Several themes emerge in considering ethnicity, culture, and substance use disorders:

There is considerable variation in alcohol and drug use and related problems, both among and within the major cultural and ethnic groups in the United States . For example, Native Americans are more likely than Whites to die from alcohol-related causes, but among Native American tribes, rates of drinking and related problems vary widely.

There are similarities in alcohol and drug use among the major cultural and ethnic groups. For example, the importance of peer influences in the use of alcohol and other drugs among youth, regardless of ethnicity, suggests a common pathway for prevention.

Writers suggest concern that the literature on groups such as Native Americas is replete with stereotypical notions such as the “drunken Indian.” Others are concerned that substance abuse problems are overlooked among groups such as Asian Americans and Jewish Americans because these groups are often described as model citizens: industrious, hardworking, and temperate.

The research on culture, ethnicity, and substance about is inadequate. The methodology of epidemiological studies has improved in many cases, but there are no good epidemiological studies of some major ethnic or cultural groups. Few studies have adequately tested culturally specific treatment approaches or the effects of special prevention programs for particular ethnic or cultural groups.

Ethnicity and acculturation are often mentioned in the alcohol and drug literature, but these concepts are generally measured too narrowly. Studies are needed that expand on these themes and clarify their relationship to alcohol and drug use and related problems.

Among all ethnic groups, women use alcohol and drugs less than men, but women who have substance use disorders are more stigmatized.

Discrimination and deprivation may be related to substance use disorders, particularly to the more severe health and social consequences experienced by members of certain ethnic groups, even when their patterns of use are similar to those of the majority.

Genetic factors have thus far not explained the differences in alcohol consumption and its consequences among ethnic groups.

Ethnic minority youth often report less alcohol and drug use than White youth, but methodological problems in studies of youth (such as exclusion of school dropouts and institutionalized individuals) may cloud the true picture of use across groups.

Strong family ties are important among most ethnic groups, but even well meaning families can present obstacles to recovery by being over-protective or denying alcohol and drug problems among their members. Educating family members and incorporating them in treatment are universally suggested.

A consistent theme in the prevention literature is that ethnic communities must take an active role in defining social norms and promoting responsible alcohol and drug use.

Community gatekeepers (such as members of ethnic, religious, business, and educational organizations and institutions) should be recruited and educated to provide pathways to prevention and treatment.

Professionals should consider indigenous helpers (medicine men, curanderas , etc.) as potentially viable helping resources. In some cases, traditional cultural and religious practices may be sufficient for recovery.

Some progress has been made, but further development and study of model programs is needed for prevention and treatment of alcohol and other drug problems among ethnic groups, along with funding to support them.

There is a need for greater understanding of those factors that protect members of ethnic groups from alcohol and drug problems, especially in the face of discrimination, poverty, and attempts to destroy their cultural traditions.

Differences in rates of alcohol and other drug problems among the various ethnic groups should not obscure the need to provide appropriate treatment to members of each ethnic group and to provide individualized treatment to any person in need.

Prevention and treatment service providers should capitalize on the strengths of ethnic groups in designing programs and offering services to individuals.

Ethnic sensitivity and competence are necessary to function effectively as a professional in the field of alcohol and drug prevention and treatment.