Perceptions of Substance-Use and Treatment in the Filipino Community in Hawaii and the United States

Background and Purpose:

Filipinos, the second largest ethnic group in Hawai‘i and third largest Asian ethnic group in the United States (US), have high substance-use service need yet low engagement in substance use disorder (SUD) treatment, as well as mental health and other health services. The objective of this study is to understand how Filipinos in Hawai‘i and other regions of the US conceptualize substance-use, addiction, and recovery and to identify the barriers and successful strategies to Filipinos engaging in substance-use services and supports. The aims are to: 1) identify Filipino cultural beliefs, practices, and values related to substance-use, addiction, and service seeking; 2) understand barriers in the Filipino community to substance-use service seeking; and 3) identify the successful strategies of substance-use service providers actively engaging the Filipino community.

Methods:

Brief surveys and semi-structured interviews in the Filipino indigenous method of pakikipagkuwentuhan were conducted via Zoom with adult members of the Filipino community (n=18) in Hawai‘i and other regions of the US and substance-use service providers (n=5) who work closely with these Filipino communities. Transcribed interviews were qualitatively analyzed through first-cycle thematic and second-cycle axial coding methods in order to identify major themes, which were subsequently interpreted by and shared with community stakeholders.

Results:

Four major themes were identified through this study. First, Filipino conceptualization and understanding of addiction is shaped by culture, migration, and historical context. Second, there are a number of barriers to substance-use service access, including stigma and Western approaches not addressing community needs. Third, Filipino cultural practices, values, and beliefs can be integrated into substance-use services in order to improve SUD treatment access and quality. Fourth, some substance-use service providers do a more effective job than others at engaging the Filipino community, responding in a more culturally appropriate and embracing way, and we can learn from their practices.

Conclusions and Implications:

Filipino behavioral health and its cultural and colonial connections are emerging in national discourse as a result of the COVID-19 pandemic and recent anti-Asian hate and violence in the US. However, research in this area is slow to progress and specific focus on substance-use and SUD treatment is limited. This study serves as a starting point for understanding Filipino community, substance-use service provider, and community priorities and identifying the essential Filipino cultural beliefs, practices, and values that improve individual and community outcomes. This knowledge has implications for making social work practice and behavioral health policies more culturally specific in order to improve access to and quality of care.