations of Asian Americans, possibly as a result of their efforts to assimilate into mainstream American culture, according to the American Psychological Association.
Like other racial minorities, Asian Americans tend to consider substance abuse a private matter to be kept within the family. When Asian Americans experience substance abuse, depression, or anxiety, they are more likely to share these concerns with close relatives or seek out traditional Asian healers rather than consulting a therapist or entering rehab. By the time they feel the need to seek help, symptoms have often become severe. First-generation Asian immigrants, in particular, may not seek professional help because of language barriers, cultural stigma against substance abuse and mental illness, and a lack of awareness of available resources.
Treatment programs tailored to the needs of Asian Americans must focus on the importance of familial bonds and traditional cultural practices, as well as the personal experiences of Asian immigrants and their exposure to violence or trauma. In particular, refugees from Southeast Asia may require specialized therapy for post-traumatic stress disorder (PTSD) because of their experiences with war and political persecution.
Rates of substance abuse are highest among Native Americans and Alaska Natives, with 12.3 percent of American Indian/Alaska Natives reporting illicit drug use, and 23.5 percent reporting episodes of binge drinking, according to the NSDUH. Drug and alcohol use is particularly high among residents of tribal lands or Indian reservations, where substandard living conditions and lack of health services lead to increased rates of disease, mental illness, and substance abuse. A history of problem drinking among American Indians has led to negative stereotypes that portray all Native Americans as alcoholics, even though a large percentage of these individuals do not drink or use drugs at all.
When Native Americans do drink alcohol, they suffer more severe consequences than other racial groups. According to the National Institute on Alcohol Abuse and Alcoholism, Native Americans experience higher rates of the following alcohol-related conditions:
Access to affordable mental health care and substance abuse treatment has been a barrier to recovery among Native Americans, both on and off the tribal lands. Outreach efforts, preventive education, and increased access to recovery services can help to correct the disparities in substance abuse and mental illness that have plagued American Indians for generations.
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