Saving Face vs. Saving Lives

Substance abuse, drug addiction, chemical dependency, Substance Use Disorder…the way that addiction to substances have been labeled has changed over time, but what appears to have stayed the same is the stigma behind the labels.  For Asian and Pacific Islanders (API), this stigma takes it a step further as cultural norms of “saving face” prevent many from seeking the services needed to recover.  Many individuals and families affected in our communities suffer silently so that they do not bring shame to themselves and those around them.  But is saving face worth losing a life to addiction? I grew tired of saving face 14 years ago… I wanted to live.  I no longer wanted to look in the mirror and see a hollow shell of a person looking back.  I was someone who once had dreams, compassion, and hope. I lost all of that through my addiction to crystal meth. It was not until I had the courage to seek recovery that I found myself once again, actually, I found more than I ever dreamed of and I am hoping that I can encourage other API individuals and families to do the same.

            The current label being used is Substance Use Disorder (SUD) found within the Diagnostic and Statistical Manual of Mental Disorders 5th edition (American Psychiatric Association, 2013, p.483) and is described as “a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using substances despite significant substance-related problems.” For the purpose of this op-ed, I will use the term addiction which is more commonly understood by the general public. An estimated 4.6 percent of Asian Americans and 11.9 percent of Native Hawaiian/Pacific Islanders have an addiction to substances, but I often wonder if this prevalence rate is accurate as factors related to shame may influence underreporting. Research has shown that substance use prevalence rates have increased within the API population, US-born API have 3 times higher likelihood of using substances, and that API are the least likely group to seek professional help related to the problem.

The Model Minority Myth, cultural and language barriers, lack of resources, lack of awareness of the problem, and stigma make it difficult for API to seek treatment services. Many API media outlets focus on addiction as a criminal behavior and sensationalize the issue when a well-known celebrity is caught using substances and falls from grace.  This focus on punitive measures and public shaming does nothing but push those who need treatment services further into isolation.  Individuals and families attempt to hide the problem or begin to withdraw from their usual sources of support.  This is not a fight that they can overcome by keeping it in the family.  Stigma of having an addiction needs to be reduced, communities need to increase resources, and those affected by drug addiction need to speak up.

            How often do we talk about those who had the courage to seek help, recover, and then help others? When have we highlighted those individuals and families who have overcome addiction problems and continued to live successful and meaningful lives? Instead of focusing on all the ugliness of addiction, there needs to be some discussion and celebration around the resiliency developed through recovery.  I have been privileged to witness the transformation of individuals who find the courage and hear those stories while working as a certified alcohol and drug treatment counselor and a therapist. The problem is that for API, these stories are far and few in between. Most API clients I have worked with enter treatment through a court mandate, and by then, the shame and devastation has become so severe that they have trouble believing that they deserve anything better. Do we, as API individuals, families, and communities need to wait until the problem is this severe, or can we at least have a little compassion for those who are suffering? Continuing to hide the problem or punishing those who are afflicted will not make addiction problems go away. Let’s start having the conversation about addictions and how we can support those who need services find the help that they need. Let’s help those who are struggling with addiction truly become resilient and strengthen our communities. Let’s start saving lives rather than saving face.

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