Substance use disorders and treatment in Asian American and Pacific Islander women: A scoping review

Wang, Callie L; Kanamori, Margaux; Moreland-Capuia, Alisha; Greenfield, Shelly F.; Sugarman, Dawn E.

doi:10.1111/ajad.13372

Cited by 6 publications

(8 citation statements)

References 40 publications

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“…Prior studies have indicated potential underreporting of substance use disorder and lower receipt of treatment among Asian and Pacific Islander people compared with most other racial groups. 29,30 Firearm mortality rates increased throughout the study period. In recent years, homicide rates have increased substantially and are an important public health concern.…”

Section: Discussionmentioning

confidence: 95%

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Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

et al. 2023

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ImportanceAlthough deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood.ObjectiveTo examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined as poisonings (eg, drug overdose), firearms, and all other injuries, including motor vehicle injuries and falls. Given the repercussions of the COVID-19 pandemic, US death rates for 2019 and 2020 were also compared.Design, Setting, and ParticipantsSerial cross-sectional study using national death certificate data obtained from the National Center for Health Statistics and including all external causes of 3 813 894 deaths among individuals aged 20 years or older from January 1, 1999, to December 31, 2020. Data analysis was conducted from January 20, 2022, to February 5, 2023.ExposuresAge, sex, and race and ethnicity.Main Outcomes and MeasuresTrends in age-standardized mortality rates and average annual percentage change (AAPC) in rates calculated by intent (suicide, homicide, unintentional, and undetermined), age, sex, and race and ethnicity for each external cause.ResultsBetween 1999 and 2020, there were 3 813 894 deaths due to external causes in the US. From 1999 to 2020, poisoning death rates increased annually (AAPC, 7.0%; 95% CI, 5.4%-8.7%). From 2014 to 2020, poisoning death rates increased the most among men (APC, 10.8%; 95% CI, 7.7%-14.0%). During the study period, poisoning death rates increased in all the racial and ethnic groups examined; the most rapid increase was among American Indian and Alaska Native individuals (AAPC, 9.2%; 95% CI, 7.4%-10.9%). During the study period, death rates for unintentional poisoning had the most rapid rate of increase (AAPC, 8.1%; 95% CI, 7.4%-8.9%). From 1999 to 2020, firearm death rates increased (AAPC, 1.1%; 95% CI, 0.7%-1.5%). From 2013 to 2020, firearm mortality increased by an average of 4.7% annually (95% CI, 2.9%-6.5%) among individuals aged 20 to 39 years. From 2014 to 2020, mortality from firearm homicides increased by an average of 6.9% annually (95% CI, 3.5%-10.4%). From 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, and homicide due to firearms and all other injuries.Conclusions and RelevanceResults of this cross-sectional study suggest that from 1999 to 2020, death rates due to poisonings, firearms, and all other injuries increased substantially in the US. The rapid increase in deaths due to unintentional poisonings and firearm homicides is a national emergency that requires urgent public health interventions at the local and national levels.

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Section: Discussionmentioning

confidence: 95%

“…Additionally, we observed an increase in poisoning deaths among Asian and Pacific Islander persons from 2014 to 2020. Prior studies have indicated potential underreporting of substance use disorder and lower receipt of treatment among Asian and Pacific Islander people compared with most other racial groups …”

Section: Discussionmentioning

confidence: 99%

Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

et al. 2023

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“…Asian American individuals are less likely than other groups to receive treatment for substance use disorder, regardless of insurance . A particular challenge in understanding this disparity is the ethnic and socioeconomic heterogeneity of the Asian American population . For example, HCV in Asian American individuals may be particularly concentrated in people who emigrated from endemic countries, and who in turn may face a higher risk of decreased health care access due to limited English proficiency .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Treatment Initiation Among US Medicaid Enrollees

et al. 2023

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ImportanceDirect-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection is highly effective but remains underused. Understanding disparities in the delivery of DAAs is important for HCV elimination planning and designing interventions to promote equitable treatment.ObjectiveTo examine variations in the receipt of DAA in the 6 months following a new HCV diagnosis.Design, Setting, and ParticipantsThis retrospective cohort study used national Medicaid claims from 2017 to 2019 from 50 states, Washington DC, and Puerto Rico. Individuals aged 18 to 64 years with a new diagnosis of HCV in 2018 were included. A new diagnosis was defined as a claim for an HCV RNA test followed by an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis code, after a 1-year lookback period.Main Outcomes and MeasuresOutcome was receipt of a DAA prescription within 6 months of diagnosis. Logistic regression was used to examine demographic factors and ICD-10–identified comorbidities associated with treatment initiation.ResultsAmong 87 652 individuals, 43 078 (49%) were females, 12 355 (14%) were age 18 to 29 years, 35 181 (40%) age 30 to 49, 51 282 (46%) were non-Hispanic White, and 48 840 (49%) had an injection drug use diagnosis. Of these individuals, 17 927 (20%) received DAAs within 6 months of their first HCV diagnosis. In the regression analyses, male sex was associated with increased treatment initiation (OR, 1.24; 95% CI, 1.16-1.33). Being age 18 to 29 years (OR, 0.65; 95% CI, 0.50-0.85) and injection drug use (OR, 0.84; 95% CI, 0.75-0.94) were associated with decreased treatment initiation. After adjustment for state fixed effects, Asian race (OR, 0.50; 95% CI, 0.40-0.64), American Indian or Alaska Native race (OR, 0.68; 95% CI, 0.55-0.84), and Hispanic ethnicity (OR, 0.81; 95% CI, 0.71-0.93) were associated with decreased treatment initiation. Adjustment for state Medicaid policy did not attenuate the racial or ethnic disparities.ConclusionsIn this retrospective cohort study, HCV treatment initiation was low among Medicaid beneficiaries and varied by demographic characteristics and comorbidities. Interventions are needed to increase HCV treatment uptake among Medicaid beneficiaries and to address disparities in treatment among key populations, including younger individuals, females, individuals from minoritized racial and ethnic groups, and people who inject drugs.

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“…Asian Americans are one of the fastest growing minority groups in America, yet because of the "model minority" stereotype and limited research on substance use among this population in comparison to other major ethnic groups, Asian Americans have been thought to have lower than expected rates of substance use disorders. [31][32][33] However, more recent research has shown that this is not the case. 25,34 Some studies suggest that factors including trauma from resettlement, acculturation, urbanicity, and cultural influences may explain the increasing substance use seen in both Asian and Black populations.…”

Section: Discussionmentioning

confidence: 99%

“…This was also one of the first studies to report that those identifying as Asian were at increased odds for ecstasy/MDMA use. Asian Americans are one of the fastest growing minority groups in America, yet because of the “model minority” stereotype and limited research on substance use among this population in comparison to other major ethnic groups, Asian Americans have been thought to have lower than expected rates of substance use disorders 31–33 . However, more recent research has shown that this is not the case 25,34 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States

et al. 2023

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Objectives: 3,4-Methylenedioxymethamphetamine (MDMA) (also known as "ecstasy" or "Molly") has regained attention in recent years for its efficacy in treating posttraumatic stress disorder, and the drug was granted breakthrough therapy designation for such use by the US Food and Drug Administration in 2017. However, little is known about the current epidemiology of recreational ecstasy/MDMA use. Methods: We estimated past-year prevalence and correlates of ecstasy/ MDMA use based on a representative sample of noninstitutionalized US individuals 12 years or older from the 2015-2020 National Survey on Drug Use and Health (N = 315,661). Results: An estimated 0.9% (95% confidence interval [CI] = 0.9-1.0) of individuals used ecstasy/MDMA in the past year. Compared with those ages 35-49 years, all younger age groups were at increased odds for use, while those older than 50 years (adjusted odds ratio [aOR] = 0.14, 95% CI = 0.08-0.23) were at low odds for use. Compared with heterosexual men, those identifying as bisexual women (aOR = 1.32, 95% CI = 1.02-1.72) were at increased odds for use, and compared with White individuals, those identifying as Asian (aOR = 1.92, 95% CI = 1.42-2.59), Black (aOR = 1.70, 95% CI = 1.41-2.06), or multiracial (aOR = 1.61, 95% CI = 1.19-2.16) were at increased odds for use. Past-year use of other drugs (e.g., cannabis, ketamine), prescription drug misuse (e.g., pain relievers, stimulants), nicotine dependence (aOR = 1.21, 95% CI = 1.00-1.45), and alcohol use disorder (aOR = 1.41, 95% CI = 1.25-1.58) were also associated with increased odds for use. Conclusions: While use of ecstasy/MDMA continues to be relatively rare, findings from this study can help inform prevention and harm reduction strategies, especially among certain subpopulations that are at high risk for use.

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Substance use disorders and treatment in Asian American and Pacific Islander women: A scoping review

Cited by 6 publications

References 40 publications

Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

Hepatitis C Treatment Initiation Among US Medicaid Enrollees

Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States

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