Prepared in 2002 for the Women’s Addiction Foundation, a public foundation committed to the physical, mental, emotional and spiritual wellness of women whose lives have been affected by their misuse of, or dependency on alcohol or other drugs. Part of BC Women’s Health Centre. See www.womenfdn.org or call (604) 875-3756. Reprinted with permission.
Reprinted from "Women's" issue of Visions Journal, 2004, 2 (4), p. 32-33
Indo-Canadian’ refers to people who trace their roots back to the South Asian subcontinent. They are a highly diverse population embracing many religious, cultural, and linguistic traditions.
Substance use among Indo-Canadian women is relatively low, as they usually shun illicit drugs, alcohol, and tobacco based on their cultural attitudes and religious taboos. In a Toronto-area study, the rate of substance use varied: 88% of Sikh women said they had never consumed alcohol, compared to 76% of Hindu women.
Despite these low rates, some Indo-Canadian women do face substance use problems. And those who have been born in Canada are at higher risk, as research has shown that among immigrants in general, each successive generation is slightly more at risk for alcohol, drug and tobacco use.
Substance use issues for Indo-Canadian girls and women
Conflict with parents and culture
Substance use is on the rise among the current generation of Indo-Canadian women. When they do use alcohol and tobacco, their reasons often include conflict with parents and emotional resistance to the double standard between genders. (Teenage girls and young women in many Indo-Canadian families are given far less personal freedom than their male counterparts.) Outside the family, experiences of racism and peer pressure may also contribute to their substance use.
The violence/alcohol link
Some Indo-Canadian women face violence and abuse at home related to alcohol use by a spouse or another relative. The problem is serious as the rate of alcohol abuse among Indo-Canadian men is approaching that of males in mainstream society.
Prescription drug abuse
Many Indo-Canadian women are vulnerable to depression because of their social isolation, loss of extended family support, racism, alienation, and domestic violence. This means they are at risk of being overprescribed antidepressants.
Barriers to getting help
The greatest barriers to Indo-Canadian women seeking help are cultural attitudes and the strong stigma attached to substance use and mental health problems. Indo-Canadian Canadian women often find it very hard to look for outside help, because they do not want their husbands, fathers, or sons to ‘lose face’ within the community, and do not want to be shunned by their families for getting help. They may blame themselves for substance misuse or abuse problems. This self-blame can also be encouraged by the community.
Another barrier is lack of information and outreach into Indo-Canadian communities by social and health care services. Existing services can also be insensitive or even racist. Many studies show that people from minority groups are frequently treated differently and/or inappropriately by the medical system, compared with people from the mainstream.
Language can also be a barrier, especially when a woman does not have the words to express her feelings in English.
Finally, Indo-Canadian women have strong traditions of seeking community-based help and guidance from people such as extended family members, elders, and spiritual leaders. Unfortunately, these people may be unable to give a woman appropriate support and useful advice about treatment services.
Culturally relevant service options
Many Indo-Canadian women prefer more familiar forms of healing such as yoga, Aryuvedic medicine, and homeopathy. Services that include these traditional approaches are more helpful.
Service in one’s first language
Inroads are being made by alcohol and drug services towards hiring counsellors who can speak languages other than English—including Hindi, Punjabi, and Tamil.
Another good approach is to include alcohol and drug counselling programs into general ethnic community services. Some BC examples are Deltassist Family and Community Services (Delta and Surrey), and Mosaic (Vancouver), which work with immigrant and visible minority communities on a range of issues.
Safe and confidential services
It is a risk for many IndoCanadian women to defy cultural strictures and seek help for substance use and violence problems. Therefore, it is extremely important that services create safety and ensure confidentiality.
For all women, providing practical supports (such as financial support for child care and transportation) can make the difference in their ability to access the help they need and deserve.
The Centre for Addiction and Mental Health in Toronto has done research into best practices for reaching an ethnically diverse population. Their publication Cultural Diversity: A Handbook for Addiction Service Providers (1994) outlines a series of goals and guidelines for setting up treatment programs. This is but one resource designed to help the alcohol and drug field provide culturally competent care.
Alcohol and Drug Referral Service Toll-free: 1-800-663-1441 or (604) 660-9382
Deltassist Family and Community Services, North Delta Alcohol and Drug Program: (604) 591-1185
It is important that service providers address barriers to care related to language, gender, culture and ethnicity, and work toward the following:
Increasing the number of treatment providers who speak Hindi, Punjabi and Tamil languages.
Do outreach to ensure that Indo-Canadian women can find alcohol and drug services when they need them.
Promote trust in women needing help, ensuring that they will find safety, respect and sensitivity in alcohol and drug services.
Involve representatives from the Indo-Canadian community in helping us define and deliver culturally competent care.
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Alcohol-Drug Education Services. (1989). Alcohol/Drug Education Needs Assessment: Four BC Ethnic Communities. Vancouver, BC: Alcohol-Drug Education Services.
Clarke, K.I.M. (1999). Assessing the impact of South Asian male alcohol use on their female relatives. Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism, 34(1), 96-97.
Dubey, A. (1999). The language of care. Journal of Addiction and Mental Health, 2(4), 11.
Health Canada. (1996). Immigrant Women and Substance Use: Current Issues Programs and Recommendations. Ottawa, ON: Office of Alcohol, Drugs and Dependency Issues, Population Health Directorate.
Masi, R., Mensah, L. & McLeod, K. A. (1993) Health and Cultures: Exploring the Relationships (Vol. 2). Oakville, ON: Mosaic Press.
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SHARE Family and Community Services. (1993). Identifying and Responding to the Needs of Ethnic Women and Seniors in the Tri-City Area. Coquitlam, BC: SHARE.
Tsang, B. (1994). Cultural Diversity: A Handbook for Addiction Service Providers. Toronto, ON: Addiction Research Foundation.
Weber, T.R., Biring, P. & Mutta, B. (1993). Punjabi Community Health Project. Toronto, ON: Addiction Research Foundation.