NAPAFASA Facts and Resources

Quickjump List

Treatment, Prevention, and Services
Substance Abuse Studies & Reports - General
Substance Abuse Studies & Reports - Asian Americans and Pacific Islanders
Substance Abuse Reports - Ethnic Specific
Dual Diagnosis
Mental Health Issues
Problem Gambling
Asian Americans and Pacific Islanders Demographics
Multimedia Resources
API Language Materials
Technical Assistance Project - Information for Staff

Treatment, Prevention, and Services

CSAT - Recovery Month Webcast

Recovery from addiction to alcohol and drugs is something we can celebrate throughout the year. But the September observance of National Alcohol and Drug Addiction Recovery Month provides millions of Americans with a unique opportunity to see and embrace what addiction and recovery mean to families, communities, and people in recovery. In September 2005, hundreds of Recovery Month events were held across the country to celebrate recovery and highlight the fact that addiction is treatable and recovery is possible.

This program looks at the tremendous educational and awareness raising events conducted in communities large and small as the country came together to heal lives, families and communities. It highlights Recovery Month community forums, walks and runs for recovery, Major League Baseball games, music-based activities, and other events that exemplify that addiction is treatable and recovery is possible.

The webcast is available here.

National Asian Pacific American Families Against Substance Abuse. (2008). Asian American and Pacific Islander Treatment Providers Directory.

This directory provides detailed descriptions of substance abuse and mental health services for AAPIs in California. For each agency included, information on location, services provided, language capabilities, ethnicities served, and fees are listed. The directory also includes a list of support groups available for limited English speaking populations. Agencies are also indexed by language capabilities and area, allowing easy access to finding services depending on the clients' needs.

Available at the Los Angeles office NAPAFASA resource library. For a full-text of the directory, please click here.

Asian American Federation of New York. (2003). A Resource Directory of Human Services for Asian Americans in Metropolitan New York.

This Directory profiles select health and human service organizations for Asian Americans in the metropolitan New York City area. It also contains listings of community resources, national APA organizations, and community press and media organizations.

This publication can be accessed and ordered at www.aafny.org/directory/new/default.asp.

Barreto, R. M. & Segal, S. P. (2005). Use of Mental Health Services by Asian Americans. Psychiatric Services, 56:746-748, June 2005.

This study explored the use of mental health services by Asian Americans and other ethnic populations in California. East Asians were found to use more services than Southeast Asians, Filipinos, other Asians, Caucasians, African Americans, Latinos, and Native Americans. The findings suggest that aggregating Asian subpopulations into a single group in services research is no longer appropriate. Attention needs to be placed on the needs of Southeast Asians and other Asians, whose service use patterns approximate those of the traditionally most underserved groups, e.g. African Americans and Latinos.

This publication can be accessed and order at ps.psychiatryonline.org/cgi/content/full/56/6/746.

California Department of Alcohol & Drug Programs. (2002). Treatment Works! (Publication number: ADP-02-3485) Department of Alcohol and Drug Programs Data Management Services Section.

A complete directory to help find alcohol and drug abuse treatment services throughout California. Includes not only contact information, but a detailed chart of services such as programs specifically designed for youth, Asian/Pacific Islanders, Relapse Prevention, or Gay, Lesbian, Bisexual or Transgender.

This publication is available to view online at www.adp.cahwnet.gov/PDF/txworks.pdf. This publication can be ordered at no charge at www.adp.cahwnet.gov/feedback/contact4.asp?rn=7.

Chin, J. (2001). Asian Americans/Pacific Islanders: Assessing the Unmet Needs for Mental Health Services CMHS Contract#: OM5742). Unpublished document.

This study is a detailed assessment of the unmet needs of the AAPI community in terms of mental health services and asks if the public, state, and federal mental health systems are adequately serving the mental health needs of AAPIs. The second focus of the study is on the cultural competency of state mental health systems to enable them to be responsive to the unique needs of API communities. Includes focus group data with mental health providers, consumers, community advocates and leaders from the AAPI community and AAPI state mental health personnel from 8 states.

This publication is available to view online at www.culturalcompetence2.com/asian.html. To order the full report, e-mail CEOServices@yahoo.com. Available at the Los Angeles office NAPAFASA resource library.

Chow, J. (2002). Asian American and Pacific Islander Mental Health and Substance Abuse Agencies: Organizational Characteristics and Service Gaps. Administration and Policy in Mental Health, 30(1).

Documents organizational service characteristics of community-based ethnic-specific service agencies in AAPI communities nationwide and identifies areas of need. Among the key findings was the need for more diversified mental health and substance abuse services, particularly for emerging AAPI groups.

Subscriptions or order of back issues to Administration and Policy in Mental Health can be made online at www.kluweronline.com/issn/0894-587X/contents. Available at the Los Angeles office NAPAFASA resource library.

Chow, J. (2003). Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas. American Journal of Public Health, 93(5).

This study examines racial/ethnic disparities in mental health service access and use at different poverty levels by comparing demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Results show that residency in a poor neighborhood moderates the relationship between race/ethnicity and mental health services access and use.

Subscription and reprint order information is available online at www.ajph.org/ Available at the Los Angeles office NAPAFASA resource library.

Marshall, G. N., Schell, T. L., Elliott, M. N., Berthold, M., & Chun, C. (2005). Mental Health of Cambodian Refugees Two Decades After Resettlement in the United States. The Journal of American Medical Association, 294(5): 571-579.

A study funded by the NIH, NIMH, and NIAAA, found that most Cambodian refugees who resettled in the U.S. remain traumatized, with 62% reporting posttraumatic stress disorder and 51% reporting depression in the past year, six to seventeen times the national average for adults.

This article reports on the findings of a survey done on the nation's largest Cambodian community in Long Beach, California.

For abstracts of the article, see jama.ama-assn.org/cgi/content/abstract/294/5/571.

Migration Policy Institute (MPI). (2004). Putting Data to Work for Immigrants and Communities.

The primary purpose of this publication is to promote the use of data by groups that work with or on behalf of immigrants in order to strengthen their advocacy, research, and internal management capacity.

This publication can be downloaded from the Internet at www.migrationpolicy.org/pubs/PUTTINGDATATOWORK.pdf.

National Asian Pacific American Families Against Substance Abuse. (2001). Asian American Pacific Islander Substance Abuse Needs Assessment Project.

This report identifies and constructs profiles of the parts of the AAPI substance abuse and mental health process as it exists in communities today. These profiles are created in order to identify several objectives toward the overall goal of improving substance abuse and mental health services for these populations and prioritizing AAPI health and human services needs.

Available at the Los Angeles office NAPAFASA resource library.

National Institute on Drug Abuse. (1999). Principles of Drug Addiction Treatment: A Research-Based Guide (NIH Publication No. 99-4180).

Principles of Drug Addiction Treatment is an effective guide to understanding various approaches to drug addiction treatment. The principles outlined in the publication provide a framework through which to understand treatment options. Includes references and additional resources for further information on treatment approaches.

This publication is available to view online at 165.112.78.61/PODAT/PODATindex.html. This publication can be ordered at no charge online at store.health.org/catalog/productDetails.aspx?ProductID=15565. Available at the Los Angeles office NAPAFASA resource library.

Philleo, J., Brisbane, L., & Epstein, L. G., eds. (1997). Cultural Competence in Substance Abuse Prevention. National Association of Social Workers (NASW).

This guide is specifically designed for alcohol and drug abuse (A/D) professionals working with racial and culturally-diverse communities. The book provides A/D professionals with the knowledge and strategies they need to become more culturally competent. It demonstrates how to integrate cultural competence and an A/D curriculum and how to develop highly effective prevention messages and treatment modalities within a cultural context.

The editors examine five major cultural groups - Native Americans, Hispanics/Latinos, African Americans, Asian Americans, and Pacific Islanders - and provide culturally sensitive treatment recommendations. A chapter focuses on sexual diversity in a cultural context when considering prevention and treatment for gays and lesbians.

Available through the National Association of Social Workers (NASW), 750 First St NE, Ste 700, Washington, DC 20002-4241; 202-408-8600.

Special Service for Groups. Asian Pacific Alcohol Peer Consultation and Training Project Needs Assessment.

The target population of the Needs Assessment for the Asian Pacific Alcohol Peer Consultation and Training Project included those who are at-risk for alcohol problems from six Asian Pacific groups (Chinese, Japanese, Korean, Pacific Islander, Pilipino and Southeast Asian). Sociodemographic characteristics and associated psychosocial factors were assessed for this at-risk group.

This publication is available online at paadp.org/needassestment.pdf. Available at the Los Angeles office NAPAFASA resource library.

Zane, N., Sue, S., Chang, J., Huang, L., Huang, J., Lowe, S., et al. (2005). Beyond ethnic match: Effects of client-therapist cognitive match in problem perception, coping orientation, and therapy goals on treatment outcomes. Journal of Community Psychology, 33(5): 569-585.

This study examined the outcome effects of cognitive match between Asian and white outpatient clients and their therapists. Many clinicians believe that one hindrance to the treatment of ethnic minority clients is that therapists and clients may not share common assumptions and attitudes about therapy and about the problems that are presented in treatment.

The study investigated client-therapist similarity in their perceptions of the presenting problem, coping orientation, and expectations about treatment goals. This study constituted a more rigorous test of the cognitive match hypotheses in that it was prospective in nature, used separate and independent sources for the cognitive predictors, employed multiple outcome measures, and focused on specific attitudes and perceptions that are salient and relevant to treatment. Cognitive match on treatment goals was predictive of session impact. Moreover, cognitive matches in avoidant coping orientation and in perceived distress associated with interpersonal problems were predictive of certain treatment outcomes. The findings may help explain why clients matched on ethnicity with their therapists tend to stay longer in treatment and do better in psychotherapy.

Abstract for this article is available at www3.interscience.wiley.com/cgi-bin/abstract/110571050/ABSTRACT. Full text can also be purchased at this website.

Substance Abuse Studies & Reports - General

Smoking, Alcohol & Other Substance Abuse Among Middle and High School Kids in California

NAPAFASA has created a PowerPoint that illustrates the results from a 2005-2006 California Health Kids Survey on smoking, alcohol and other substance abuse among middle and high school kids in Callifornia.

Please visit this link for the PowerPoint Presentation.

Monitoring the Future - 2005

Monitoring the Future is an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, a total of approximately 50,000 8th, 10th and 12th grade students are surveyed (12th graders since 1975, and 8th and 10th graders since 1991). In addition, annual follow-up questionnaires are mailed to a sample of each graduating class for a number of years after their initial participation.

The newly released 2005 results can be found here.

The general Monitoring the Future website is www.monitoringthefuture.org.

Bachman, J., Cooper, S., Johnston, L., O'Malley, P., Schulenberg, J., & Wallace, J. (2002). Tobacco, Alcohol, and Illicit Drug Use: Racial and Ethnic Differences Among U.S. High School Seniors, 1976-2000. Public Health Reports, 117.

Examines the differences in adolescents' use of tobacco, alcohol, and illicit drug use by racial and ethnic groups based on a questionnaire from a large nationally representative sample of U.S. high school seniors. Among the findings are that significant differences exist in adolescent use of tobacco, alcohol, and illicit drugs by racial and ethnic groups, and these differences have changed over time.

Subscriptions to Public Health Reports* can be made online at phr.oupjournals.org or at the Elservier website at www.elsevier.com/wps/find/journalbibliographicinfo.cws_home/703066/description?navopenmenu=1. Available at the Los Angeles office NAPAFASA resource library.

Beauvais, F., Belgrave, F., Buka, S., Estrada, A., Galea, S., Iguchi, M., et al. (2002). Drug Use, HIV/AIDS, and Health Outcomes Among Racial and Ethnic Populations. Public Health Reports, 117.

Presents articles derived from a workshop examining health disparities among drug users in racial and ethnic populations. It reports on results of research supported by the National Institute on Drug Abuse, describes innovative programs being implemented, and synthesizes the current literature on various topics in the field.

Brown, J. M., Council, C. L., Penne, M. A., Gfroerer, J. C. (2005). Immigrants and Substance Use: Findings from the 1999-2001 National Survey on Drug Use and Health. (DHHS Publication No. SMA 04-3909, Analytic Series A-23). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

This report presents information on the prevalence of alcohol, tobacco, and illicit drug use among immigrants aged 18 or older in the United States during 1999-2001. The report is organized by immigrant groups from similar background but also provides disaggregated data for several specific ethnicities. Immigrants from the following Asian countries were included in the analysis: Japan, Korea, Philippines, China, Vietnam, and India.

Available at www.drugabusestatistics.samhsa.gov/immigrants/immigrants.pdf.

Buka, S. (2002). Disparities in Health Status and Substance Use: Ethnicity and Socioeconomic Factors. Public Health Reports, 117.

Reviews the literature on racial, ethnic, and socioeconomic disparities in morbidity and mortality, focusing on substance use and abuse. Among the conclusions are that racial and ethnic differences in health and health behaviors are likely to be by socioeconomic differences, cultural factors, and prejudice and discrimination, both institutional and individual.

Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States, 2003. May 21, 2004. MMWR 2004:53 (No. SS-2).

The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults - behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity - plus overweight. YRBSS includes a national school-based survey conducted by CDC as well as state and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 32 state surveys, and 18 local surveys conducted among students in grades 9-12 from February through December 2003.

This publication is available online at www.cdc.gov/HealthyYouth/yrbs/index.htm. Available at the Los Angeles office NAPAFASA resource library.

Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2003). Monitoring the Future: National Survey Results on Drug Use, 1975-2003: Volume I, Secondary school students. (NIH Publication No. 04-5507). Bethesda, MD: National Institute on Drug Abuse.

Monitoring the Future is an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, a total of some 50,000 8th, 10th and 12th grade students are surveyed (12th graders since 1975, and 8th and 10th graders since 1991). In addition, annual follow-up questionnaires are mailed to a sample of each graduating class for a number of years after their initial participation.

This publication is available online at www.monitoringthefuture.org/pubs/monographs/vol1_2003.pdf.

Ma, G. X. & Henderson, G., eds. (2002). Ethnicity and Substance Abuse. Charles C. Thomas Publisher, LTD.

This book offers an interdisciplinary approach to understanding drug abuse problems within the U.S. ethnic minority community, including African American, Asian Pacific American, Hispanics, and Native Americans.

The three main objectives of this book are: (1) to make care providers aware of cultural factors that affect substance abuse and cessation; (2) to review multidisciplinary research studies in order to ascertain helpful and unhelpful health care practices; and (3) to provide practical suggestions for improving community-wide substance prevention and intervention programs.

Chapters specifically devoted to Asian Pacific Islander Americans include:

Substance Abuse Among Southeast Asians in the U.S.: Implications for Practice and Research
Treating Southeast Asian Immigrants: Miem Opium Users in California
Smoking Prevention and Intervention in Asian American Communities: A Case Study

Available at the Los Angeles office NAPAFASA resource library.

Partnership for a Drug Free America. (2000). Inhalant Abuse Research Report. New York: Partnership for a Drug Free America.

The goal of this study is to update understanding and knowledge of inhalant abuse among adolescents through 810 personal interviews in 31 geographically dispersed markets. Particularly, the study asks if there is still a need to inform youth and parents of risks associated with inhalant abuse and looking at differences in attitudes and understanding on inhalant abuse by race and ethnicity.

Available at the Los Angeles office NAPAFASA resource library.

Schwartz, W. (1997). Smoking Prevention Strategies for Urban and Minority Youth. ERIC Clearinghouse on Urban Education: New York.

Adolescents living in disadvantaged urban areas suffer from many of the stresses shown to increase tobacco use. Most strategies developed for anti-tobacco campaigns are most effective with white, middle-class adolescents. This digest discusses various initiatives being taken to create new prevention strategies specifically targeting urban and minority youths.

This digest is available at www.ericdigests.org/1998-1/smoking.htm.

Substance Abuse Studies & Reports - Asian Americans and Pacific Islanders

Joe, K. A. (1996). The Lives and Times of Asian-Pacific American Women Drug Users: An Ethnographic Study of Their Methamphetamine Use. Journal of Drug Issues, 26(1): 199-218.

Although Asian-Pacific Islander Americans (APIA) have a long history in American society and represent the fastest growing minority group, they remain a relatively unknown and obscure population. While ethnic myths about Asian women continue to persist, the complexities of the lives of APIA women remain a mystery. This article represents the first ethnographic account of APIA women drug users, and specifically explores their onset and patterns of drug use and coping strategies in relation to the competing cultural claims on their lives.

Availability: Journal of Drug Issues, P.O. Box 4021, Tallahassee, FL 32303

National Institute on Drug Abuse. Drug Abuse Among Racial/Ethnic Minorities.

The purpose of this valuable report is to provide policymakers, program leaders and staff, health administrators, scientists, and others with information that may help them understand the nature and extent of illegal drug use, associated behaviors, and problems that now affect our Nation's racial/ethnic minority populations and the current non-Hispanic White majority population. Its content has been culled from the best and most recent reports on these topics.

Download the report here.

Kwon, H. T., Wang, Q. W., & Valmidiano, L. L. (2005). Risk Behaviors Associated with Cigarette Use Among Asian American Adolescents. The International Electronic Journal of Health Education, 8: 11-17.

Asian Americans are one of the fastest growing minority groups in the United States. This study examined the association between several common youth risk behaviors, including cigarette use among Asian American adolescents, using data (N=408) from the 2001 Youth Risk Behavior Survey (YRBS). The weighted univariate and multivariate logistic regression analyses were performed with Survey Data Analysis (SUDAAN) to adjust the standard error estimate of the multistage sampling. The main outcome variable was cigarette smoking behavior (past 30 days), reported as a binary (dichotomous) variable. The significant predictors from the univariate model were alcohol use, marijuana use, academic grades, multiple sex partners, and weight (p<.01). The multivariate logistic regression revealed that Asian American adolescents who engaged in alcohol use (OR=10.43, 95% CI=5.02, 21.68), used marijuana (OR=4.90, 95% CI=1.91, 12.59), and had mostly C or lower academic grades (OR=5.86, 95% CI=2.66, 12.90) were more likely to report cigarette use. Common risk factors and adolescent behaviors play a role in cigarette use, and this information can be applied in developing health education programs for Asian American high school students.

A copy of the study is available at the NAPAFASA resource library.

Sakai, J. (2005). Asians in the United States: Substance Dependence and Use of Substance-Dependence Treatment. Journal of Substance Abuse Treatment, 29.

Clinicians have often observed that Asians are unlikely to utilize substance-dependence treatment services but few have reported empirical data examining this phenomenon. This study used data from the National Household Survey on Drug Abuse, 2000-2002, and tested whether Asians in the United States have relatively low rates of drug and alcohol dependence and whether substance-dependent Asians use treatment services less than Caucasians. Subsequent analyses were undertaken to identify factors that explained these racial differences. Of the 5,118 Asians, 159 met criteria for past-year drug or alcohol dependence. Asians with past-year substance dependence were significantly less likely than substance-dependent Caucasians to report past-year treatment (odds ratio 0.42, 95% confidence interval 0.19-0.96). Differences in past-year substance-dependence prevalence appear to be partially explained by between-group differences in ever using substances; differences in past-year treatment use appear to be in part related to differences in levels of acculturation and education.

A copy of the complete article is available at the NAPAFASA resource library.

Asians and Pacific Islanders in substance abuse treatment. (2005, June 10). The DASIS Report.

This report details API admissions into substance abuse treatment programs in 2002. Data on primary substance abused, route of substance abuse administration, demographic and socioeconomic characteristics are included. Data on API subgroups are not included.

Some main findings include:

"Asian/Pacific Islander admissions were more likely than all other admissions to go into treatment for either marijuana or methamphetamine/amphetamine."
"The mean age of admissions was slightly younger for API admissions (30 years old) compared to all other admission (34 years old)."
"Just over one third (38%) of API admissions had no health insurance compared to almost two thirds (61%) of all other admissions."

This publication is available online at www.oas.samhsa.gov/2k5/AsianTX/AsianTX.htm. Available at the Los Angeles office NAPAFASA resource library.

Wong, M. M., Klingle, R. S., & Price, R. K. (2004). Alcohol, Tobacco, and Other Drug Use among Asian American and Pacific Islander Adolescents in California and Hawaii. Addictive Behaviors, 29(1): 127-141.

As an aggregate group, the lowest rates of alcohol, tobacco, and other drug (ATOD) use are often reported for Asian Americans/Pacific Islanders (AAPIs), compared to other groups. However, the low rates are often based upon samples with small numbers of AAPIs or samples including only one or two AAPI groups. Consequently, reliable data on the rates of ATOD use among specific AAPI subgroups are severely lacking.

This article used data from school surveys collected from 9th grade students in California and 10th grade students in Hawaii and compared the ATOD rates of Whites, Chinese, Filipino, Japanese, and Pacific Islander/Native Hawaiian adolescents. Considerable variation in ATOD rates among subgroups of AAPIs was consistently found across the surveys. The article discusses the implications for these findings and recommendations for future research are discussed.

The abstract and full text of this article is available here.

Price, R. K., Risk, N., Wong, M., & Klingle, R. S. (2002). Substance Use and Abuse by Asian Americans and Pacific Islanders: Preliminary Results From Four National Epidemiologic Studies. Public Health Reports, 117.

Provides an analysis of four recent large national surveys to assess the degree of use and abuse of a wide range of psychoactive substances among subgroups of Asian Americans and Pacific Islanders (AAPIs) and in comparison with whites.

Subscriptions to Public Health Reports* can be made online at phr.oupjournals.org or at the Elservier website here. Available at the Los Angeles office NAPAFASA resource library.

Asians and Pacific Islanders in Substance Abuse Treatment: 1999. (2002, August 16). The DASIS Report.

This report details API admissions into substance abuse treatment programs between 1994 and 1999. Data is disagreggated by age, gender, referral source, and primary substance abused. Data on API subgroups are not included.

This publication is available online at www.oas.samhsa.gov/2k2/AsiansallTX/AsiansallTX.cfm. Available at the Los Angeles office NAPAFASA resource library.

Substance Abuse Reports - Ethnic Specific

Amodeo, M., Peou, S., Grigg-Saito, D., Berke, H., Pin-Riebe, S., & Jones, L. (2004). Providing Culturally Specific Substance Abuse Services in Refugee and Immigrant Communities: Lessons from a Cambodian Treatment and Demonstration Project. Journal of Social Work Practice in the Addictions, 4(3).

Several agencies interested in serving Cambodian immigrants established a substance abuse treatment demonstration project which included culturally specific elements such as co-therapy done by a bilingual, bicultural Cambodian worker and a mainstream American social worker; formation of an advisory committee with Cambodian members; home visiting and family involvement; emphasis on traditional cultural values as motivators; integration of Buddhist philosophy; and use of acupuncture for detoxification. In spite of careful planning and several program accomplishments, the program initially received few client referrals. A fact-finding process revealed several barriers, including stigmatization of substance abuse and few Cambodian providers with substance abuse training. Case vignettes and organizational and clinical recommendations are provided for community leaders and advisory groups working with other low-incidence refugee and immigrant populations.

A copy of the article is available at the NAPAFASA Resource Library.

D'Avanzo, C., Frye, B., & Froman, R. (1994). Culture, Stress, and Substance Use in Cambodian Refugee Women. Journal of Studies on Alcohol, 55: 420-426.

Focuses on the use of alcohol and other drugs by Cambodian refugee women and their families in Massachussetts and California. The purpose of the study is to generate initial data within this group on substance abuse topics such as frequency of use, situations surrounding use, and culturally specific substance use.

Subscriptions to Journal of Studies on Alcohol* can be made online at www.rci.rutgers.edu/%7Ecas2/journal/subscribe.html. Available at the Los Angeles office NAPAFASA resource library.

Hanipale, F., & Whitney, S. "Feeling Strong": Themes in Samoan Drinking and Recovery. Pago Pago, American Samoa: Social Services Division, Department of Human Resources, Government of American Samoa.

This study looks at the thematic content in Samoan views about over-drinking and its results. By looking at the form and meaning of such cultural behaviors and beliefs about alcohol, the authors hope to reveal the necessary clues to help address the damage which over-drinking can cause.

Available at the Los Angeles office NAPAFASA resource library.

Patel, S. (2001). Substance Abuse in the South Asian Context in the United States. South Asian Public Health Association.

An examination of the widespread complexity of substance abuse in the United States with a focus on underlying barriers and implications faced by South Asians at-risk for substance abuse.

Includes an examination of epidemiological studies, organizational efforts to address substance abuse, identification of risk factors, assessment of cultural factors, as well as an offering of culturally appropriate recommendations.

Publication can be ordered for $25 for the first copy and $15 for additional copies at www.sapha.net/bporder.htm. Available at the Los Angeles office NAPAFASA resource library.

U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention. (1999). Responding to Pacific Islanders: Culturally Competent Perspectives for Substance Abuse Prevention (DHHS Publication No. (SMA)98-3195).

Dedicated exclusively to health issues affecting Pacific Islanders, this publication focuses on the concept of cultural accessibility as a tool to evaluate how well health services respond to the unique needs of the Pacific Islander community. The volume also addresses programs that link culturally appropriate healing strategies with complementary and alternative health practices.

This publication can be ordered at no charge online at store.health.org/catalog/productDetails.aspx?ProductID=15438. Available at the Los Angeles office NAPAFASA resource library.

Workman, R., Pinhey, T., & Perez, M. (1998). In Pursuit of Happiness: A Study of Substance Use Among Guam High School Youth. Mangilao, Guam: University of Guam.

This study is meant to provide empirical evidence and documentation of substance abuse patterns among high school youth in Guam. The report presents the result of a survey of Guam's high school students which examines their use of various drugs and to examine the association of their use patterns with their knowledge and perceptions of various forms of physical violence.

Available at the Los Angeles office NAPAFASA resource library.

Dual Diagnosis

Tsuang, J., Fong, T. W., & Lesser, I. Psychosocial Treatment of Patients with Schizophrenia and Substance Abuse Disorders.

Substance abuse among patients with schizophrenia is quite common, with at least half of these individuals having a lifetime diagnosis of a substance abuse disorder. These so called "dual diagnosis" or "co-occurring disorder" patients have an increased utilization of medical and psychiatric services. They are more difficult to treat and usually have a worse prognosis as compared with nonsubstance abusing patients with schizophrenia. Fortunately, in recent years, the treatment of dually diagnosed patients has significantly improved. It has been established that the best treatment of these patients includes enrollment in an integrated program that treats both mental illness and substance abuse problems simultaneously. Previously, we published an article that reviewed the available psychopharmacological options for treatment of co-occurring disorder patients. This article will focus more on the psychosocial treatment modalities that have been used to reduce the psychiatric morbidity and substance relapse in these patients.

A copy of the article is available online, courtesy of NAPAFASA.

Mental Health Issues

Addressing Stigma in Culturally Diverse Communities (August 20, 2003): A teleconference of the Resource Center to Address Discrimination and Stigma, a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

This powerpoint presentation addresses the mental health problems that can emerge as a result of discrimination and stigma in certain ethnic communities. The speakers were:

Henry Acosta, M.A., M.S.W., L.S.W., Project Director, Changing Minds, Advancing Mental Health for Hispanics
D.J. Ida, Ph.D., Executive Director, National Asian American Pacific Islander Mental Health Association
Laurene Finley, Ph.D., Multicultural Training and Research Institute, Temple University

The presentation is divided into three sections: Hispanics, Asian American Pacific Islanders (AAPI), and African Americans. For each section, there is a background on demographics, followed by information about challenges faced by that group, such as underutilization of mental health services and language barriers. Finally, each section ends with recommendations and goals for helping that group overcome the mental health issues associated with discrimination and stigma. The full presentation is available by clicking here.

Additional archived teleconferences/trainings on the topic of stigma and mental health are available by clicking here.

Problem Gambling

Lee, B. Chinese Playground: A Memoir.

"This stark and unsentimental recollection of childhood and coming of age in the back alleys and bustling streets of San Francisco's Chinatown reveals the sinister and pervasive influences of organized crime. Delivering an almost casual expose into the underworld of an urban Chinatown, Chinese Playground: A Memoir traces author Bill Lee's maturation from innocent child in a troubled family to a street punk, gang member, and college graduate struggling to break free of his involvement in escalating violence. In a dark journey spanning forty years, Lee fights an ongoing battle against relentless childhood demons and nightmares, acknowledging a spiritual guardian throughout his life, ultimately coming to terms with his past and peace with himself.

A moving look at the murky histories of Lee's parents -- both Chinese immigrants -- adds depth to this story and poignantly points to typical family dysfunctions that contribute to confusion, fear and aggression in young people. The author's early recollections are seen through the eyes of an innocent boy who was nearly aborted and sold away. As a young gang member, his pain and fears are hidden beneath a tough, macho facade as he contends with gambling, drugs, extortion and murder. Entering adulthood, Lee's street savvy and dark view of the world manifests itself into an aggressive, win-at-any-costs attitude which he unleashes in Silicon Valley. Lee faces his biggest challenge when he returns to the streets of Chinatown in search of his runaway son and confronts his own dark past. Lee's determination to nurture his soul and transform his life is inspiring." - taken from the book cover

Lee, B. Born to Lose: Memoirs of a Compulsive Gambler.

Second generation Chinese-American Bill Lee was living the American dream. He had a successful career as a corporate headhunter, bank accounts overflowing with money, and a perfect son who adored him. In just a few short years, he lost it all. Born to Lose starts before Mr. Lee was even born, with the story of his grandfather who was sold into slavery to settle family gambling debts. Chronicling the violent and oppressive history of his family, we see that Mr. Lee truly was "born to lose," destined to suffer from a gambling addiction that had affected so many members of his family in the generations before.

We see Mr. Lee as a young kid: winning money from other kids in school yard card games, then losing it in turn to older kids. We see him playing the stock market as a young professional and ultimately succumbing to the lure of casinos from Las Vegas to Reno. For people who fail to see compulsive gambling as a "real" addiction, this book serves as a harsh reminder of the ways in which gambling can destroy people's lives. As Mr. Lee navigates the world of problem gambling, attending a variety of meetings of Gamblers Anonymous (GA), we are exposed to the stories of many individuals who lost everything they had because they could not resist the temptation to put it all on the line.

In the end, this is a book about taking responsibility. Mr. Lee makes several attempts at ending his addiction through participation in GA. However, these attempts continually fail as a result of his determination to maintain control of his own life, to deal with his recovery on his own terms. It is only when he makes serious changes in his lifestyle, such as changing careers, and makes an effort to take GA seriously (instead of just going through the motions), that he is able to truly face his addiction. This message of addiction, failure, and redemption, is inspiring to people suffering from all addictions, not just gambling.

Slutske, W. S., Caspi, A., Moffitt, T. E., & Poulton, R. (2005). Personality and Problem Gambling: A Prospective Study of a Birth Cohort of Young Adults. Archives of General Psychiatry, 62: 769-775.

This study compared the personality traits of problem gamblers with individuals with alcohol or other drug addictions. Researchers performed personality assessments on about 1,000 18-year-olds from New Zealand and focused on results from those who had been diagnosed with gambling addiction and three types of substance abuse disorders. After cross-referencing with 10 basic personality variants, they found that the personality profiles for the gamblers and addicts were very similar.

The findings may help explain the relationship between problem gambling and other addictive disorders, as well as providing clues for the development of better treatments for these problems.

Available at archpsyc.ama-assn.org/cgi/content/abstract/62/7/769.

Levens, S., Dyer, A. M., Zubritsky, C., Knott, K., & Oslin, D. W. (2005). Gambling Among Older, Primary-Care Patients. American Journal of Geriatric Psychiatry, 13: 69-76.

This study reported that some older Americans may be at-risk gamblers who are prone to betting more money than they can afford. Of the 843 people aged 65 or older that were interviewed, 70 percent had been involved in at least one gambling activity within the previous year. Eleven percent could be classified as at-risk gamblers. Women were also found to be just as likely as men to be gamblers and to show signs of gambling problems.

Available at ajgp.psychiatryonline.org/cgi/content/full/13/1/69.

Skolnik, S. (2004). Deck Stacked Against Asians; Casinos Play Off Gambling-Intensive Culture. Seattle Post-Intelligencer.

This article explores the relationship between Asian culture and compulsive gambling. While alcohol or drug use may be frowned upon in the Asian community, in many parts of Asia, gambling is a deeply ingrained social activity. This acceptance is especially strong in recent immigrants. Casinos are aware of their market and employ several devices to attract Asian customers, including bilingual employees, Asian-themed holiday celebrations, Asian popular musical acts, Asian restaurants, and free bus services from popular Asian ethnic enclaves.

For the full article, click here.

Zander, D. B. (1996). A Report on the Effects of Problem Gambling on Southeast Asian Families and Their Adjustments to Life in Minnesota: Report and Recommendations.

This exploratory field study by the Council on Asian-Pacific Minnesotans found that the problem of compulsive gambling is affecting significant numbers of families and children. The report discusses the ways treatment needs to be implemented in a more culturally sensitive way. It concludes with a set of recommendations that would strengthen the work of the Mutual Assistance Associations in coping with the identified compulsive gambling problems at a community level. These include:

Funding bilingual preventative education materials such as brochures and videos in Southeast Asian languages
Making funds available for training bilingual and culturally sensitive staff to take compulsive gambling in-service training
Funding key Southeast Asian organizations to run prevention and intervention programs

Available at the Los Angeles office NAPAFASA resource library.

Asian Americans and Pacific Islanders Demographics

Asian Pacific American Legal Center. (2005). The Diverse Face of Asians and Pacific Islanders in California: Asian & Pacific Islander Demographic Profile.

This report is a fourth in a series of demographic reports on Asians and Pacific Islanders in the state of California. The report uses disaggregated Census 2000 data to provide information on 20 API ethnic groups, including indicators on socioeconomic status, education, housing, language, and immigration.

This report in particular focuses on 3 regions of California: Southern California, the Central Valley and the Bay area. The California report is produced by the Asian Pacific American Legal Center, in conjunction with the Asian Law Caucus and the National Asian Pacific American Legal Consortium.

Available at demographics.apalc.org/.

Dela Cruz, M., & Patraporn, R. V. (2004). Socioeconomic Status of Asians in Los Angeles County: A Closer Examination of Chinese, South Asian, and Thai Populations.

This report provides data and analysis about homeownership status of various Asian ethnic groups. It includes information about housing within specific neighborhoods in Los Angeles County. The research findings reveal critical information that can assist community, housing and policy advocates in identifying issues and concerns that can improve programs to serve the Asian American community well and effectively.

This study was conducted as a collaboration between the Asian American Studies Center (www.sscnet.ucla.edu/aasc) and the Ralph and Goldy Lewis Center for Regional Policy Studies Center (lewis.sppsr.ucla.edu) at the University of California, Los Angeles. To request copies of the publication, please see their websites for inquiry.

Available at the Los Angeles office NAPAFASA resource library.

Lai, E., & Arguelles, D., eds. (2003). The New Face of Asian Pacific America: Numbers, Diversity & Change in the 21st Century.

This publication is the most comprehensive, up-to-date analysis of demographic and cultural changes of Asian Pacific America and includes the latest census information. Through informative essays and over 100 photos, charts, and graphics, this book provides the first analysis of census socioeconomic data on the Asian Pacific American population and the first demographic analysis of the fast-growing mixed race/ethnicity population in the Asian Pacific American community.

Purchase available online at www.asianweek.com/census/census_home.html. Available at the Los Angeles office NAPAFASA resource library.

Leadership Education for Asian Pacifics, Inc. (LEAP). (2008). The State of Asian America: Trajectory of Civic and Political Engagement.

LEAP's report seeks to provide community activists, policymakers and researchers with a road map for Asian American civic engagement in two crucial ways: first, help readers understand what the future might hold for Asian American civic engagement; and second, stimulate and focus discussion on possible ways to intervene to take advantage of potential opportunities and to meet new challenges.

Available at www.leap.org/inform_ppi_downloads.html.

Southeast Asian Resource Action Center (SEARAC). (2004). Not the "Model Minority": 2000 Census Reveals Achievement Gaps, and Signs of Hope for Americans from Cambodia, Laos, and Vietnam.

According to the 2000 Census, Americans from some Asian backgrounds - for example, people from Cambodia and Laos - are significantly less likely than most other Americans to hold college degrees, more likely to have had no formal education, and more likely to live in poverty. However, the communities are quickly progressing in these and other areas. SEARAC, a national organization for Americans from Cambodia, Laos, and Vietnam, has just released statistics from the 2000 Census and other sources detailing its community's profile. The report is accessible on the internet at www.searac.org/new.html.

Southeast Asia Resource Action Center (SEARAC). (2003). Southeast Asian American Elders in California: Demographics and Service Priorities Revealed by the 2000 Census and a Survey of Mutual Assistance Association (MAAs) and Faith-Based Organizations (FBOs).

Through an analysis of 2000 Census results and the findings from a survey of Mutual Assistance Associations (MAAs) and Faith-Based Organizations (FBOs) in California, this report provides a baseline for further study as well as guidance for policymakers and grant makers who work with Southeast Asian American elders.

Available at www.searac.org/sea-eldersrpt-fin.pdf.

Multimedia Resources

Prevention Communication Research Database

The Prevention Communication Research Database is a searchable collection of audience research conducted or sponsored by HHS agencies and designed to provide access to research findings that may not be widely known or published in peer-reviewed journals.

There are several reports addressing API and/or substance abuse issues, including:

Addressing Cardiovascular Health in Asian Americans and Pacific Islanders: A Background Report
Anti-Drug Research: Topline Report
High-Risk Drinking in College: What We Know and What We Need to Learn: Final Report
Knowledge, Attitudes, and Behavior of Immigrant Asian American Women Ages 40 and Older Regarding Breast Cancer and Mammography Screening
Review of Literature and Secondary Research on Generation Y - Lessons to Apply in the Development of a Youth-targeted CDC Web Site

The database can be accessed at www.health.gov/communication.

Making Your Model Program Culturally Appropriate

This presentation discusses how model programs can be successfully implemented with target populations for which they were not originally designed. Additionally, it discusses the importance of selecting appropriate models that match the community needs in terms of target population, appropriate settings, community climate and culture. It explores issues such as:

Identifying and selecting programs that address cultural diversity within your target population.
How to stay true to a proven model program when adapting it for different audiences and settings?
What are the benefits and costs of making these changes?
Under what conditions do adaptations work best or not at all?

This presentation is available as a webcast at www.ncadi.samhsa.gov/multimedia/webcasts/w.aspx?ID=265. To order a video of this broadcast, visit www.mctft.com.

Media Campaign Resource Center (MCRC)

MCRC, a service of the Centers for Disease Control and Prevention's Office on Smoking and Health, offers tobacco control and prevention advertisements.

A list of free TV, radio, print, and outdoor advertisements, available for a small duplication fee (e.g., $5-25) from MCRC can be found at www.cdc.gov/tobacco/MCRC/nofees.htm. All other MCRC advertisements can be found at www.cdc.gov/tobacco/MCRC. Many advertisements are available in various languages. Call 770-488-5705, option 2 or e-mail mcrc@cdc.gov to order free ads or discuss specifics.

The Office on Smoking and Health offers other materials useful for educators and students. To order these materials (including posters and kits on media literacy and anti-smoking messages), call 770-488-5705, option 3 or e-mail tobaccoinfo@cdc.gov.

National Youth Anti-Drug Media Campaign

The National Youth Anti-Drug Media Campaign was established in 1998 through the White House Office of National Drug Control Policy. The Campaign targets youth ages 9-18 - especially the vulnerable middle-school adolescents - their parents, and other adults who influence the choices young people make.

The website offers media tools targeting youth and their parents. Preview of the material and information on how to obtain them can be found at www.mediacampaign.org.

Substance Abuse Prevention Curriculum Guide

This web-based guide provides resources for developing as substance abuse curriculum targeting youths. The guide has 3 components:

A Resource Library with detailed information on more than 1,000 interactive activities and materials (available for free or for marginal costs)
The free Substance Abuse and Prevention Handbook, which provides a summary of current research on substance abuse prevention and guidelines for needs assessment and curriculum building.
The Curriculum Builder, a step-by-step process of assessing your needs and selecting appropriate activities and materials.

This guide can be accessed at www.preventioncurriculum.com or by calling 1-800-544-5921.

API Language Materials

National Clearinghouse for Alcohol and Drug Information - Asian Language Lines for Material Request

SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI) is the Nation's one-stop resource for information about substance abuse prevention and addiction treatment.

You may request materials in several Asian languages using the telephone numbers below:

Cambodian (888) 258-3145
Chinese (Cantonese) (888) 258-3139
Chinese (Mandarin) (888) 258-3144
Korean (888) 258-3137
Vietnamese (888) 258-3138

A Network of Care and Supports for Behavioral Health & Mental Retardation Services

A new website funded by the city of Philadelphia offers residents centralized access to information on addiction and mental-health treatment as well as news about policy decisions on these issues. The website is designed for both patients and care providers. The site is being billed as part of a campaign to eliminate racial disparities in health care and empower consumers of health services. In addition to providing information about various behavioral-health problems and where people can get help, the site allows users to create profiles and track their own medical information, such as doctors' contact information, drug dosages, and other data. The information is stored confidentially, although users can give others permission to view their health data online. The site is available in seven languages: English, Cambodian, Cantonese, Russian, Spanish, Tagalog, and Vietnamese.

Click here for the website.

Selected Patient Information Resources in Asian Languages (SPIRAL), 2005.

Tufts University's Health Sciences Library has developed health resources for Asian and Pacific Islander Americans whose first language is not English. The website (http://spiral.tufts.edu) provides detailed health information in Asian languages, specifically Chinese, Hmong, Khmer, Korean, Laotian, Thai and Vietnamese. It is a unique multi-language health information site because it is for both physicians and patients.

Segmented by language and by subject, a user - either a patient, doctor or other caregiver - can search for documents in an Asian language on topics such as asthma, diabetes, nutrition, substance abuse, SARS and HIV/AIDS. A native speaker of an Asian language would go to the main web site, select his/her language, and then search for the information that was needed.

Material is also provided in English so that an English-speaking physician or caregiver can see what patients are reading.

For more information, please go to spiral.tufts.edu.

Technical Assistance Project - Information for Staff

Key Terms to Understand

Chronic Care Model

The Chronic Care Model (CCM) was created by Dr. Ed Wagner of the MacColl Institute for Healthcare Innovation, Group Health Cooperative of Puget Sound. The CCM identifies the different systems in which chronic illnesses are treated, such as hospitals and families of chronically ill patients, and seeks to standardize the links between them. The goal is for patients and their primary caregivers to be informed about their own care, while provider teams are prepared and proactive. This is a contrast to the traditional model of managed care, in which patients, who are often uninformed about their own health care needs, are treated only after problems arise. By creating standard cooperation among systems of care, the CCM prevents problems from developing in the first place, while preparing for treatment in the event they do occur (Improving Chronic Illness Care, The Robert Wood Johnson Foundation). The CCM is important to the substance abuse treatment field because of the belief that substance abuse and dependence are chronic illnesses that must be continually monitored and treated for the lifetime of the patient. It is important for both patients and caregivers to recognize this. In its substance abuse field manifestation, the CCM is divided into six elements: community resources and policies, health care organization, self-management support, delivery system design, decision support, and clinical information systems (Thomas & McCarty, 2004). The CCM was first applied to the substance abuse treatment field when it was used to treat tobacco addiction in a study (Bodenheimer, Wagner, and Grumbach, 2002a, 2002b). For more information, refer to the ICIR website.

Institute of Medicine's Continuum of Care Model

The Institute of Medicine recognizes that addiction is a chronic disease, and thus should be treated like other chronic diseases through a continuum of treatments and social services. The Continuum of Care Model calls for the creation of networks of service providers which can cater to the diverse types of substance abusers. These networks of service are not limited to treatment facilities, but include prevention and intervention services, as well as recovery and relapse prevention services. To assist with relapse prevention, the networks are enlarged to include all agencies that support those in recovery, such as educational facilities, religious organizations, and housing agencies. The Continuum of Care Model has four key stages: identification, assessment, treatment, and ongoing recovery management. These four stages reflect the dedication to the entire continuum of substance abuse services, from universal prevention to recovery assistance (National Conference of State Legislatures). For more information, and explanations of the four key stages, click here.

Framework for Prevention of Alcohol and Drug Problems

The Framework for Prevention of Alcohol and Drug Problems is a document released by the California Department of Alcohol and Drug Programs (ADP) in 1991 to set forth the State's prevention policies and strategies. It states that prevention is a constantly evolving process, and that prevention programs should encompass multiple community interests (White House Office of National Drug Control Policy). Additionally, the framework affirms CSAP's six strategies for prevention (a list of the strategies and their explanations can be found here). This framework is important to service providers because it provides them with established strategies around which to base their prevention programs. It is useful to organizations just starting prevention programs in need of ideas, as well as established prevention programs that simply need minor adjustments. A copy of the framework will be available in the NAPAFASA resource library. Additional information about the framework and ADP prevention practices can be found here and here. In 1998, ADP held a prevention summit, which resulted in the revised version of the document which is called The California Prevention Platform - A Framework for the Future. This document sets forth a series of eight "planks," which are steps that California should take in order to revitalize prevention efforts (California ADP). These "plans" are:

Create a Representative Statewide Prevention Collaborative
Assert State Leadership with a Prevention Services Division
Incorporate a Youth-Development Model into Prevention and Actively Engage Youth in the Decision-Making Process
Ground California State ATOD Policies in Research-Based Strategies and Programs within a Results-Based System
Move Toward Professional Standards in the Field of Prevention by Developing Core Curriculum and Training Programs
Maintain and Expand, as Appropriate, Contracts to Provide Technical Assistance
Ensure Appropriate Utilization of Block Grant Prevention Sources
Convene an Annual Prevention Training Summit

The full text of the prevention platform can be found here.

*If back issues are not available, this publication is available at the Los Angeles office NAPAFASA resource library.

Home | Site Map | Search | Contact Us