What is culture? One widely accepted definition is from Dr. Dwight Heath’s Culture and Substance Abuse, which observes:
"It is a system of patterns of belief and behavior that shape the worldview of the member of a society. As such, it serves as a guide for action, a cognitive map, and a grammar for behavior."
This article explores the role of cultural competence in addiction treatment. How might treatment vary with the person's ethnic or cultural background taken into consideration? Why is this the best approach? How can cultural sensitivity open the doors to more effective treatment?
How Does Culture Affect Addiction Treatment?
The medical and environmental factors tied to addiction are equally difficult to master in therapeutic settings. While medication-assisted therapies can ease withdrawal, psychosocial counseling can help address the stressors that led to addiction. Many of these stressors came from cultural factors that therapists must be sensitive to and compassionate toward.
Addiction has changed over time to reach into virtually every cultural subset from Appalachia to suburbia. Attitudes about addiction can be different based on these cultures. For example:
- Native Americans believe strongly that substance abuse is tied to the death of their traditional culture.
- One study suggests that a failure to assimilate into American culture has been tied to an increase in illegal drug use in Hispanics. Certainly, there are acculturative difficulties related to adapting to new cultures, but today there are more stresses related to discrimination and the fear of deportation than ever before.
- Teenagers struggling with cultural identity often turn to self-medicating as a form of stress reliever. Peer groups may encourage drug or alcohol use as part of the cultural norm.
Developing culturally appropriate addiction treatment programs may require a diverse set of treatment locations to reach the most vulnerable populations. For example, MinnPost published an article on a set of treatment centers designed specifically for the low-income African American community.
Developing a diverse network of peer counselors and creating culture-specific social media and traditional advertising will help extend a hand to all communities and cultures struggling with addiction.
An editorial in The St. Louis American pointed out the importance of providing a culturally supportive environment for addiction treatment:
"Because of the serious, life-and-death implications of opioid addiction and misuse, it is even more critical to use a culturally specific and relevant framework for developing campaigns that could effectively address these issues. Campaigns must also pay more than lip service to the social determinants of health and the many daunting disparities evident in low-income rural and urban communities. They must embrace trauma-informed strategies that reflect the daily realities of our most vulnerable populations."
The point is that addiction treatment must be culturally sensitive within the context of these and other issues affecting young and old, black, brown, and white, as well as gender, sexual orientation, and socioeconomic status. Addiction treatment providers must seek a better understanding of the differences that could potentially divide us in order to cast the widest safety net possible.
If you are a clinician looking for culturally sensitive care for your patients with substance use disorders, contact us to find out more about referring patients to our facilities.
