Diversity Issues in Substance Abuse Treatment and Researchlthough the term “diversity” is widely used, there is often no agree- A ment as to its meaning or how attention to diversity should be - erationalized within the context of programming or research. This text provides a foundation for the examination of such issues, with sugg- tions for the integration of various approaches into substance use tre- ment programs and research. The impetus for this work derived from multiple interactions over a period of several years with colleagues, s- dents, research participants, and community-based providers, who noted the frequent inattention paid to such concerns in the context of treatment and research, often despite an acknowledgment of a group’s particular historical legacy in the United States and the impact of that history on the initiationandprolongationofsubstanceusewithinaspeci?edcommunity, or the barriers to treatment that may have resulted. Chapter 1 de?nes what is meant by diversity through an examination ofrelatedterms,suchas“culture,”“ethnicity”“race,”“sex,”“gender,”and “sexual orientation. ” Clearly, this discussion does not and cannot re?ect all possible permutations of human existence that re?ect diversity. For instance, although the text does make mention of considerations related to religious differences and cognitive capacity, neither is highlighted as a separatetopic. Additionally,theemphasisonspeci?edgroupsisnotmeant to imply that other groups, such as Euro-Americans or heterosexual men, do not have concerns that may differ from those of other communities and that deserve consideration in the development and implementation of programs and research endeavors. However trite it may seem, one text cannot do it all. |
Contents
Introduction | 1 |
Barriers to Addressing Difference | 16 |
The Genetic Contribution to Addiction | 24 |
Use Abuse and Policy | 37 |
Use Abuse and Policy | 43 |
Use Abuse and Policy | 57 |
Use Abuse and Policy | 63 |
Race | 79 |
Historical and Cultural Context | 116 |
Considering the Historical and Cultural | 127 |
Queer Communities | 135 |
Diversity Issues in Treatment | 145 |
Developing CultureCentric Approaches | 153 |
Diversity Issues in Addiction and Treatment | 165 |
References | 175 |
| 223 | |
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acculturation addiction adolescents African-American alcohol Asians and Pacific associated attributed behavior believed berdache California cancer Census Centers for Disease characterized Chinese cigarettes Clinical coca cocaine context Control and Prevention culture area dependence Disease Control disorders diversity Drug Abuse drug courts effects ethnic factors federal female Grinspoon groups harm reduction Health Care Survey heroin Hispanic Hmong homosexuality illness immigration impact increased Indians individuals instance Institute of Medicine issues Japanese Johnson Journal Latino lesbian male marijuana mental health National Native Americans nicotine non-Hispanic whites Numerous one’s opium Pacific Islander participants patients percent physicians pregnancy prevalence prohibited Puerto Ricans race reported response result risk role sexual slaves smoking social substance abuse treatment suicide symptoms syndrome syphilis Takaki tion tobacco transsexuals treatment programs tuberculosis Tuskegee syphilis study U.S. population United various violence Wagenheim women York