Comparison of substance abuse treatment utilization and preferences among Native Hawaiians, Asian Americans and Euro Americans

Abstract

Use and preferences for substance abuse treatment can vary by ethnicity. However, little is known about use and preferences among Native Hawaiians and Asian Americans. Interviews from 192 admitted multi-ethnic residents from two treatment facilities in Hawaii were conducted. More similarities than differences were found. The most utilized treatments were Alcoholics Anonymous and the emergency department, with no significant ethnic differences. However, Native Hawaiians and Asian Americans were significantly less likely to have spoken to a mental health provider about alcohol problems (32%, 39%, respectively vs. 69% of Euro Americans) and to have seen a physician for a drinking-related problem (21% of Native Hawaiians and 19% of Asian Americans vs. 41% of Euro Americans). Native Hawaiians were significantly more likely to consider marriage counselling to be an effective form of treatment (33% vs. 11% of Asian Americans and 9% of Euro Americans). Implications for substance abuse treatment are discussed. The findings suggest that it is important to integrate the field of substance abuse in multiple systems; including substance abuse, medical, criminal, social service and community settings to ensure treatment preferences are met. Ethnic differences may also have implications for expanding and tailoring services.

Patient Preferences and Shared Decision Making in the Treatment of Substance Use Disorders: A Systematic Review of the Literature

“… [ 34 ] Lieberman et al (2014), [ 35 ] Flach & Diener (2004), [ 36 ] White et al (2007), [ 37 ] Green (2011), [ 38 ] Goebert & Nishimura (2011), [ 39 ] Luty (2004), [ 40 ] Tuten et al (2007), [ 41 ] Dillworth et al (2009), [ 42 ] Adamson et al (2006), [ 43 ] Bernstein et al (1999), [ 45 ] Friedman et al (1999), [ 46 ] Gossop et al (1986), [ 47 ] Hser et al (1999), [ 48 ] Marlowe et al (2003), [ 49 ] McCrady et al (2011), [ 50 ] McKay et al (1995), [ 51 ] McKay et al (1998), [ 52 ] Sterling et al (1997). …”

“…Considering treatment preferences, patients with alcohol use disorders rather preferred outpatient / day hospital to inpatient treatment [ 37 , 50 ], although Goebert and Nishimura [ 38 ] couldn´t find any differences. However, the majority of opioid [ 39 , 40 ] and cocaine dependent patients [ 51 ] preferred outpatient to inpatient treatment.…”

“…Further the majority of chemical dependent smokers as well as staff would support an optional smoking cessation program [ 43 ] in addition to the regular treatment, after taking part in a two-hour educational awareness session. Regarding general services, Goebert and Nishimura [ 38 ] found significant different preferences between Asian American and Euro American drinkers. The former preferred less detoxification services (p = .013), whereas the latter preferred e. g. significantly less drug abuse programs (p = .013) and more mental health provider services (p = .037).…”

“…Regarding treatment preferences, we found that preferences were evaluated for either alcohol or illicit drug populations for different treatment settings (e.g. [ 38 , 45 ]) preferring outpatient/ day hospital treatment. Research involving effectiveness of different treatment settings has often methodological problems, but two reviews showed that there is no difference in in- or outpatient treatment for preferences of severe mental ill patients [ 61 ] except that the longer the treatment went, the more successful it was for alcohol patients [ 62 ].…”

Ethnic-Specific Support Systems as a Method for Sustaining Long-Term Addiction Recovery

“…AA's view of alcoholism and its solution are widely accepted within communities of color (Caetano, 1993;Goebert & Nishimura, 2011). 2.…”