Substance use and treatment disparities among Asian Americans, Native Hawaiians, and Pacific Islanders: A systematic review

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Abstract

Background: The increasing relevance of substance use disorder (SUD) within the Asian American, Native Hawaiian, and Pacific Islander (AA&NH/PI) communities, particularly amidst rising anti-Asian hate incidents and the disproportionate health and economic challenges faced by the NH/PI community during the COVID-19 pandemic, underscores the urgency of understanding substance use patterns, treatment disparities, and outcomes. Methods: Following PRISMA guidelines, 37 out of 231 studies met the search criteria. Study characteristics, study datasets, substance use rates, SUD rates, treatment disparities, treatment quality, completion rates, and analyses disaggregated by the most specific AA&NH/PI ethnic group reported were examined. Results: Despite increased treatment admissions over the past two decades, AA&NH/PI remain underrepresented in treatment facilities and underutilize SUD care services. Treatment quality and completion rates are also lower among AA&NH/PI. Analyses that did not disaggregate AA and NHPI as distinct groups from each other or that presented aggregate data only within AA or NHPI as a whole were common, but available disaggregated analyses reveal variations in substance use and treatment disparities among ethnic groups. There is also a lack of research in exploring within-group disparities, including specific case of older adults and substance use. Conclusions: To address disparities in access to substance use treatment and improve outcomes for AA&NH/PI populations, targeted interventions and strategic data collection methods that capture diverse ethnic groups and languages are crucial. Acknowledging data bias and expanding data collection to encompass multiple languages are essential for fostering a more inclusive approach to addressing SUD among AA&NH/PI populations.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What works to prevent or reduce substance use among newcomer populations?

Very strong evidence suggests that culturally adapted and family-centered substance use programs can be effective in immigrant and minority adolescents. Incorporating some level of cultural adaptation into a substance use program (even just translating materials) is associated with more positive outcomes in minority adolescents than maintaining the original format of a program. Programs that either…

About this study

AGE: Adults

DIRECTION OF EVIDENCE: No evidence about impact

FULL TEXT AVAILABILITY: Free

HOST COUNTRY: United States

POPULATION: Other

STRENGTH OF EVIDENCE: No evidence about impact

TYPE OF STUDY: Systematic review

YEAR PUBLISHED: 2021

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