The development and implementation of various drug treatment programs has always been the topic of the major professional concern. While thousands of medical professionals seek to prove the relevance of universal treatment programs and their positive influence on drug treatment outcomes, the issues of culture, ethnicity, and gender are still overlooked.
More often than not, drug treatment programs are limited to medicine and environment, with minor attention paid to how the cultural and ethnic backgrounds of program participants might influence program effectiveness and help individuals with diverse individuals resolve their drug abuse problems.
Given the relevance of cultural factors and their potential impact on how drug abusers perceive and approach different treatment programs, ethnic and cultural differences should be included into the list of critical drug treatment variables, with ethnicity and racial backgrounds being the integral components of successful drug treatment programs and long-term recovery. 12-Step Program participation and effectiveness: Review of findings In their article, Hillhouse and Fiorentine (2001) discuss the importance of gender and ethnic differences in a 12-step drug treatment program, and their impact on the program participation and effectiveness.
The authors assert that “although 12-Step is increasingly utilized as a recovery resource and is viewed by many addiction specialists as an integral component of treatment and long-term recovery”, questions regarding the role of ethnicity and gender in these programs are still unresolved (Hillhouse & Fiorentine, 2001). It is obvious that 12-Step programs are designed in a way, which make participation in them easy, beneficial, and effective; as such, the number of attendees in these programs and the level of integrating 12-Step programs with conventional drug treatment initiatives constantly grow (Hillhouse & Fiorentine, 2001).
However, it is still unclear whether 12-Step programs are equally effective for participants with diverse cultural and ethnic backgrounds. By recruiting a group of clients from 26 outpatient drug treatment programs, the researchers have come to conclude that 12-Step programs are equally effective for European-Americans and those from ethnic minorities; although there are documented differences, which turn ethnicity and gender into important drug treatment variables, Hillhouse and Fiorentine (2001) show 12-Step programs as a resource equally important to everyone due to the open-door policy, which these programs usually exercise.
As a result, the major problem to solve is about the real place of culture in drug treatment programs. Given the relevance of cultural variables and their impact on drug treatment outcomes, it is very probable that open-door policies will not suffice to help minority populations overcome the difficulties on their way to long-term recovery. The role of culture in drug treatment: Issues, benefits, and ramifications When it comes to the role and place of culture in drug treatment and the potential effect of ethnicity considerations on the effectiveness of drug treatment programs and long-term recovery, several issues require special attention.
First, researchers in psychology of drug abuse and drug treatment do recognize the difficulties, differences, and confusions in the current definition of culture and ethnicity in the context of drug treatment. Even if they are able to identify the clear boundaries of culture and ethnicity, they often fail to see that “in any ethnic group there is usually significant heterogeneity, reflective diversity on a wide range of economic, social, political, cultural, and regional indices” (Turner 2000, p. 288). Durrant and Thakker (2003) write that the patterns of drug use vary between different ethnic groups.
These differences are not limited to the prevalence rates, which are the highest among Native Americans and African Americans, and even if Caucasians are reported to be more than twice likely as Asians to report illicit drug use (Durrant & Thakker, 2003), the differences in drug use patterns are much more complicated. Very often, to have an open-door policy is not enough to attract potential participants who, for various cultural and ethnic reasons cannot overcome numerous barriers on their way to long-term recovery.
Unfortunately, “little culturally-focused case conceptualization and research has been conducted to examine substance abuse treatment outcomes as these may be influenced by cultural variables” (Castro & Alarcon 2002, p. 791). In the context of culture and its impact on drug treatment programs, the potential ramifications of not resolving the issue and the potential benefits of addressing these cultural inconsistencies are clear. The lack of cultural consciousness in drug treatment is likely to result in the deteriorating quality of drug treatment programs.
That psychologists and drug treatment professionals cannot adjust their drug treatment programs to the cultural beliefs and norms of program participants means that they reduce participants’ chances for long-term recovery. The impact of culture on drug treatment is significant, and by taking into account cultural factors and considerations, psychologists and drug treatment professionals will help minority individuals overcome the obstacles they may face on their to participating in these programs; they will also help minority men and women to grasp the meaning of these programs and to perceive the benefits of these programs to the fullest.
Culture and Drug Treatment: Potential Solutions Although Hillhouse and Fiorentine (2001) confirm the similarities in participation and effectiveness of 12-Step programs on different ethnic groups, culture remains one of the determining factors in the success of drug treatment. Certainly, given the multitude of cultural predispositions and patterns of drug use, it is simply impossible to develop drug treatment programs which will address each and every racial/ ethnic profile, but it is possible to include culture into the list of critical drug treatment variables.
Professionals in drug treatment should be familiar with the results of the most recent findings regarding the role of ethnicity and culture in drug treatment. Turner (2000) is correct in that “mainstream investigators often overlook the wealth of knowledge that is available from small scale studies” (p. 299). With the aim to prevent and reduce drug abuse among minority populations, psychologists and investigators should have a good knowledge of diversity and culture, which will be used to develop conceptual models of drug treatment in minor populations.
Finally, culturally specific interventions should become a viable alternative to the programs that were developed to target broad population groups – in this way, psychologists and drug treatment professionals will be more likely to address the most serious and the most complex risk factors characteristic of particular minority groups. As such, only by integrating cultural variables with conventional drug treatment programs will investigators and other professionals succeed to improve the overall effectiveness of these programs among minority population groups.
Conclusion In the process of developing, implementing, and improving drug treatment programs, culture is often overlooked. Despite the growing wealth of literature regarding the role and the impact of cultural variables on the quality of drug treatment among minority populations, culture in drug treatment remains a problem. In their article, Hillhouse and Fiorentine (2001) confirm the similarity of effectiveness and participation in 12-step programs among ethnic minorities, but that does not mean that culture and drug treatment effectiveness are not interlinked.
More often than not, it is culture that can become a serious obstacle on one’s way to entering and participating in a drug treatment program. As such, culture should be included into the list of the critical drug treatment variables, and new culture-specific drug treatment interventions should become a viable alternative to conventional drug treatment programs that were designed to target majority populations. References Castro, F. G. & Alarcon, E. H. (2002). Integrating cultural variables into drug abuse
prevention and treatment with racial/ ethnic minorities. Journal of Drug Issues, 32 (3), 783-810. Durrant, R. & Thakker, J. (2003). Substance use & abuse: Cultural and historical perspectives. London: SAGE. Hillhouse, M. P. & Fiorentine, R. (2001). 12-Step program participation and effectiveness: Do gender and ethnic differences exist? Journal of Drug Issues, 31 (3), 767-780. Turner, W. L. (2000). Cultural considerations in family-based primary prevention programs in drug abuse. Journal of Primary Prevention, 21 (2), 285-303.