The Role of Hawaiian Elders in Substance Abuse Treatment Among Asian/Pacific Islander Women

SUMMARY

The elders of a culture are often the designated transmitters of long-standing values and ways that define the unique essence of a people. Küpuna (elders) teachings are especially important to Native Hawaiians who have experienced the cumulative effects of cultural imperialism, which has taken their lands, discouraged use of their language and cultural ways, damaged their identity as a people and destroyed their sovereignty.

Modern day cultural imperialism, which universalizes the dominant group's experience and culture, renders minority groups as invisible while marginalizing them (Young, 1990). The chronic stress of this insidious form of oppression can translate into physical, mental health problems which lead to decreased life expectancy (McEwen, 1998; Schulkin, Gold & McEwen, 1998). Statistics on Hawaiians and other Asian/Pacific Islanders in Hawaiì indicate these groups have high rates of health problems and increasing rates of substance abuse (Office of Hawaiian Affairs, 1998).

This article describes the roles and Hawaiian practices of küpuna who acted as facilitators in the healing of Asian/Pacific Islander pregnant and postpartum women who participated in a culturally based substance abuse treatment program (CBSATP). The findings of a qualitative study, which examined the effectiveness of küpuna in these roles and their implications for practice are discussed.     

Retrospective Reasons for the Initiation of Substance Use

ABSTRACT

Evidence for comorbidity in psychiatric disorders and chemical depend ency suggests that peopie with ad dietion problems use drugs and alcohoito cope with painful affeetive states and symptoms. At the same time, sus tained chem i cal use may also lead to fur ther dam age and mimic symp toms of dis or ders. This study was de signed to build knowledge about the rea sons in-patient and out-patient sub stance abus ers in treatment initially use, and to test if there were dif fer ences be tween gender and eth nie (White non-His panic and Af ri can-Amer i can) groups. Findings in di cated that peo pie not only started using drugs and al co hoi to en hance af feetive states, they also were likely to use chem i cals as a way to cope with pain ful, af feetive symp toms. Gender seemed to play a salient role than ethnieity in that fe males of either ethnieity were more likely than males to end or se items relating to the management of negative af feetive states, for enhancement of skills and prob-lem-solving abilities, and for per ceived lack of alternatives. Implications of this study are provided.     

Co-Occurring Substance Use and Personality Disorders: Current Thinking on Etiology,Diagnosis, and Treatment

ABSTRACT

Despite the high prevalence of personality disorders among substance abusing individuals, the literature on these co-occurring disorders is limited. This paper reviews the literature and provides the most current data on the demographics, the criteria for diagnosing both personality disorders and substance use disorders, and the effects of substance abuse and co-occurring personality disorders, particularly antisocial and borderline, on prognoses and treatment approaches. Recommendations for further research on these co-occurring disorders are provided.     

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