As previously stated, the topic of substance abuse prevalence and treatment within immigrant and refugee communities is complex as it involves many different types of populations representing different cultures, resources, traditions, and challenges. For some populations, family connection has been found to be a protective factor against substance abuse, but there is simply an overall dearth of research on the topic. It is clear that more research is needed across each of the areas discussed in this chapter specific to immigrant and refugee communities: theoretical, policy, familial, methodological and intervention-based. Additionally, it has been several years since the United States has published a comprehensive study on prevalence rates for substance abuse among immigrants and refugees (Brown et al., 2005). Given how much our country has changed politically, economically, and demographically in the past decade, it may be timely for the National Surveys on Drug Use and Health to publish the prevalence rates within the more recent 2013 survey and for other researchers to focus on substance use among immigrant and refugee populations.
Jon is a 23-year-old first-generation Laotian man who has been using heroin for the past two years. Recently, he has been evaluated and recommended to attend drug treatment. Jon’s parents struggle to understand what addiction is. Historically, Jon’s father has struggled with alcohol abuse; his family reframes his drinking as normal behavior.
Prior to his heroin use, Jon used marijuana exclusively. Fifteen years ago, John came with his family (i.e., parents, younger brother, and older sister) from Vietnam as a refugee.
Jon states that he must return to work in order to help his family pay for living expenses (i.e., rent, food, transportation, medication). The family also supports extended family members back home in Vietnam; these family members are dependent on these financial remittances. Jon agrees that he needs to change, but struggles knowing how to make changes and with his motivation to change.
Jon appears to use the fact that he is proficient in English to his advantage. When communicating with employees at the treatment facility and with court representatives, he communicates different information to different staff members. He also continues this pattern with his family members. Jon does this by leaving out important details for his family and not translating his parents’ express wishes for his discharge. Jon states that his family does not understand addiction and therefore, do not need to be involved in his discharge recommendation planning.
- How might the living situation of newly immigrated refugees influence Jon’s substance use and treatment?
- Can you list 2-3 services in your community that would address Jon and his family needs on different subsystems? Would these resources be culturally sensitive and appropriate?
- What are some common intervention strategies that may encourage Jon’s family to engage in his treatment?
- How has traumatic stress potentially contributed to Jon’s substance abuse? How do you believe traumatic stress has impacted other generations of Jon’s family?
- What are some cultural barriers Jon faces in seeking treatment?
Drug and Alcohol Use in Refugee Communities
- This webinar by Dr. Simmelink McCleary describes how immigrants and refugees understand substance use and trauma, with guidelines for treatment providers.