Vancouver's Asian drug addicts 'overlooked'

In a city with the most visible East Asian population in Canada, there is one type of Asian who remains almost invisible in Vancouver: the drug addicts.

Health workers and drug counselors say there is a hidden group of mostly Chinese and Vietnamese drug users who receive no treatment because they are flying under every official radar. Language barriers and discrimination hinder the ones who do seek help.

Ann Livingstone, program director of the Vancouver Area Network of Drug Users, says she only became aware of the problem in 1999 when a representative from the Asian Society for the Intervention of AIDS (ASIA) told her that Asian addicts represent a third of the drug-using population.

“I thought, she’s got to be kidding…and then the next time I went to the corner of Main and Hastings, I just stood still and I counted the number of people, and then I counted the number of Asians…it was thirty per cent, like she said. For some reason, they seem invisible.”

Official studies estimate the number of Asian addicts to be far lower. The Vancouver Injection Drug User Survey (VIDUS) has no available data on the Asian population, but researcher Thomas Kerr estimates that they make up five per cent.

But he admits that VIDUS may have overlooked Asians. “The only sampling bias is that we recruit quite heavily from the Downtown Eastside,” he says.

Related: Chinese experiences in drug treatment

The vast majority of Asian drug users left the Downtown Eastside in the last ten years, says Tuan Luu, an outreach worker with the Street Nurse Program who has worked in the field since he immigrated from Vietnam in 1998.

“The number that we see on the street, and can obviously observe, it could be maximum five to ten percent … another ninety percent are still in the community.”

Data from Insite and other studies that track clients of health and addiction centers may be missing Asian drug users as well. Asian immigrants are one-third as likely as Canadian-born residents to use mental health services, according to recent Canadian research.

Tomiye Ishida, who started an outreach program for Asian drug users at ASIA and is herself a recovering addict, says, “they’re not visible in mainstream services, but it’s a huge problem. That’s even understating it.”

Invisible barriers

Ishida believes that Asian drug users face greater challenges than addicts of most other ethnic groups because of language barriers.

“There were some people [the ASIA drug outreach team] connected with on the street who hadn’t talked to anybody in weeks because they didn’t know anybody who spoke their language. You probably can’t even imagine how limited their knowledge of resources is,” she says.

The problems continue when drug users seek treatment. Luu says, “They have street language, but they don’t really have enough English to listen to hours and hours in the support group or discussion about drugs, so they get bored,” and then they leave.

Cultural taboos can isolate addicts even further. Dr. Yuet-wah Cheung, a Chinese-Canadian sociologist, explains that drug abusers “may suffer a double stigma of personal failure and a disgrace to the ethnic community.”

Because ancestry is so important in most Asian societies, addicts face the shame of dishonouring not only their immediate family but their entire lineage. Asian societies also place a large emphasis on dealing with personal problems privately, according to Ishida.

She says that the ones who overcome the language and cultural barriers to make it to treatment have still more obstacles to face.

“A lot of people who did try to access mainstream alcohol and drug services felt that they were biased against. People assumed they were drug dealers because they’re Asian.”

Even something as simple as food can alienate Asian addicts in recovery centres. “They don’t serve any food that any Asians are going to eat,” says Ishida. “It’s hard enough putting yourself into treatment without suffering from food that you’re not familiar with.”

One Chinese-Canadian addict who was interviewed by a researcher about his time in drug treatment said, “[On the first day of admission] I craved for hot rice … however, when I was in the dining hall, my heart went down. Anything in my dish is cool … there is a sandwich but not rice.”

A vicious cycle

Ishida is frustrated by the vicious cycle that Asian drug users face.

When she has applied for funding for Asian drug addiction services, “They will look at how many Asians will access addiction services like detox, [and then] they say there’s no need.”

She would eventually like to see ethnicity-specific drug treatment such as a recovery house.

For now, she has tried to get detoxification centres to change their menus, giving them Chinese recipes. But Kerr of VIDUS says there are greater needs to address first.

“The reality is we don’t have enough treatment for anybody, let alone making ethnicity-specific treatment, which is unfortunate. There is certainly a need for it, but we don’t have it,” says Kerr.