Shaquila Sarapao
•
August 15, 2025
Perspective. An intersection of my Betty Ford experience and substance use disorder in Asian Americans.
In the middle of a Californian desert, there lies an oasis where palm trees shake their heads and mountains hug the valley. Driving twenty minutes south and reaching Rancho Mirage, California, there is an area that former First Lady Betty Ford bought and turned into a treatment center, inspired by her own personal dependence on alcohol and prescribed opioids. For five days, I visited this drug and alcohol treatment facility and learned about how addiction is truly a disease of the brain.
Hazelden Betty Ford Foundation is a world-renowned organization that focuses on addiction treatment and recovery with several locations spanning across the United States. Their scope encompasses from treating people struggling with substance use disorder (SUD) and mental health conditions to having a program for children that have been affected by family members with SUD. I witnessed firsthand their mission statement, “Harnessing science, love and the wisdom of lived experience, we are a force of healing and hope for individuals, families and communities affected by substance use and mental health conditions.”
When I first entered the facility, I was in awe at how organized and well-kept everything was. It was like a very tiny college campus–dorm buildings, a dining hall, a gym, walkways. There was a sense of disbelief, for me, that this space was created. Everyday was the same but different. The schedule consisted of lectures, small groups, lunch, and group process sessions. However, the topics and moods varied each day. The lectures provided the science, which would cause the residents to mumble in agreement or give rise to heated discussions between their lived experience and the world. At lunch, I would bond with the residents and talk about their family, upcoming plans, and the life they had before. However, during these lunches, amongst the faces of white and black, I noticed a lack of another color.
According to the 2020 official report of the United States Census Bureau, California had a total population of 39,538,223. Looking at Asians alone, it comprised 18% of the state’s population, which is 6,085,947 people1. With this many Asians in the state, why were there none I could see in the dining hall?
It begs the question: do Asian Americans truly not have substance use disorder? Or are there barriers that prevent addressing SUD?
There is a cultural emphasis that Asian Americans are a relatively healthy group compared to non-Asian Americans, beginning from the generations that moved to the U.S. and seeped into the minds of the Asian American youth and into American? society. Whether that means denying symptoms or avoiding the discussion about health, it is a detrimental mindset that delays addressing the problem and getting medical treatment. Although there is improvement in research showing that Asians face higher risks of Hepatitis B and liver and gastric cancer, there needs to be more about SUD. From 2018 to 2022, there has been a significant increase of overdoses in Asian Americans with the top three substances being fentanyl, methamphetamine, and cocaine, respectively2. Additionally, a 2024 National Survey of Drug Use and Health showed that even with Asians classified as needing treatment, only 13.7% will receive treatment compared to the national total of 22.3% and the lowest when compared to any other race3. Language poses another barrier that may deter Asian Americans from seeking rehabilitation centers or even going to a healthcare provider. Many barriers including cultural, communicational, and psychological hinder Asian Americans from recognizing and seeking help for SUD.
Consequently, there is an urgent need for more intervention and research on Asian communities with substance use disorder. Some key recommendations include disaggregating Asians and being attentive to their cultural norms, improving data-collecting and research through appropriate language, and increasing NIH funding and support in this area4. These efforts are essential to creating more equitable, effective, and culturally responsive care for Asian populations affected by substance use disorders.
Another way of addressing SUD in Asian Americans is exposure with the Hazelden Betty Ford Foundation. With the support of my medical school and generous donors, a select group of sixteen students traveled to California as part of Hazelden Betty Ford’s Summer Institute for Medical Students (SIMS), where students immerse themselves in the facility and follow residents to learn more about them as well as addiction treatment and recovery. Medical schools don’t provide enough classroom teachings on substance use disorder, so this program allows for future physicians to be equipped with the knowledge and tools to promote healing and lasting recovery.
During my time at Hazelden Betty Ford, I learned that many people are good at hiding their SUD–until they can’t anymore. In my family, it’s hard to address any mental or health concerns because it is met with disdain and exasperation. I distinctly remember one Hazelden Betty Ford resident turning to us medical students and saying, “Had my doctor asked me one more question about my alcohol use, I might have looked for help.” Back then, I didn’t ask my dad how he was, even though I noticed him getting skinnier–quieter. As a future healthcare worker, it’s our responsibility to take care of our patients, even if it means asking one more question.
For more information about Hazelden Betty Ford, visit their website https://www.hazeldenbettyford.org/.
Choi, S., Lim, S., Kwon, S. C., Trinh-Shevrin, C., Neighbors, C. J., & Yi, S. S. (2023). Urgent need for substance use disorder research among understudied populations: Examining the Asian-american experience. Health Affairs Scholar, 1(5). https://doi.org/10.1093/haschl/qxad058
-7.svg)
At AAPI Chronicles: Voices in Medicine, we are committed to fostering a supportive and inclusive environment where the AAPI medical community can share their stories, celebrate their achievements, and advocate for a more equitable and compassionate healthcare system.
