Cultural Competency: Drug Culture by Soraya Chanyasubkit

In my Community Health Practices among Refugees and Immigrants Global Health course (long name, I know), we learned the LEARN acronym to familiarize ourselves with the foundations of cultural competency. LEARN stood for listen, explain, acknowledge, recommend, and negotiate. While in the global health class, we are refering to newly arrived immigrants and refugees who have trouble navigating a new culture, language, society, and health care system who probably keep dear and want to maintain their customs and traditional methods of healing, which can conflict when integrating themselves in America.

This is a similar predicament when it comes to the international drug culture. Because it really is what we’re dealing with – another culture. Sure the drug of choice may vary across nations, but it’s the same problem, intravenous drug users. Which are tied with prostitution, violence, high crime levels, and stigma. They have their own customs, vocabulary, and circumstances – a “new” population that instead of a refugee resettlement agency must contend with, but rather public health.

And honestly it’s really, to put it simply, hard. There are so many pre-conceived judgements, discrimination swirling around these individuals. It begins as an escape and in turn entraps them so they themselves can’t escape. And with all the resources and funding available (or rather, not available) why should we help these junkies? Aside from the altruistic, moral, social responsibility that I’m happy the class feels, but just doesn’t cut it in terms of gaining actual funding, there’s a host of public health and societal reasons to clean up the streets – or at least the needles. Whatever belief you hold (“We shouldn’t condone drug use by giving them needles/starting a needle exchange program”), the article stands correct when it says that these people – because they are people – should have the right to reduce the risk they have for themselves and others.

Ideally, we’d rid the world of drug users, but that goes along with the equally intangible racism, terrorism, poverty, hunger, HIV/AIDS, malaria, etc. But like the article notes, that this will never happen so the best that we can do is accomodate them in the saftest way possible. And here we can enact the LEARN principle. We can listen to these people, their addiction, their poverty, why they turned to drugs in the first place. Explain to them their options and it’s possible to stop, or at least reduce the harm. Acknowledge their problem, the difficulties. Recommend rehabilitation, detoxification and counselling. And the one that is most fitting negotiate. You can’t force anyone to change without their own volition. And that’s why we negotiate: we won’t force a behavior (until you choose to change it) as long as you protect yourself and those around you. That’s the best that we can hope for. Because like Dr. del Rio said last class: HIV/AIDS isn’t an infectious disease – it’s a reflection of society, economy, religion. And so is the international drug problem.

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