Finalized Digital Files.pdf COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 115 114 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII INSPIRATION FOR ARTICLE After moving from the other side of the globe to the U.S., I realized I am viewed just as ‘Asian’ here. It was as if all my cultural experiences and diverse ethnic backgrounds were deliberately ignored. After I started talking to other BIPOC folks who are non-citizens, immigrants, or first-generation immigrants, I found that many feel the same as I did. Eventually, I learned about different ethnicities that fall under the Asian, Latinx, and Black umbrella terms and how different they are. For instance, it is rare to find an Indonesian American to drink beyond their capacity due to the extremely conservative culture in Indonesia. On the other hand, Korean Americans are likelier to drink because it is part of their culture in Korea. This was basic knowledge for myself and many around me. Hence, when finding that data collection in the U.S. disregards, I instinctively knew that many ethnic groups are currently overlooked, but also ironically very much acknowledged though only as a monolithic group. This inspired me to look into disparities in social and health issues impacting different ethnicities under the same racial umbrella. I’m a proud Southeast Asian, born and bred in Indonesia. Before pursuing a Master’s in Social Work at Columbia, I served as the youngest policy analyst in the Governor’s Delivery Unit of Jakarta, the capital of Indonesia. My research interests are mainly in social and psychosocial determinants of health and empowerment of vulnerable communities. ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 117 116 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN ABSTRACT This reading challenges the prevailing Model Minority Myth perspective which influences the examination of substance use patterns among different subgroups of East Asian American (EAA) youth. A disaggregated analysis of existing literature reveals significant variations in substance use across EAA subgroups. This article explores influencing factors such as acculturation, cultural norms, and peer dynamics, emphasizing distinctions between Chinese Americans, Taiwanese Americans, Korean Americans, and Japanese Americans. Several EAA subgroups show a higher prevalence of cigarette or alcohol use than their white counterparts, a finding normally hidden by the aggregation of Asian American data. These unrealized differences prompt a call for tailored and culturally appropriate treatment approaches. Data shows EAA youth are more likely to not seek treatment or to drop out after beginning treatment (Wang & Kim, 2010 as cited in Ong, 2023). Understanding the typical family dynamics as well as the discrimination faced by EAA communities, including cultural stigma and culture-specific syndromes, plays a crucial role in improving treatment adherence. Additionally, studies of treatment preferences show that implementing family-based programs, outreach efforts, and involving culturally attuned treatment providers is crucial to actively address the unique needs of youth of different EAA subgroups (Lee et al., 2004). Keywords: substance use, treatment approach, culturally appropriate care, East Asian American, model minority Asian Americans (AA) are the fastest-growing minority group in the United States (Budiman & Ruiz, 2021). Often referred to as the “model minority,” the AA community is perceived as a monolithic group that is successful and stays out of trouble. The Model Minority Myth has created distortions and misperceptions about the actual struggles of many Asian Americans which range from mental health to other areas of health (Blackburn, 2019). The stereotype that Asian Americans are “doing well” ignores how many Asian American youth face dual exposure to strict parenting (i.e. tiger parenting with punishment and shaming tactics) and holding a bicultural identity, which can result in poor coping behaviors such as substance abuse (Saraiya et al., 2019). In reality, a 2002 study shows that compared to girls of other ethnocultural groups, Asian American girls have the largest increase in use of alcohol (from 9.5% to 28.4%), cigarettes (from 7.4% to 17.1%), marijuana (from 2.4% to 9.1%), and other stimulants (from 1.5% to 2.3%) from 8th to 12th grade (Wallace et al., 2003). Moreover, since research on alcohol and substance use often lumps all subgroups within the Asian American (and sometimes Pacific Islander) community together, this aggregate data masks high rates of substance use within specific groups (Kane et al., 2017). This creates an increased danger of overlooking and ignoring the needs of the AA community. EAST ASIAN AMERICAN (EAA) YOUTH Compared to other Asian American subcultures, East Asian Americans currently fit the mold of the Model Minority Myth the most. EAA ethnicities include Chinese Americans, Hong Kong Americans, Japanese Americans, Macau Americans, Mongolian Americans, North Korean Americans, South Korean Americans, and Taiwanese Americans (Asia Society, n.d.). The 2019 American Community Survey (ACS) data from the U.S. Census Bureau shows that the Asian American groups with the highest median household income and the highest percentages of adults (age 25 and above) with at least a bachelor’s degree are mainly in the EAA category (Jin, 2021). Within this group, the Taiwanese, Chinese, COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 119 118 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII Japanese, and Korean American subgroups stand out the most in terms of economic and educational achievement. When referring to Asian Americans in the U.S., most only consider East Asians, further perpetuating the misconception of Asian Americans as a “successful” monolithic model minority. The common perception is that Asian Americans in general are as successful as their white counterparts, at least from an economic and educational standpoint. This translates into a double-layered assumption that East Asian Americans are economically successful and, therefore, not at high risk of substance use. However, simply earning a high income or a bachelor’s degree does not define the population’s well-being, especially in terms of mental health and substance use. Additionally, even if rates of substance use for Asian Americans are lower than other racial groups, most data do not show the variances among different Asian American subgroups/ ethnicities nor their experiences of racial or minority stress (National Survey on Drug Use and Health, 2021). Many East Asian Americans are from immigrant families where using certain substances, namely alcohol, is common or seen as a norm in their country of origin. This paper focuses on the high prevalence of substance use, especially alcohol and cigarette use, among some EAA subgroups. Furthermore, cultural norms in the Asian American community mean these groups are already less likely to seek professional help, and false assumptions of substance use among different EAA subgroups have further contributed to limited availability and accessibility to treatment for those who do need help (Guarnotta, 2023). In general, public health researchers and practitioners have been led to deprioritize analyzing the patterns of substance use among East Asian Americans and Asian Americans (Kane et al., 2017). Hence, it is unsurprising that policies and programs tend to ignore the need for prevention and treatment for this population. The relationship between different subgroups of EAA youth and substance use, as well as treatment approaches appropriate for this population, should be examined. Youth populations are prioritized in this paper since this is a crucial stage for intervention in the development of alcohol and substance use issues. FACTORS INFLUENCING SUBSTANCE USE ACROSS SUBGROUPS The 2019 ACS data from the U.S. Census Bureau shows that the East Asian American subgroup has the highest percentage population (8.6 million) in the U.S compared to other Asian American subgroups. Acknowledging the distribution of ethnicities of Asian Americans is crucial to understanding how current aggregated data concerning Asian American substance use has created biases and oversight of substance use prevention and treatment for Asian American subgroups that need them the most. ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN TABLE 1 ETHNICITIES UNDER THE ASIAN AMERICAN UMBRELLA P O P U LA TI O N Source: U.S. Census Bureau, 2019 American Community Survey as cited in Jin’s (2021) article. COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 121 120 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII The 2013 U.S. National Survey on Drug Use and Health (NSDUH) reveals that Asian American youth have the lowest prevalence of past- month alcohol use and binge drinking compared to other races or ethnic groups (Substance Abuse and Mental Health Services Administration, 2013). However, data which combine all Asian American sub ethnicities under one category hide and ignore the reality of high-risk groups. A 2017 study found prevalence estimates of alcohol use among Korean, Japanese, and Filipino American adolescents were in fact very similar to other racial groups (i.e. white and Black populations) that experience a high risk of alcohol use (Kane et al., 2017). Another study by Cook et al. (2015) found the culture of drinking in the country of origin, namely Korea, Japan, and the Philippines, predicted heavy episodic drinking among these young adults. Low levels of alcohol use among Chinese Americans and Asian Indian Americans–the two largest Asian American subgroups in the United States, skew the data when evaluating alcohol use among Asian Americans as a whole (Saraiya et al., 2019; U.S. Census Bureau, 2021). Collectively, these findings accentuate the existing alcohol use amongst Asian American youth and the importance of disaggregating this data by ethnicity. There is limited research on illicit substance use (e.g. cannabis, opioids, and illicit stimulants) among Asian Americans. The existing small body of research depicts Japanese and Korean ethnicities reporting higher use of illicit substances compared to other Asian American ethnicities (Ryabov, 2015; Saraiya et al., 2019 as cited in Ahmmad & Adkins, 2021). CHINESE AMERICANS & TAIWANESE AMERICANS Although Chinese Americans comprise over half of the East Asian population in the U.S., this group consistently reports low alcohol use prevalence compared to other Asian American subgroups (Chang et al., 2008). However, this does not mean alcohol and substance use is non- existent among Chinese American youth. This phenomenon requires examining the process of acculturation–how closely one adheres to cultural norms in the U.S–which appears to be a strong predictor of substance use for other ethnicities. For instance, one study highlights how Chinese Americans are more influenced by specific cultural values (i.e., family obligation and expectations of autonomy). This means that Chinese American youth with a higher internalized sense of these values engaged in less misconduct (Juang & Nguyen, 2009). Although family values are a strong predictor of substance use in Chinese American youth, it is important to note that substance use is part of Chinese culture. Moreover, Chinese and Taiwanese American youth are greatly impacted by the recent history of immigration in their families. Immigration can greatly alter family dynamics and values and affect how these values contribute to substance use. In existing research on substance use in Taiwanese Americans, this group is often combined with Chinese Americans, perhaps due to the very similar culture and the comparatively lower population of Taiwanese Americans. A study on smoking behavior among Chinese American and Taiwanese American college students found personal meanings associated with smoking are powerful predictors of smoking for this population (Spruijt-Metz & Hsia, 2003). Specifically, participants of this study reported that personal feelings about smoking are closely related to culture and smoking customs in some regions in China and Taiwan where smoking is socially accepted and even encouraged among men. In comparison, the personal feelings about smoking in female participants are more influenced by family education and parental attitudes compared to social customs. KOREAN AMERICANS On the other hand, Korean American college students are found to be drinking alcohol more frequently and in higher amounts compared to Chinese American students. Particularly, Korean Americans are more likely than Chinese American students to view drinking as a socially acceptable practice and a way to facilitate social interactions (Chang et al., 2008). The two most common environments where Korean Americans drank alcohol were drinking at night with friends or at parties (Nakashima & Wong, 2000). Drinking behavior among Korean ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 123 122 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII American students is closely associated with the drinking behaviors of their parents and friends. They are more likely to drink frequently when they have more spending money and are more likely to engage in substance misuse if their parents or friends use alcohol or tobacco (Chang et al., 2008). Similarly, along with their Chinese American counterparts, acculturation is not a significant predictor of drinking for Korean American teenagers. Peer influence, scholastic achievement or aspirations, and current smoking habits are stronger predictors (Cook et al., 2009). Contrary to their Chinese American counterparts, gender difference does not significantly change the measure of alcohol use among Korean American teenagers. Regarding smoking, a 2002 study (Price et al.) found that 33.5% of Korean Americans use cigarettes, which is higher than the percentage of Caucasian Americans who do so (30%). Moreover, from 2010 to 2013, the prevalence of cigarette use among Korean Americans was 20%, a number that is almost twice the average of the aggregate Asian American population (10.9%) in the same period. This means the risk of cigarette smoking among Korean Americans is comparable to other higher-risk U.S. demographic groups (Martell, Garrett, and Caraballo, 2016 as cited in Ahmmad & Adkins, 2021). JAPANESE AMERICANS As discussed above, the use of alcohol among Japanese American youth is prevalent (Kane et al., 2017). The influence of acculturation to U.S. cultural norms is especially significant for Japanese Americans and their relationship with alcohol and substance use (Ahmmad & Adkins, 2021). The drinking culture of their country of origin is also a significant determining factor (Cook et al., 2015). These findings are unsurprising since Japan is to this day known for its drinking culture. The drinking culture in Japan has become so normalized that the Japanese government encouraged its younger generation to drink more to support the alcohol industry during the COVID-19 pandemic, exacerbating the existing prolific drinking culture (Hida & Yoon, 2022). A separate study in Hawaii indicates that the onset of smoking and drinking among Japanese American students is closely associated with Japanese culture. The findings emphasize that although acculturation is an influential factor, nationality and level of education have stronger associations with smoking, and education is a stronger predictor of alcohol use (Tomioka & Maddock, 2007). This research shows that social workers are needed to ensure a quality of education which centers the experiences of East Asian Americans, namely concerning their experience in American public education. MULTIETHNICITY ASIAN AMERICANS & PART-ASIAN AMERICANS Literature (cited in Ahmmad & Adkins, 2021) shows that marriages between two Asian ethnicities and between Asians and other racial or ethnic groups are increasing, resulting in more youth identifying as multiple Asian ethnicities (e.g. Vietnamese and Chinese). These individuals often identify as multiracial (e.g. Japanese and white); however, there is no research exploring the prevalence and patterns of substance use among these groups. The failure to consider Asian identities beyond mono-ethnic and mono-racial studies will increasingly create confusion and misinterpretations regarding the relationships between race, ethnicity, and substance use. TREATMENT CHALLENGES AND RECOMMENDED TREATMENT APPROACHES Unfortunately, research on treatment approaches for Asian Americans, including East Asian Americans and particularly EAA youth, is limited. Regardless, available studies do show that Asian Americans have certain preferences for substance use treatment (Wang & Kim, 2010). Most studies group East Asian Americans with other Asian American subgroups. Regardless, there is a common denominator showing Asian Americans require culturally appropriate care and approaches that take into consideration discrimination based on race and ethnicity. ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 125 124 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII CULTURALLY-APPROPRIATE CARE Research shows that when Asian Americans participate in therapy services, they are more likely to drop out than their white counterparts (Wang & Kim, 2010 as cited in Ong, 2023). One potential explanation for this may be the cultural practice of shaming substance use and mental illness and the pressure to maintain the family’s image. These tendencies may cause families to encourage their youth to avoid going to professionals and choose to address these issues in private or deny their existence altogether (Gateway Foundation, n.d.; Gemme, 2023). Hence, the Asian American population as a whole can benefit from family support for people who misuse substances, open discussion of the cultural stigma of substance-use problems, and culturally appropriate localized knowledge of drug misuse (Lee et al., 2004). Due to the aforementioned reasons, Asian Americans are less likely to seek help and treatment services compared to other racial groups (Guarnotta, 2023; Spencer et al., 2010). In fact, only 3.3% of Asian Americans needing substance abuse treatment receive such treatment (SAMHSA, 2019). Compared to the rest of the country, Asian Americans are three times less likely to seek and receive treatment compared to the general population (SAMHSA, 2014 as cited in Kaliszewski, 2022). Therefore, more outreach efforts regarding treatment options and processes are needed in the communities of EAA youth. As such, Asian Americans would benefit from shame and stigma reduction programs. Two studies in 2007 and 2013 on Japanese American youth highlight the need for culturally specific interventions for Japanese, Japanese American, and part-Japanese American teenagers and youth. Culturally appropriate care requires therapy providers to better understand the influences and effects that culture, ethnicity, and regional customs have on alcohol and substance use among adolescents (Tomioka & Maddock, 2007; Williams et al., 2013). As treatment adherence is also associated with how much the client can relate to and understand the treatment provider’s explanation of symptoms and illnesses, treatment providers should be trained in acknowledging and understanding the existence, prevalence, manifestation, and treatment of Asian culture-specific syndromes. Examples of these include: "hwa-byung" (Korean syndrome similar to, yet different from DSM-IV major depression), "taijin kyofyusho" (Japanese disorder similar to, yet different from DSM-IV social phobia), and "koro" (Southeast Asian syndrome now referred to as genital retraction syndrome in the global mental health literature) [which] are all psychological disorders that have been documented in Asian-Americans/Pacific Islanders. Clinicians unaware of such disorders are at higher risk for misdiagnosing such problems and, thus, implementing culturally inappropriate interventions. (Iwamasa, 2012, Inadequacies section) Additionally, American treatments and methodologies may be dismissive of culturally specific healing practices that are unknown or unfamiliar in the U.S. Treatment providers must not only be aware of culturally specific practice, but also understand how Asian healing practices have been ignored and looked down upon. Asian American youth who grow up in the U.S. may have complicated feelings regarding these practices. All in all, providers can use this as an opportunity to explore the complexities of discrimination and healing instead of ignoring them. OPPRESSION AND DISCRIMINATION Due to the myth of the model minority, oppression and racism can also be the causes of mental health issues and substance use among Asian Americans. Asian Americans and Pacific Islanders often experience discrimination in their places of employment, where they may experience the “glass ceiling effect:” Although trained and competent, in many companies, Asian Americans and Pacific Islanders find it difficult to move beyond mid-level positions. Stereotypes of Asian-American/Pacific ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 127 126 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII Islander employees as being smart, hardworking, and reliable, yet passive and quiet, result in many individuals being passed over for much-deserved promotions and recognition. Implications for negative effects on self-worth are clear. (Iwamasa, 2012, Oppression section) Accordingly, the American Psychological Association recommends treatment providers serving the Asian American population be aware of inaccurate historical stereotypes and myths of Asian Americans (e.g. the Model Minority Myth). Treatment providers should gain knowledge of the diversity in educational and occupational achievement, socioeconomic status, and the frequent need for family members to have multiple jobs to make ends meet among Asian Americans (Iwamasa, 2012). As in treatments with any other racial group, treatment providers should not make assumptions regarding a client’s experiences and how much an Asian American individual adheres to their cultural values and practices. Thus, recruiting treatment providers who identify as East Asian American and have lived experiences similar to EAA youth is extremely beneficial– although not always required. Additionally, hiring treatment providers who speak East Asian languages is important. Although language barriers can generally be a challenge for Asian Americans who are recent immigrants as well as first-generation EAA youth, it may not be a challenge for second and third-generation EAA youth. Lastly, treatment providers should be aware of the common substances used by EAA youth. For instance, between 2000 and 2010, methamphetamine and marijuana were the two most commonly reported illicit drugs among Asian Americans (SAMHSA, 2014 as cited in Guarnotta, 2023). Part of exercising due diligence in providing the best support for Asian American youth includes recognizing the common causes of substance misuse among different EAA ethnicities as outlined in this paper. For example, alcohol misuse among Korean American youth is mostly a peer-reinforced phenomenon (Nakashima & Wong, 2000). Hence, strategies and goals have to be set accordingly depending on the tendencies of each population. PREFERENCES FOR PREVENTION APPROACHES RESILIENCY-FOCUSED PREVENTION PROGRAMS A 2004 study on perceptions of substance use in Asian American communities, namely the Chinese, Indian, Korean, and Vietnamese populations, shows that these populations lack interest in using support groups such as Alcoholics Anonymous or Narcotics Anonymous because of their cultural preferences to confide in family and friends (Lee et al., 2004). The study recommends drug-prevention programs for the Asian American population to focus on a range of other available treatment options as well as the pros, cons, and feasibility of using personal resources to address substance-use problems. Also, Asian American populations tend to respond favorably to topics such as wellness, health promotion, and resiliency (Fang & Schinke, 2013). As such, family-based prevention programs focusing on strength and resiliency rather than pathology and deficits may be particularly relevant to East Asian Americans. Asian American participants in another study reported they would be more attracted to programs made specifically for Asian Americans, but very few such programs exist. Schools and community centers (e.g., health clinics, YMCA, etc.) were the most frequently mentioned locations to hold such a program. Some participants felt an online program that targeted the Asian community would be appropriate, and some also showed preferences for family-based programs (Fang et al., 2011). However, other participants noted that Asian parents’ “ordering” communication style tends to create a negative atmosphere and tense relationships with their children even in treatment settings. Many also mentioned that Asian American parents are generally more focused on their children’s academic performance than other supplemental or extracurricular activities, so parents may overlook the need for a family- based prevention program. ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 129 128 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII FURTHER RESEARCH Generally, there needs to be more research on the preferences of Asian American individuals for prevention approaches. One consistent finding among most Asian American subgroups is the importance of considering the perspectives of the family. Consequently, ensuring that treatment approaches are aligned with an individual’s family preferences and culture is crucial. There is a lack of research on prevention among Taiwanese Americans and other ethnicities with smaller populations such as Hong Kong Americans, Macau Americans, and Mongolian Americans. Moreover, due to the minute population of North Korean Americans, the term Korean Americans generally refers to South Korean Americans, although North Korean Americans have distinctly different alcohol and substance use behaviors in their country of origin. There is minimal research and data on effective treatments for East Asian Americans, much less EAA youth. More and updated research, as well as disaggregated data alongside studies on appropriate treatment approaches, specifically on EAA youth, is needed for public health professionals, social workers, and treatment providers to create appropriate policies and programs to help EAA youth who require support. Future research must look into separate Asian American subgroups/ethnicities and consider the distinct cultural differences among these groups. Research must also include South and Southeast Asian subgroups, especially groups with a high population in the U.S. (i.e. Filipino Americans and Vietnamese Americans). Ultimately, efforts for further research are increasingly needed as these populations continue to grow. CONCLUSION There are clear differences in substance use between ethnicities that fall under the East Asian American term or identity, notwithstanding the similarities among Chinese American, Taiwanese American, Korean American, and Japanese American youth, which include less likelihood to seek help and a higher likelihood to drop out of therapy services compared to their white counterparts. Differences such as drinking habits and social norms are influential determinants for higher-risk ethnicities such as Korean Americans and Japanese Americans. Due to the history of systemic racism against Asian Americans, more advocacy and cultural representation in treatment, such as understanding culture- specific explanations of certain symptoms and illnesses, is necessary (Gemme, 2023). On a macro level, efforts to dismantle stereotypes and the Model Minority Myth are also necessary as these can lead to mental health issues and substance use among Asian Americans. Lastly, the familiarity of providers with the treatment preferences of the Asian American population may improve treatment adherence and willingness to continue treatment. Consideration of family perspectives on treatment approaches and acknowledging the pressure from stigmatization of mental health among Asian Americans is crucial to the well-being of this community. REFERENCES Ahmmad, Z., & Adkins, D. E. (2021). Ethnicity and acculturation: Asian American substance use from early adolescence to mature adulthood. Journal of Ethnic and Migration Studies, 47(19). https://doi.org/10.1101/19002048 Asia Society. (n.d.). East Asia. https://asiasociety.org/countries-regions/east- asia#:~:text=East%20Asia%20includes%20China%2C%20Hong,territories%20 can%20be%20found%20below Blackburn, S.-S. (2019, March 21). What Is the Model Minority Myth? Southern Poverty Law Center: Learning for Justice. https://www.learningforjustice.org/magazine/what-is- the-model-minority-myth Budiman, A., & Ruiz, N. G. (2021, April 9). Asian Americans are the fastest-growing racial or ethnic group in the U.S. Pew Research Center. https://www.pewresearch.org/short- reads/2021/04/09/asian-americans-are-the-fastest-growing-racial-or-ethnic-group-in- the-u-s/ Chang, J., Shrake, E., & Rhee, S. (2008). Patterns of alcohol use and attitudes toward drinking among Chinese and Korean American college students. Journal of Ethnicity in Substance Abuse, 7(3), 341–356. https://doi.org/10.1080/15332640802313346 Cook, W. K., Hofstetter, C. R., Kang, M., Hovell, M. F., & Irvin, V. (2009). Rethinking acculturation: A study of alcohol use of Korean American adolescents in Southern California. Contemporary Drug Problems, 36(1–2), 217–244. https://doi. org/10.1177/009145090903600111 ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 131 130 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII Cook, W. K., Karriker-Jaffe, K. J., Bond, J., & Lui, C. (2015). Asian American problem drinking trajectories during the transition to adulthood: Ethnic drinking cultures and neighborhood contexts. American Journal of Public Health, 105(5), 1020–1027. https:// doi.org/10.2105/ajph.2014.302196 Fang, L., & Schinke, S. P. (2013). Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls. Psychology of Addictive Behaviors, 27(3), 788–798. https://doi.org/10.1037/a0030925 Fang, L., Barnes-Ceeney, K., Lee, R. A., & Tao, J. (2011). Substance use among Asian- American adolescents: Perceptions of use and preferences for prevention programming. Social Work in Health Care, 50(8), 606–624. https://doi.org/10.1080/00981389.2011.58 8115 Gateway Foundation. (n.d.). Addiction Recovery for Asian Americans. https://www. gatewayfoundation.org/addiction-blog/asian-american-drug-abuse/ Gemme, M. (2023, June 19). Asian American discrimination and substance use. Drug Rehab Services. https://www.addicted.org/asian-american-discrimination-and- substance-abuse.html Guarnotta, E. (2023, June 2). A guide to drug addiction & recovery for Asian Americans. American Addiction Centers. https://recovery.org/addiction/demographics/asian- americans/ Hida, H., & Yoon, J. (2022, August 19). Drink up, Japan tells young people. I’ll pass, many reply. The New York Times. https://www.nytimes.com/2022/08/19/world/asia/japan- alcohol-contest.html Iwamasa, G. Y. (2012). Recommendations for the treatment of Asian-American/Pacific Islander populations. American Psychological Association. https://www.apa.org/pi/ oema/resources/ethnicity-health/asian-american/psychological-treatment Jin, C. H. (2021, May 25). 6 charts that dismantle the trope of Asian Americans as a model minority. NPR. https://www.npr.org/2021/05/25/999874296/6-charts-that-dismantle-the- trope-of-asian-americans-as-a-model-minority Juang, L. P., & Nguyen, H. H. (2009). Misconduct among Chinese American adolescents. Journal of Cross-Cultural Psychology, 40(4), 649–666. https://doi. org/10.1177/0022022109335185 Kaliszewski, M. (2022, September 14). Alcohol and drug abuse among Asian Americans. American Addiction Centers. https://americanaddictioncenters.org/addiction-statistics/ asian-americans Kane, J. C., Damian, A. J., Fairman, B., Bass, J. K., Iwamoto, D. K., & Johnson, R. M. (2017). Differences in alcohol use patterns between adolescent Asian American ethnic groups: Representative estimates from the National Survey on Drug Use and Health 2002–2013. Addictive Behaviors, 64, 154–158. https://doi.org/10.1016/j. addbeh.2016.08.045 Lee, M. Y., Law, P. F., & Eo, E. (2004). Perception of substance use problems in Asian American communities by Chinese, Indian, Korean, and Vietnamese populations. Journal of Ethnicity in Substance Abuse, 2(3), 1–29. https://doi.org/10.1300/ j233v02n03_01 Martell, B. N., Garrett, B. E., & Caraballo, R. S. (2016). Disparities in adult cigarette smoking — United States, 2002–2005 and 2010–2013. MMWR: Morbidity and Mortality Weekly Report, 65(30), 753–758. https://doi.org/10.15585/mmwr.mm6530a1 Nakashima, J., & Wong, M. M. (2000). Characteristics of alcohol consumption, correlates of alcohol misuse among Korean American adolescents. Journal of Drug Education, 30(3), 343–359. https://doi.org/10.2190/xv42-mw3u-vgy9-7m0x National Survey on Drug Use and Health. (2021, October 3). Racial/ethnic differences in substance use, substance use disorders, and substance use treatment utilization among people aged 12 or older (2015-2019). Retrieved from Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/racialethnic- differences-substance-use Ong, S. (2023). Differences in therapy satisfaction among East Asian and Southeast Asian Americans. ProQuest Dissertations & Theses Global. Price, R. K., Risk, N. K., Wong, M. M., & Klingle, R. S. (2002). Substance use and abuse by Asian Americans and Pacific Islanders: Preliminary results from four national epidemiologic studies. Public Health Reports, 117(1), S39–S50. Ryabov, I. (2015). Relation of peer effects and school climate to substance use among Asian American adolescents. Journal of Adolescence, 42, 115–127. https://doi. org/10.1016/j.adolescence.2015.04.007 Saraiya, T., Smith, K. Z., Campbell, A. N. C., & Hien, D. (2019). Posttraumatic stress symptoms, shame, and substance use among Asian Americans. Journal of Substance Abuse Treatment, 96, 1–11. https://doi.org/10.1016/j.jsat.2018.10.002 Spencer, M. S., Chen, J., Gee, G. C., Fabian, C. G., & Takeuchi, D. T. (2010). Discrimination and mental health–related service use in a national study of Asian Americans. American Journal of Public Health, 100(12), 2410–2417. https://doi.org/10.2105/ajph.2009.176321 Spruijt-Metz, D., & Hsia, F.-N. (2003). The meanings of smoking among Chinese American and Taiwanese American college students. Nicotine & Tobacco Research, 5(6), 837–850. https://doi.org/10.1080/14622200310001615259 Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). National survey of drug use and health: Alcohol use in lifetime, past year, and past month among persons aged 12 to 17, by demographic characteristics: Percentages, 2012 and 2013. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2013/NSDUH- DetTabs2013.htm#tab2.38b/ ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN COLUMBIA SOCIAL WORK REVIEW, VOL. XXII | 133 132 | COLUMBIA SOCIAL WORK REVIEW, VOL. XXII Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). A treatment improvement protocol: Improving cultural competence treatment improvement protocol (TIP) series No. 59. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. Tomioka, M., & Maddock, J. (2007). Predictors of smoking and alcohol use in Japanese and Japanese-American college students. Californian Journal of Health Promotion, 5(2), 45–57. https://doi.org/10.32398/cjhp.v5i2.1231 United States Census Bureau. (2021). 2019 American Community Survey 1-year estimates. Wallace, J. M., Bachman, J. G., O’Malley, P. M., Schulenberg, J. E., Cooper, S. M., & Johnston, L. D. (2003). Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976-2000. Addiction, 98(2), 225–234. https://doi.org/10.1046/j.1360-0443.2003.00282.x Wang, S., & Kim, B. S. K. (2010). Therapist multicultural competence, Asian American participants’ cultural values, and counseling process. Journal of Counseling Psychology, 57(4), 394–401. https://doi.org/10.1037/a0020359 Williams, J. K. Y., Else, ’Iwalani R. N., Goebert, D. A., Nishimura, S. T., Hishinuma, E. S., & Andrade, N. N. (2013). A confirmatory model for substance use among Japanese American and part-Japanese American adolescents. Journal of ethnicity in substance abuse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923518/ ALCOHOL AND SUBSTANCE USE AMONG EAST ASIAN AMERICAN YOUTH ADELA JANSEN