Substance abuse is a major public health problem that affects millions of people and places enormous financial and social burdens on society. It can destroy families, cripple the economy, victimize communities and suffocate the educational, criminal justice, and social services systems. Below are some important facts that relate to substance abuse, addiction, treatment, and recovery.

Drug Abuse among Targeted Populations

• General
  According to the National Household Survey on Drug Abuse, 13 million people age 12 or older had used an illicit drug during the past month. In addition, 11 million Americans reported heavy alcohol use and 32 million people reported "binge" drinking during the previous month.
  
• Youth/Adolescents
  Use of any illicit drug by students who are warned "a lot" about the dangers of alcohol and drugs by their parents is lower (26 percent) than among students who "never" get parental warnings (37 percent) - a 30 percent relative difference.(2)
  
• Men
  As in prior years, men continued to have a higher rate of current illicit drug use than women (8.1 percent vs. 4.2 percent).(3)
  
• Women
  Adult women who were divorced/separated or never married reported a significantly higher prevalence of any illicit drug use and problem drug use than adult women who were married.(4)
  
• Pregnant Women
  Among pregnant women, rates of substance use were higher among women age 15-25 than among those age 26-44.(3)

Use of Alcohol and Specific Drugs

• Illicit Drugs
  In the past school year, one quarter of senior high students (25 percent) used an illicit drug on a monthly or more frequent basis.(2)
  
• Alcohol
  Twenty-one percent of state inmates incarcerated for violent crimes were under the influence of alcohol when they committed their crimes.(5)
  
• Marijuana
  Students were twice as likely to smoke marijuana at home than at school (13.5 percent vs. 6.5 percent), and more than four times more likely to smoke pot at a friend's house than at school (28.5 percent vs. 6.5 percent).(2)
  
• Cocaine/Crack
  In 1996, cocaine-related episodes comprised 30 percent of all hospital emergency room drug-related visits, with "dependence" commonly being reported as the motive for drug use.(6)
  
• Heroin
  An estimated 2.4 million people use heroin at some time in their lives.(3)
  
• Inhalants
  According to a 1995 survey, when reporting on first use, inhalants was mentioned as the substance most often tried before the age of 13 (30 percent of the respondents).(7)

 

"An estimated 2.4 million people use heroin at some time in their lives. (3)

Critical Issues Related to Substance Abuse

• Crime
  By the year 2000, if current trends continue, this nation will break the $100-million-per-day barrier in money spent to incarcerate individuals with serious drug and alcohol problems.(5)
  
• Employment
  In 1994, more than 69 percent of those reporting use of illicit drugs were employed full time. Respondents were between the ages of 18 and 49. Of those reporting heavy use of alcohol (five drinks or more on five or more occasions in the past 30 days), 77.4 percent were employed full time.(8)
  
• Welfare
  Following treatment, clients receiving welfare declined from 40 percent to 35 percent - an almost 11-percent overall decrease.(9)
  
• Perceptions
  Children are now less likely than ever to believe that using drugs is "dangerous" and that people on drugs "act stupid."(10)
  
• Availability
  More than half of youths age 12-17 reported that marijuana was easy to obtain in 1996, and about one quarter reported that heroin was easy to obtain. Fifteen percent of youths reported being approached by someone selling drugs in the month prior to being interviewed.(3)

Effectiveness of Treatment

• One year after treatment, clients' use of their primary drug(s) declined from 73 percent to 38 percent.(9)
  
• Drug use declined by more than 40 percent among women in treatment for as long as a year after leaving treatment.(9)
  
• Any drug use was reduced by 31 to 47 percent among young adults in treatment.(9)
  
• Among the chronic users of marijuana, treatment resulted in a 45-percent reduction in use, and for those who used marijuana in combination with other drugs, there was a 50-percent reduction.(9)
  
• Treatment reduced cocaine use by 55 percent and reduced crack use by 51 percent, among users of these drugs.(9)
  
• Among those who reported supporting themselves through criminal activity, treatment reduced illegal activity by 49 percent.(9)

 

Among the chronic users of marijuana, treatment resulted in a 45-percent reduction in use, and for those who used marijuana in combination with other drugs, there was a 50-percent reduction. (9)

Center for Substance Abuse Treatment National Helpline
800-662-HELP

Through this toll-free, confidential service, supported by the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration, trained specialists provide information on alcohol and drug abuse and available treatment options. They also provide referrals to treatment programs, self-help and family support groups, and crisis centers nationwide.

Sources

(1) Recovery from Substance Abuse and Addiction: Real People Tell Their Stories, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1997

(2) Parent Resource Institute for Drug Education (PRIDE) Survey, 1997

(3) Preliminary Results from the 1996 National Household Survey on Drug Abuse, Substance Abuse and Mental Health Services Administration, 1997

(4) Substance Use Among Women in the United States, Substance Abuse and Mental Health Services Administration, 1997

(5) Behind Bars: Substance Abuse and America's Prison Population, The National Center on Addiction and Substance Abuse at Columbia University, 1998

(6) Year-End Preliminary Estimates from the 1996 Drug Abuse Warning Network, Substance Abuse and Mental Health Services Administration, 1997

(7) Treatment Episode Data Set Advance Report #12, Substance Abuse and Mental Health Services Administration, 1997

(8) An Analysis of Worker Drug Use and Workplace Policies and Programs, Substance Abuse and Mental Health Services Administration, 1997

(9) The National Treatment Improvement Evaluation Study, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1997

(10) 1996 Partnership Attitudinal Tracking Study, Partnership for a Drug-Free America, 1996

A Call to Action

All businesses - large and small - may at some point be faced with an employee who has a substance abuse problem. In fact, nearly three in four people who acknowledged using drugs in 1996 were employed, including 6.2 million full-time workers and 1.9 million part-time workers.(2) Given that more than 131 million people in the nation are employed (as of January 1998), the workplace is one of the most effective places to reach Americans with information about the success of treatment for substance abuse.(3) Investing in treatment and recovery is sound business. Consider the following facts:

• The cost of alcohol and illicit drug use in the workplace, including lost productivity, medical claims, and accidents, amounts to $140 billion per year.(4)
  
• Thirty-eight to 50 percent of all workers' compensation claims are related to the abuse of alcohol or illicit drugs in the workplace.(5)

It is important that companies design policies and implement workplace programs before they are directly confronted by this issue. Studies have shown that substance abuse treatment results in a significant reduction in medical claims, absenteeism and disability; an increase in productivity; and a healthier and safer environment for all employees. For example:

• Increasingly, employers with drug-free workplace policies and programs are enjoying discounts on their workers' compensation insurance. Premium discounts of 5 percent or more are provided in nine states, including Florida, Georgia, Alabama, Washington, Tennessee, Mississippi, South Carolina, Virginia, and Ohio. Similar initiatives are planned in Illinois, New Jersey, North Carolina, Louisiana, Massachusetts and Texas.(6)
  
• A study of the economic impact of substance abuse treatment in Ohio found significant improvements in job-related performance, including: a 91-percent decrease in absenteeism; an 88-percent decrease in problems with supervisors; a 93-percent decrease in mistakes at work; and a 97-percent decrease in on-the-job injuries.(7)
  
• Full parity for substance abuse services in private health insurance plans that tightly manage care would increase family insurance premiums less than one percent.(8)
  
• In Kent, Washington, an electric supply company with 150 employees experienced a 39-percent decrease in absenteeism and a 36-percent increase in productivity as a result of a workplace substance abuse program.(7)

Getting Involved - Next Steps

• Establish a workplace substance abuse program to reflect your company's commitment to operate and maintain a work environment free of substance abuse. There are some standard program components to consider: a written substance abuse policy statement, supervisor training for implementing a drug-free workplace program, employee education and awareness, and assistance to employees needing help.(1)
  
• Educate yourself on the signs, symptoms, and effects of substance abuse addiction among your employees.
  
• Fully explain the benefits and procedures of your drug-free workplace program or policy to all employees.(1)
  
• Help supervisors and managers to understand the value of treatment and recovery, rather than firing employees with addictions.
  
• Educate employees about the issue of substance abuse and promote program activities through internal vehicles such as interoffice newsletters or bulletin boards in the company lunchroom or other common areas.
  
• Host alcohol-free events, emphasizing commitment to preventing injuries or deaths associated with drinking and driving, especially around the holidays.(1)

Other Things You Can Do

• Go public about your program. Publicize your efforts through the local media to promote your company as a good corporate citizen. Your program may also serve as a model for other businesses in your community.
  
• Provide pro bono services or encourage employees to volunteer to assist at a local treatment facility in your community.
  
• Encourage employees to serve on boards or committees of local substance abuse treatment organizations.

Successful Programs

Here are some real examples of how businesses across the country have implemented successful drug and alcohol workplace programs for their employees.

• Fifteen years ago, at Capitol Ford, an auto dealership in Washington, D.C., a body shop employee high on PCP slammed a car into a wall, pinning a co-worker to the wall and crushing both his legs in the process. Following the incident, the company convened its top managers and set up a drug testing and treatment program that covered each employee for up to $1,500 worth of treatment. "The policy stated that if someone had a drug or alcohol problem, they would not lose their job as long as they got into a treatment program and stuck with it," said spokesperson Ed Friedson. In the wake of the PCP incident, most of the dealership's employees accepted the new policy with enthusiasm. Capitol Ford's policy has fostered employee accountability, a first-year insurance savings of $75,000, and a better bottom line.(9)
  
• Quaker Furniture, a top area company in Catawba County, North Carolina, was founded by Clyde Lail in 1966. When Quaker appeared to have high workers' compensation claims a few years ago, Mr. Lail hired an industrial nurse to initiate a formal substance abuse policy. Within a year of the nurse's arrival onsite, workers' compensation claims were reduced by one-half. Employees were comfortable going to the nurse for advice and referrals that, in turn, enabled their troubles to be recognized before they interfered with work. Quaker Furniture has a drug testing program and a policy to hold jobs for employees who require a leave of absence for substance abuse assistance. As a result of their substance abuse policy, Quaker has experienced greater business profits through reduced insurance claims, high-quality products and an award-winning, growing company.(9)
  
• The Warner Corporation, a 280-employee company in Washington, D.C., that provides plumbing, heating, and air conditioning services, is reaping handsome benefits from its campaign against drugs. In 1985, CEO Tom Warner established a drug-free workplace program in response to worsening job performance, skyrocketing insurance premiums, and an above-average number of accident claims among his employees. Warner's substance abuse program included drug testing, counseling, and access to a 28-day treatment program at the company's expense for employees who admit to a drug problem. In a single year, the program saved the company at least $385,000 through fewer accidents and a decrease in workers' compensation claims, which declined from 111 to 35 annually.(9)
  

 

"The policy stated that if someone had a drug or alcohol problem, they would not lose their job as long as they got into a treatment program and stuck with it." - Ed Friedson Capitol Ford, Washington, D.C.

Additional Resources

Employee Assistance Professionals Association
2101 Wilson Boulevard, Suite 500
Arlington, VA 22201
703-522-6272

Institute for a Drug-Free Workplace
1225 I Street, NW, Suite 1000
Washington, D.C. 20005
202-842-7400

Community Anti-Drug Coalitions of America
901 North Pitt Street, Suite 300
Alexandria, VA 22314
703-706-0560

National Drugs Don't Work Partnership
33 Washington Street, 10th Floor
Newark, NJ 07102
888-339-4665

Workplace Helpline: 800-WORKPLACE
This is a toll-free helpline, which is a service of the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention. This provides employers with consultations on policy development, supervisory training, employee education, employee assistance programs, and drug testing.

Sources

(1) Making Your Workplace Drug Free: A Kit for Employers, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention

(2) Preliminary Results from the 1996 National Household Survey on Drug Abuse, Substance Abuse and Mental Health Services Administration, August 1997

(3) Bureau of Labor Statistics, U.S. Department of Labor, February, 1998

(4) Brandeis University, 1993

(5) National Council on Compensation Insurance, 1993

(6) Keeping Score 1997, Drug Strategies, 1996

(7) Background Information - Workplace Substance Abuse, U.S. Department of Labor

(8) The Costs and Effects of Parity for Mental Health and Substance Abuse Insurance Benefits, Substance Abuse and Mental Health Services Administration, 1998

(9) Working Partners: Substance Abuse in the Workplace - A Small Business Initiative, U.S. Department of Labor

A Call to Action

By almost any measure, the impact of alcohol and drug abuse and addiction on the health care system of the United States is enormous. It is estimated that up to 26 percent of general medical clinic patients - a prevalence rate similar to such commonly seen medical conditions as diabetes and hypertension - exhibit alcohol-related disorders.(1) Every man, woman, and child in America pays nearly $1,000 annually to cover the costs of unnecessary health care, extra law enforcement, motor vehicle crashes, crime, and lost productivity due to substance abuse.(2) The economic costs and the magnitude of human suffering are staggering. However, something can be done, and it can start in your community. When we encourage those in need to enter treatment, we are making one of the best possible investments in our communities. Among the people who are in the position to take action against substance abuse are providers of primary health care. They are our gatekeepers.

Health care providers play a pivotal role in the diagnosis and treatment of substance abuse and addiction because they occupy a special place of trust and confidence in our society. By recognizing warning signs and investing a little more effort, health care providers can unearth substance abuse and addiction problems earlier rather than later.

Getting Involved - Next Steps

Here are some steps health care providers, especially those engaged in direct patient care, can take to identify substance abuse problems:

Screening

• Periodically and routinely screen all patients for substance use disorders.(1)
  
• Ask questions about substance abuse in the context of other lifestyle questions.(1)
  
• Screen adolescents for substance abuse every time they seek medical treatment.(1)

Brief Intervention

• Perform a brief intervention with patients whose substance abuse problems are less severe.(1)
  
• Include in the brief intervention: feedback about screening results and risks of use; information about safe consumption limits and advice about change; an assessment of patient's readiness to change; negotiated goals and strategies for change; and arrangements for follow-up visits.(1)

Assessment and Treatment

• Refer high-risk patients to a specialist, if possible, for in-depth assessment.(1)
  
• Ensure that a specialized assessor has familiarity with psychiatric disorders.(1)

Confidentiality

• Assure patients, including adolescents, that anything discussed will be held in strictest confidence.(1)
  
• Consult patients before discussing their substance abuse with anyone else - family, employers, treatment programs, or the legal system.(1)

Successful Programs

• A unique screening program tested by Harvard Vanguard Associates doubled the number of patients identified as being at potential risk of substance abuse. According to Steven Adelman, M.D., who developed the program, a basic change was made to the patients' medical records system. It required that all patients undergoing a physical exam be screened for substance abuse. Thus, a physician or other health care provider was reminded to ask a series of questions about substance abuse, just as they were reminded to screen for other serious conditions such as hypertension, or for the use of tests such as pap smears and mammograms, which can detect potential problems. If the provider did not conduct the screening, the computer added an asterisk to the patient's record that could only be removed by undertaking the screening. Because asterisked items are taken into account in evaluations, providers were motivated to take appropriate action. At the same time, Harvard Vanguard initiated a substance abuse training program to help providers identify and treat at-risk patients. Since it is estimated that 15 percent or more of patients misuse drugs and alcohol, early identification and treatment can have a significant positive impact on the health of many plan members and reduce more costly treatment required when a patient is diagnosed at a later stage.
  
• In response to the closing of the alcohol and drug treatment unit at Bryn Mawr Hospital outside of Philadelphia, James Berman, M.D., initiated an ambulatory detoxification program that helps people begin the recovery process in an outpatient setting. The program is affiliated with a regional treatment provider, Caron Foundation, which provides the inpatient services to support Dr. Berman's outpatient practice. "More and more treatment is being steered outside the rehabilitation facilities, and we're going to need a lot more foot soldiers," says Dr. Berman, referring to the increasingly important role health care professionals will play in treating addiction, the disease he recognizes as America's number one health problem.

 

"More and more treatment is being steered outside the rehabilitation facilities, and we're going to need a lot more foot soldiers." - James Berman, M.D. Bryn Mawr Hospital, Philadelphia, PA

Additional Resources

American Medical Association
515 North State Street
Chicago, IL 60610
312-464-5000

American Psychiatric Association
1400 K Street, NW, Third Floor
Washington, D.C. 20005
202-682-6000

American Psychological Association
Office of Substance Abuse Prevention
750 First Street, NE, Suite 4000
Washington, D.C. 20002
202-336-5500

National Association of Alcoholism and Drug Abuse Counselors
1911 North Fort Myer Drive, Suite 900
Arlington, VA 22209
703-741-7686

National Association of Social Workers
750 First Street, NE, Suite 700
Washington, D.C. 20002
202-408-8600

Sources

(1) A Guide to Substance Abuse Services for Primary Care Clinicians, Treatment Improvement Protocol (TIP) Series 24, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment, 1997

To obtain a copy of TIP 24, contact the SAMHSA National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Or call 800-729-6686, 800-729-6686 (Se habla Espaņol), or 800-487-4889 (TDD). To order electronically: http://ncadi.samhsa.gov

(2)Institute for Health Policy, 1993

A Call to Action

Providing high-quality addiction treatment, and encouraging those in need to enter treatment, is one of the best investments we can make in our communities. It is a way of saving lives. It is a means of dramatically improving the quality of life of addicted men and women, and those whose lives they touch. The faith community can and should play a vital part in the community's efforts to end substance abuse dependence and addiction through treatment.

Some of the most significant institutions in any community are institutional faith groups. In many neighborhoods battered by drugs and alcohol, religious institutions play an important role in reaching out and helping addicts and alcoholics into recovery. Whatever the denomination, these faith organizations have in many communities been the scene of ongoing efforts for treatment. Many of the treatment programs conducted by faith communities fill a special niche by providing services to those whose needs are not easily met in public programs and those for whom a spiritually oriented, communal, and supportive approach is both necessary and meaningful.

An important characteristic shared by all effective substance abuse ministries is their adherence to their particular religious values and the integration of those values into the services provided. Religious values provide a platform on which many people may choose to build their recovery. Clergy and others involved in the ministry use their religious beliefs as a positive force in supporting recovery from substance abuse.

Getting Involved - Next Steps

• Acknowledge that treatment of substance abuse problems is a major concern for the congregation/faith community and that religious and lay leaders will dedicate themselves to this concern.(2)
  
• Determine the particular activities the religious institution can and will undertake.
  
• Schedule sermons on alcohol and drug abuse and tie them into treatment-related community campaigns or special events.(2)
  
• Encourage those who have undergone substance abuse treatment to serve as role models and resources to those in need of similar help.(2)
  
• Establish a planning group, committee or task force that includes representation from clergy, lay leaders, youth, religious educators, parents, respected elders within the congregation, and individuals recovering from chemical dependency. The planning group's purpose is to coordinate the development of ongoing efforts of the congregation to meet the substance abuse needs of its members.
  
• If hosting support groups or recovery meetings, carefully consider the credentials and experience of the staff to be recruited and a comprehensive training plan for clergy, staff, and volunteers.
  
• Include substance abuse treatment hotline numbers and other resource information in congregation/faith community publications such as bulletins and newsletters.(2)
  
• When conducting premarriage counseling sessions, integrate information on issues such as fetal alcohol syndrome, parents serving as role models and educators about alcohol and drugs, the warning signs of alcoholism and drug addiction, and the value of substance abuse treatment.(2)

 

Freedom Now, the substance abuse ministry of the Bethel A.M.E. Church in Baltimore, Maryland, is a small outpatient program that teams each participant with a recovering lay counselor. The Freedom Now model has been replicated in a number of churches in Maryland and Pennsylvania looking for approaches that work effectively with African American substance abusers.

Successful Programs

The following programs are examples of how religious institutions are making a difference in their communities by taking an active role in helping individuals and families suffering from the effects of substance abuse:

• The Queen of Peace Center in St. Louis was developed to meet the specialized needs of adolescent, chemically dependent girls, who required the structure provided by a residential treatment program as well as the opportunity to receive an education.
  
• The Baptist Pastors Council of the Greater Detroit Area and Vicinity operates an outpatient treatment program as one of many services within its comprehensive program to confront substance abuse.
  
• Freedom Now, the substance abuse ministry of the Bethel A.M.E. Church in Baltimore, Maryland, is a small outpatient program that teams each participant with a recovering lay counselor. The Freedom Now model has been replicated in a number of churches in Maryland and Pennsylvania looking for approaches that work effectively with African American substance abusers.

Additional Resources

Catholic Charities, USA
1731 King Street, Suite 200
Alexandria, VA 22314
703-549-1390

Congress of National Black Churches
National Anti-Drug Campaign
1225 I Street, NW, Suite 750
Washington, D.C. 20005
202-371-1091

General Board of Global Ministries of the United Methodist Church
Program on Substance Abuse
110 Maryland Avenue, NE, Suite 404
Washington, D.C. 20002
202-488-5653

International Affairs Office
Church of Jesus Christ of Latter Day Saints
529 14th Street, NW, Suite 900
Washington, D.C. 20045
202-662-7480

Jewish Alcoholic and Chemically Dependent Persons and Significant Others
426 West 58th Street
New York, NY 10019
212-397-4197

Sources

(1) Recovery from Substance Abuse and Addiction: Real People Tell Their Stories, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1997

(2) Alcohol, Tobacco, and Other Drug Abuse: Challenges and Responses for Faith Leaders, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, Spring 1995

A Call to Action

The rate of illicit drug use for African Americans is 7.5 percent of the population. This usage rate remained somewhat higher than for whites (6.1 percent) and Hispanics/Latinos (5.2 percent) in 1996.(2)

• A recent study found that 27 percent of drug-related hospital emergency room visits occurred among African Americans.(3)
  
• One out of every 14 African American men is behind bars for a crime in which drugs or alcohol was involved.(4)

African Americans have traditionally relied on the support of family, church and the community. Culturally sensitive and relevant treatment programs and materials specifically targeting African Americans are available through the public and private sectors. It is the responsibility of local organizations to invest in their communities by using available resources to inform and educate those in need of substance abuse treatment.

Getting Involved - Next Steps

• Set up outreach ministries within your church to talk about issues that are affecting parishioners' lives. Include individuals who are in recovery, are sensitive to substance abuse problems, or have had specialized training.
  
• Encourage people in your community to write to local radio/television/cable stations to encourage community-based forums, or to national outlets, such as Black Entertainment Television, or other cable television producers, to encourage them to include addiction and recovery topics in their programming.
  
• Work with local African American sorority and fraternity organizations, as well as other groups, to encourage them to serve as mentors to local teens to show them the path to a successful life.
  
• Provide substance abuse treatment-related information to local small businesses, such as restaurants, hair salons and barber shops.

Successful Programs

• The Saginaw Odyssey House is a treatment facility that serves indigent, substance-abusing, urban women and their infants living in inner-city Saginaw, Michigan. Its clients, 90 percent of whom are African American, range in age from 19 to 44. The Saginaw Odyssey House aims to decrease alcohol and other drug use, improve physical health, promote safe and healthy pregnancies, and improve emotional and social functioning among substance-abusing women. It also strives to enhance the developmental outcomes of children born to women in recovery. The program includes several components, such as therapeutic substance abuse treatment, culturally sensitive parenting classes, medical assessments and care, drug screening, dental care, family therapy, and educational and vocational skills training.
  
• The Calvary's Alternative To Alcohol And Drug Abuse (CATAADA) House Program in Washington, D.C., is a free and confidential alcohol and drug intervention program which stresses spiritual growth and knowledge of the disease of addiction. CATAADA House also offers an after-care program that includes a multi-faceted, holistic Afro-centric educational component. The philosophy of after-care is that long-term sobriety and good health can be achieved through extended abstinence and education. The CATAADA House approach adheres to the concept that clients' culture, values, religion, economic status, history, social status, and practices all have significant impact on shaping their behavior patterns.

 

The CATAADA House approach adheres to the concept that clients' culture, values, religion, economic status, history, social status, and practices all have significant impact on shaping their behavior patterns.

Additional Resources

National Black Alcoholism and Addictions Council
1104 14th Street, NW, Suite 630
Washington, D.C. 20005
202-296-2696

National Black Child Development Institute
1023 15th Street, NW, Suite 600
Washington, D.C. 20005
202-387-1281

African American Family Services
2616 Nicollet Avenue, South
Minneapolis, MN 55408
612-871-7878

Saginaw Odyssey House
128 North Warren Street
Saginaw, MI 48407
517-754-8598

Supportive Intensive System of Treatment,
Empowerment and Recovery (SISTER)
1324 Adeline Street
Oakland, CA 94607
510-645-4290

Calvary's Alternative To Alcohol And Drug Abuse
802 Rhode Island Avenue, NE
Washington, D.C. 20008
202-832-8336

Sources

(1) Recovery from Substance Abuse and Addiction: Real People Tell Their Stories, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1997

(2) Preliminary Results from the 1996 National Household Survey on Drug Abuse, Substance Abuse and Mental Health Services Administration, 1997

(3) Year-End Preliminary Estimates from the 1996 Drug Abuse Warning Network, Substance Abuse and Mental Health Services Administration, 1997

(4) Behind Bars: Substance Abuse and America's Prison Population, The National Center on Addiction Substance Abuse at Columbia University, 1998

A Call to Action

The Hispanic/Latino community is growing at an extraordinary rate - six times faster than the general U.S. population. This rapid demographic growth has been accompanied by positive educational and economic achievements, as well as a surge in social problems, such as the increase in substance abuse that is particularly prevalent among youth.

According to preliminary results from the 1996 National Household Survey on Drug Abuse, there were an estimated 1.1 million Hispanic/Latino illicit drug users in 1996.(1) The rate of binge alcohol use among Hispanics/Latinos was slightly higher than that of whites, 16.7 percent and 16.1 percent respectively. According to the 1997 Monitoring the Future Study, from 1991 through 1997, eighth and tenth grade Hispanics/Latinos have consistently shown higher rates of marijuana use than both African Americans and whites.(2)

The needs of this rapidly growing, changing and diverse population present new challenges and require that treatment of substance abuse problems be both relevant and sensitive to the needs of Hispanic/Latino clients and their families. Hispanic/Latino health professionals, community-based organizations and religious leaders have a unique opportunity to make an investment in their community by communicating culturally relevant treatment messages to the Hispanic/Latino community, especially to those at risk and their family members. According to the Agency for Health Care Policy and Research's National Medical Expenditures Survey, Hispanics/Latinos are the ethnic group most likely to be uninsured.(3) Therefore, the most useful treatment messages for this audience are those that focus on the availability of and access to public services for clients in need.

Getting Involved - Next Steps

• Recognize the importance of family in the Hispanic/Latino community, and make outreach efforts inclusive of the family and community.
  
• Develop strong outreach components by channeling efforts through Hispanic/Latino community leaders and organizations to increase the acceptability of treatment programs.
  
• Work in partnership with community-based organizations that directly serve Hispanics/Latinos to ensure that treatment program information and resource materials are readily available to those in need.
  
• Collaborate with local school administrators to develop programs that can offer students information on substance abuse treatment resources available to them and their loved ones.
  
• Develop a working relationship with the local Chamber of Commerce to obtain assistance in identifying resources (jobs, training and internships) to help those presently in treatment make a successful transition into the work force.
  
• Work with Hispanic/Latino radio and TV stations to get the word out on the availability and efficacy of treatment.
  
• Work with mainstream substance abuse treatment organizations to encourage development and adaption of Spanish-language materials targeting youth.
  
• Maximize opportunities to promote the effectiveness of treatment services at community events during Hispanic Heritage Month, celebrated September 15 through October 15, which corresponds with the annual celebration of National Alcohol and Drug Addiction Recovery Month each September. One such event could be a symposium, composed of state and community leaders, treatment professionals, and those in recovery, to discuss the most pressing issues surrounding substance abuse and treatment in the Hispanic/Latino community. Local businesses and other organizations with a vested interest in dealing with substance abuse problems also should be included.

After recognizing a need to better assess the target demographic for their treatment services, staff of the Los Angeles Charles Drew University of Medicine and Science conducted door-to-door interviews in South Central Watts neighborhoods.

Successful Programs

• After recognizing a need to better assess the target demographic for their treatment services, staff of the Los Angeles Charles Drew University of Medicine and Science conducted door-to-door interviews in South Central Watts neighborhoods. Uncovering the unique needs of the Chicano and Central/South American communities has helped improve Drew University's community treatment programs, King/Drew Place of Family and Casa De Freedom. By utilizing the skills of bilingual counselors and by holding celebrations for both Cinco de Mayo and September's Celebracion, the University's two treatment facilities have successfully tailored their services and outreach efforts to better serve the Hispanic/Latino communities in Southern California.
  
• The Pinal Hispanic Council is an adolescent treatment program in Eloy, Arizona, for Mexican American youth between the ages of 10 and 18. The program receives the majority of its patients from the juvenile probation department, local schools, and local Chicano families. These young people are undergoing treatment for alcohol and a variety of drugs, including marijuana, crack cocaine, and inhalants. This program is a model because it uses home-based counseling as a vehicle to increase trust, make services accessible, evaluate the home environment, and focus on the family climate. Other program components include case management, life-skills training, and aftercare services.
  
• Aliviane, Inc. is a nonprofit private substance abuse treatment provider founded in 1971. Aliviane, Inc., located in El Paso, Texas, recently created two new outpatient clinics to serve rural migrant populations in five remote west Texas counties. The recipients of these substance abuse services are primarily Chicano families who live and work in the region or migrant farm workers from south Texas who are in transition to pick the crops in California and the Northwest. Aliviane, Inc. serves approximately 100 persons and their immediate families per year. In addition, this organization has an excellent outreach and education program for HIV/AIDS that is bilingual/bicultural in nature.

 

Aliviane, Inc. is a nonprofit private substance abuse treatment provider founded in 1971. Aliviane, Inc., located in El Paso, Texas, recently created two new outpatient clinics to serve rural migrant populations in five remote west Texas counties.

Additional Resources

Coalition of Hispanic Health and Human Services Organizations
1501 16th Street, NW
Washington, D.C. 20036
202-387-5000

National Council of La Raza
1111 19th Street, NW, Suite 1000
Washington, D.C. 20036
202-785-1670

Latino Coalition on Alcohol and Tobacco
1015 15th Street, NW, Suite 409
Washington, D.C. 20005
202-371-1186

Sources

(1) Preliminary Results from the 1996 National Household Survey on Drug Abuse, Substance Abuse and Mental Health Services Administration, 1997

(2) Monitoring the Future, University of Michigan, 1997

(3) National Medical Expenditures Study, Agency for Health Care Policy and Research

A Call to Action

The Native American population is young and fast growing. It was almost driven out of existence, declining from about 2.5 million prior to contact with Europeans, to less than a quarter of a million at the turn of the century. Today, Native Americans once again number more than two million and represent about one percent of the U.S. population.(2) This group represents one of the U.S.'s youngest populations, with a median age of 26. While this population has enormous strength and resiliency, it is also one that faces daunting problems, including poverty, a significant school drop-out rate, inadequate job training, and health problems, many stemming from alcohol and drug abuse. These problems may have led to a weakening of the Native American family structure.

The family unit is central to the Native American culture. "A child learns social attitudes, beliefs, values and behaviors through involvement with other people. The immediate family is clearly the most important socialization force in the young child's background, followed closely by the extended family."(3) Unfortunately, this is a family structure that has all too often been undermined and weakened by powerful social and cultural forces, including poverty, dislocation, separation of family members, limited educational opportunities, less than adequate medical care, and sub-standard living conditions. The result has been that Native Americans have experienced an upsurge in social and health problems, including a propensity for substance abuse problems, especially among youth.

Alcohol abuse and alcoholism have long been documented as pervasive problems in the Native American community. Perhaps the single most disturbing statistic is that 75 percent of all Native American deaths are related to alcohol. In fact, five of the ten leading causes of death among Native Americans are directly related to alcohol: accidents, cirrhosis of the liver, alcohol dependency, suicide, and homicide.(4) In addition to the wide use of alcohol, Native American youth also have high rates of use of marijuana and inhalants. It is estimated that about 41 to 62 percent of American Indian youth have tried marijuana, compared with less than half of other youths.(5) In addition, data released from the U.S. Department of Health and Human Services, National Institute on Drug Abuse, suggests that inhalant abuse is among the popular drug preferences for American Indian youth, fourth grade through high school senior level.(6)

Getting Involved - Next Steps

• Initiate activities that empower the Native American community. Help develop community programs and organizations for youth that promote healthy, fun, and engaging activities to compete with the lure of alcohol and other drug use.(7)
  
• Help local health, justice system officials, teachers and other service providers become sensitive to Native American culture and ways to cope with alcohol and drug-related problems. Increase awareness of the need to improve access and utilization of existing health services and research, and to integrate them with traditional methods of healing.(7)
  
• Become a leader in your community, church, family or tribe in an effort to create and enforce a substance-free atmosphere, especially for Native American youths. Promote sober leadership and reinforce involvement with the community and the family.(4)
  
• Contact and use local newspapers; radio stations; community events; family festivals, nights and retreats; community speakers; and drug awareness activities to encourage the community to become more aware of the dangers of substance abuse.(5)
  
• Utilize tribal holidays, pow-wows, schools, tribal colleges and university service units, and American Indian and Alaskan Native Heritage Month in November, as a means of communicating the need for more effective treatment services focused on the Native American culture. These events can not only help to gather community members to discuss key issues related to substance abuse, but can also be used to recruit Native American treatment staff and to sensitize non-Native American staff.
  
• Study the effectiveness of programs on reservations without severe alcohol and drug problems.

Successful Programs

• Indian Rehabilitation, Inc., in Phoenix, Arizona, provides residential treatment, transitional housing, outpatient and aftercare services to the Native American community as well as the non-Native population in the region. Aside from staffing the facility with treatment counselors from the surrounding reservations, they also use Native American culture as a tool in helping addicted individuals on the road to recovery. "We use spirituality to help them find their direction," says Larry Osmonson, Outpatient Therapist. The facility also integrates cultural ceremonies to meld the patient's personal spirituality with clinical recovery. For example, the graduation ceremony for clients consists of a talking circle, an Indian tradition that provides a "sacred circle" setting for teaching, listening, learning, and sharing. In addition, this program also works with the Federal Government's Indian Health Services, Arizona's Department of Health Services, the city of Phoenix, numerous housing agencies, and other organizations to provide informational and financial support to Native Americans in need of treatment and other medical and housing services.
  
• Gateway Center for Human Services is a publicly funded treatment provider serving the population of Ketchikan, Alaska, and nearby Saxman Village, a Native American community. Gateway has found it helpful to include Native American staff among its treatment professionals. "One of the fastest ways to lead Natives into treatment is to have Natives on staff who can draw in people from the community," says Bruce Dixon, Outpatient Coordinator for Gateway. Gateway participated in outreach efforts by helping organize the Saxman Sobriety Potlatch - a community gathering to share food, give gifts, and recognize community members who have helped others. Gateway assisted by promoting, planning, and providing speakers for the event. In addition, Gateway has helped organize the Walk for Sobriety, which took participating pedestrians through downtown Ketchikan.
  

 

"One of the fastest ways to lead Natives into treatment is to have Natives on staff who can draw in people from the community." - Bruce Dixon, Outpatient Coordinator Ketchikan, AK

Additional Resources

Gateway Center for Human Services
3050 Fifth Avenue
Ketchikan, AK 99901
907-225-4154

Indian Rehabilitation, Inc.
650 North Second Avenue
Phoenix, AZ 85003
602-254-3247

Indian Health Services
Department of Health and Human Services
5600 Fishers Lane, Room 6-35
Rockville, MD 20857
301-443-3593

National Congress of American Indians
1301 Connecticut Avenue, NW, Second Floor
Washington, D.C. 20036
202-466-7767

Sources

(1) Recovery from Substance Abuse and Addiction: Real People Tell Their Stories, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1997

(2) Drug Use Among Racial and Ethnic Minorities, National Institute on Drug Abuse, U.S. Department of Health and Human Services, 1995

(3) Londo, Harlon and Devore, Wynetta. "Layers of Understanding: Counseling Ethnic Minority Families." Family Relations, 1998

(4) M. Fine, S.H. Akalias, and S. Bellinger. "Cultures of Drinking: A Workplace Perspective," Social Work, 27, 1987

(5) Prevention Primer: An Encyclopedia of Alcohol, Tobacco, and Other Drug Prevention Terms, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, 1994

(6) Drug Use Among Racial/Ethnic Minorities, National Institutes of Health, 1995

(7) Making Prevention Work, National Clearinghouse for Alcohol and Drug Information, 1995

(8) Wilbur, S., Director of Maehnoweseikiyah Treatment Center, Menominee Indian Tribe, Gresham, Wisconsin, 1994

A Call to Action

Through the early 1990's, the Asian/Pacific Islander American population in the United States had one of the fastest growth rates of all racial and ethnic groups and is expected to reach 41 million by 2050. The population is comprised of more than 60 separate ethnic/racial groups and subgroups, representing diversity in terms of their histories and experiences in the United States, languages and dialects, religions, cultures, socioeconomic status, and places of birth.(2) Such diversity has made the challenge of culturally competent substance abuse treatment services a complex one for providers.

Although there has been little research conducted on alcohol and drug use among Asian/Pacific Islander Americans, available substance abuse studies indicate that, in general, drug use among this audience is less frequent than that of non-Asian populations.(3) It must be remembered, however, that this is an aggregate view of many diverse populations. Targeted studies are required to identify potential problem areas, for example:

• Asians and Pacific Islanders in New York State use cocaine at the same rate as African Americans, and use inhalants at a rate (14 percent) higher than African Americans (11 percent) and similar to Hispanics (16 percent).(3)
  
• Asians and Pacific Islanders on the West Coast may be at relatively higher risk for illicit drug use and for using these drugs in sequence with alcohol and tobacco.(3)

Prevention and treatment programs for this population will be most effective if they reflect the values and norms of the population being served. To be successful, recovery programs for Asian/Pacific Islander Americans should address a variety of important issues, including: language, socioeconomic, cultural and geographical barriers to treatment; status and length of time in the United States; and level of acculturation and assimilation into mainstream American culture.

Getting Involved - Next Steps

• Acknowledge the diversity - including the conflicts, shared values, and attitudes - of the many cultures included within the Asian/Pacific Islander American population.(4)
  
• Involve community members whose voices command respect of both parents and youth - elders, teachers, doctors, merchants/business leaders, community leaders, and youth role models - in treatment efforts.(4)
  
• Help recent immigrants adapt to the English language and American culture. Life stresses, such as a major relocation, can be a precursor to abusing alcohol and drugs.(4)
  
• Acknowledge, respect, and celebrate prevention/healing practices of traditional cultures. Prevention and treatment should incorporate culturally based support systems in families and communities, as well as Eastern and Western wellness models.(4)
  
• Incorporate messages about the effectiveness of substance abuse treatment services at community events and through promotional activities during Asian Pacific Heritage Month, which takes place in May.
  
• Conduct outreach about important substance abuse treatment issues to newspapers, magazines, and radio and television stations that provide media coverage in Asian/Pacific Islander languages, such as Chinese, Japanese, Korean, Vietnamese, Samoan, Tagalog, Tongan, and others.
  
• Promote research initiatives designed to study the tremendous ethnic, racial and geographic diversity of Asian/Pacific Islander populations in the United States.

Successful Programs

• Asian American Recovery Services, Inc. (AARS) was established in 1985 in response to rising substance abuse rates among San Francisco's Asian/Pacific Islander population. Created as a culturally responsible alternate to existing treatment programs that offered little or no programming specific to Asians/Pacific Islanders with substance abuse problems, AARS continues to adapt and change to meet the rapidly growing and diverse needs of the Asian/Pacific Islander communities in the San Francisco Bay Area. AARS develops and provides innovative outreach, treatment, prevention, and research services for its target populations. These services include a variety of activities, including intervention, health education and information, family and individual counseling, residential treatment, case management, and aftercare.
  
• The Asian American Drug Abuse Program (AADAP) began operating in Los Angeles, California, in 1973 as a result of an alarming number of Asian Americans dying from drug overdoses in the prior two years. These overdoses were particularly distressing since they occurred among youth who were not considered part of the delinquent subculture. Today, AADAP has a variety of programs in place to meet the needs of the diverse Asian/Pacific Islander community. These initiatives include: the Indochinese Youth Center, which provides culturally relevant and language-appropriate drug abuse prevention, early intervention, HIV/AIDS education and tobacco prevention to Vietnamese youth and their families; Outpatient Services, which operates under the philosophy that substance abuse and addiction must be treated holistically, giving consideration to cultural, environmental, emotional, and other factors; Residential Treatment Services, a 24-hour live-in program that provides a protective, supportive environment for those with drug abuse problems; and other targeted prevention and education programs.

 

Asian American Recovery Services, Inc. was established in 1985 in response to rising substance abuse rates among San Francisco's Asian/Pacific Islander population.

Additional Resources

National Asian Pacific American
Families Against Substance Abuse
300 West Cesar Chavez Avenue, Suite B
Los Angeles, CA 90012-2818
213-625-5795

Asian and Pacific Islander American Health Forum
942 Market Street, Second Floor
San Francisco, CA 94102
415-954-9988

Asian American Recovery Services, Inc.
785 Market Street, 10th Floor
San Francisco, CA 94103
415-541-9285

Asian American Drug Abuse Program, Inc.
5318 South Crenshaw Boulevard
Los Angeles, CA 90043
213-293-6284

Ho'omau Ke Ola/Hawaii Addiction Center, Inc.
P.O. Box 837
Wai'anae, HI 96792
808-696-4266

Sources

(1) Rice Paper, Asian American Drug Program, Inc., April/May 1998

(2) Prevention Primer: An Encyclopedia of Alcohol, Tobacco, and Other Drug Prevention Terms, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, 1994

(3)Technical Assistance Bulletin: Communicating Effectively with Asian and Pacific Islander Americans, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, 1997

(4) Making Prevention Work, National Clearinghouse for Alcohol and Drug Information, 1995