Addiction And Substance Abuse Among Pacific Islanders

Medically Reviewed by Johnelle Smith, M.D. on

Although Pacific Islanders experience drug abuse at lower rates than the general population, they often lack access to addiction treatment and may never receive proper care. Fortunately, research is revealing how rehab centers can meet their unique needs.

Addiction And Substance Abuse Among Pacific Islanders

Pacific Islanders, commonly grouped in with Asian Americans for census reasons (known as AAPI), are one of the fastest-growing demographics in the United States.

By 2050, there are estimates that AAPI groups will make up more than 10% of the American population, and it’s essential to ensure they’re getting proper healthcare.

There are more than 20 subsets of Pacific Islanders, including Hawaiians and people from Guam, the Virgin Islands, Polynesia, Fiji, and American Samoa, among others.

Although rates of substance abuse are lower in Pacific Islander populations, they face unique disparities and challenges when seeking treatment.

Rates Of Substance Abuse In Pacific Islander Groups

According to the Asian American Psychological Association, around 14% of AAPI young adults aged 18 to 25 have a substance use disorder, compared to nearly 22% in other ethnic groups.

Pacific Islanders account for around 4% of drug abuse among American adults, and they enter drug and alcohol treatment at similar rates.

While drug abuse rates are lower, nicotine and alcohol use disorder rates are slightly higher among Pacific Islanders than other groups. They are also more likely to experience gambling addictions.

One survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) among Pacific Islanders in treatment found that 64% of them named alcohol as their primary problem.

Addiction Risk Factors Among Pacific Islanders

Many Pacific Islanders lack access to proper addiction treatment and may be hesitant to seek help, worsening any existing mental health or addiction issues.

One study found that only 8% of AAPI people enter treatment, compared to double that (16%) in other populations.

Pacific Islanders also battle racism, financial hardships, and other difficulties that can lead to substance abuse as a form of escapism.

Racism And Discrimination

Racism is a major barrier to achieving equitable healthcare among all minorities in the U.S. Patients may be neglected or dismissed due to bias from providers.

During the COVID-19 pandemic, instances of violence and prejudice against Pacific Islanders increased significantly, leading to further reservations when attempting to find treatment.

Language barriers and a lack of patient advocacy are also problems frequently experienced by Pacific Islanders seeking addiction care.

Without feeling safe and supported by healthcare providers, Pacific Islanders are less likely to get life-saving mental health and substance abuse treatment.

Education Disparities

Pacific Islanders, particularly teenage boys, often face stereotyping from teachers and more time in suspension as they progress through school.

They may experience bullying or be unfairly perceived as lazy or delinquent, leading to less academic support and a more difficult time pursuing higher education.

Native Hawaiians and Pacific Islanders drop out of school at higher rates than some other groups, which puts them at an increased risk of economic disparities in adulthood.

Financial Difficulties

Up to 23% of Pacific Islander children live below the poverty line, making addiction treatment inaccessible for many.

Many Pacific Islanders live in states with high costs of living, such as Hawaii or California. Tourism has only exacerbated this issue in Hawaii, where native people are more likely to be unhoused.

AAPI people also deal with discrimination in the home-buying industry and suffered the worst decline in homeownership of any group during the 2008 financial crisis.

Military Service

With around 77,000 AAPI people currently enlisted, Native Hawaiians and Pacific Islanders make up about 7% of the U.S. military.

There are a number of health and addiction risks associated with veterans, who often face disproportionate rates of substance abuse and poor access to healthcare services.

Combat trauma can lead to mental illnesses such as post-traumatic stress disorder (PTSD), which often directly correlates to substance addiction due to self-medication of symptoms with drugs or alcohol.

Minority groups also frequently experience discrimination, sexual assault, and prejudice while serving in the military.

Mental Health Difficulties

The impacts of colonization, racism, and discrimination on Pacific Islander communities have had a ripple effect on mental health across generations.

One recent study conducted in 2019 found that suicide was the leading cause of death for Pacific Islanders and Native Hawaiians between the ages of 15 and 24.

The study also concluded that Pacific Islander groups are three times less likely to receive mental health treatment than non-Hispanic white groups, compounding existing problems.

Only 5% of Pacific Islander adults receive mental health medication, compared to more than 16% of non-Hispanic white adults.

Some of the most commonly diagnosed mental illnesses among Pacific Islanders include:

  • anxiety disorders
  • major depressive disorder
  • obsessive-compulsive disorder (OCD)
  • eating disorders
  • personality disorders

Most Commonly Used Drugs Among American Pacific Islanders

Pacific Islanders experience alcohol abuse more than any other racial group. Other common substances of use include stimulant drugs, nicotine, and marijuana.


Alcohol is one of the most commonly abused substances among Pacific Islanders in both teenagers and adults.

Underage drinking is a frequent contributor to adult substance abuse since it can directly affect brain development and is often easier to access than other drugs.

Drinking alcohol may be used as a coping mechanism for some of the risk factors we looked at earlier, like poverty or educational disadvantages.

Up to 60% of adult men in Pacific Island countries drink alcohol regularly. This can create a social acceptance of drinking that can make it harder for someone to recognize when they have a problem.

Methamphetamines And Stimulants

Native Hawaiians and Pacific Islanders report addictions to cocaine, methamphetamines, and other stimulants at concerning rates. Some studies demonstrate that 9% of this group has an addiction to one of these substances.

There are a few potential reasons for this. One major factor is that many of these islands are in direct paths of international drug smuggling routes, leading to easier access to stimulant drugs.

While cocaine is a more expensive substance, methamphetamines are much cheaper, causing a rapidly growing crisis with this drug in particular.

Methamphetamine drug trafficking on these islands causes not only addiction but increased rates of violence, arrests, poverty, and other social issues.

Nicotine Vaping

Nicotine use is significant among AAPI populations. In 2019, the Centers for Disease Control and Prevention (CDC) found that nearly 19% of Pacific Islander adults used nicotine that year.

Children are also susceptible to nicotine abuse. The same study documented that 45% of Pacific Islander middle schoolers admitted to using or trying nicotine at least once.

Heart disease and cancer, which can be caused or dramatically worsened by cigarette smoking, are the two current leading causes of death among Pacific Islanders and Native Hawaiians.


Although the legality of growing cannabis varies widely among Pacific Island countries, marijuana consumption has increased in all Pacific Islander age groups in recent years.

Cannabis is often grown in Pacific Island areas due to the warm climate and high humidity, which may contribute to the rise in marijuana use.

Despite this, cannabis use disorders are still lower among Pacific Islanders than many other groups.

Complications And Barriers To Addiction Treatment Among Pacific Islanders

Even when there are drug and alcohol treatment centers available, many Pacific Islanders won’t seek care for themselves. There are several factors that contribute to this problem.

Lack Of Access To Culturally Competent Care

One of the most significant problems Pacific Islanders face when they enter treatment is cultural and language barriers.

Many Pacific Islanders currently living in the U.S. were born outside the U.S. and raised with different societal and cultural expectations.

Common treatment services in the U.S., like the 12-step method, require people in recovery to open up and confide about their struggles, often to complete strangers.

This method may prove ineffective for Pacific Islanders in recovery due to concerns over family reputation, distrust of Western medicine, or personal shame and violation of privacy.

Many Pacific Island groups also believe that asking for help is a sign of weakness or failure, which may be compounded by existing addiction stigmas.

Difficulty Accessing Affordable Rehab Programs

Pacific Islanders face a number of unique challenges when accessing American healthcare, particularly after immigrating.

Some of these challenges include:

  • lack of transportation
  • lack of local treatment programs
  • lack of health insurance
  • inability to speak English
  • lack of gender-specific treatment

These issues can combine into a daunting search process for addiction recovery care, particularly if a Pacific Islander is unaware of any potential resources that can help them.

Lack Of Research

Studies have found that Pacific Islanders who do seek medical help for addiction often present with physical problems instead of mental or emotional ones.

They may complain of headaches, nausea, or other physical health problems that are common symptoms of substance use disorders without acknowledging their substance abuse issues.

This, particularly when combined with language barriers and other cultural differences, can mean that the patient never receives any help for drug and alcohol abuse.

There is an additional dearth of evidence-based treatment programs designed specifically for Pacific Island populations, making it difficult for providers to properly treat these patients.

Specialized Addiction Treatment Services For Pacific Islanders

If you or someone you love is a Pacific Islander in need of addiction treatment, do not despair. Efforts are being made to increase access and provide the right care for these minority groups.

One method provides 12-step alternatives that focus less on openly sharing and more on providing community support.

The inclusion of holistic and holistic medicinal practices can also help Pacific Islanders feel more at ease.

Bringing in kapunas, or spiritual leaders, can also help guide Pacific Islanders through treatment. Support from family, friends, and community is invaluable during this time.

Bilingual healthcare providers or on-site translators are other essential tools in providing care.

Finally, many Pacific Islanders are often more receptive to physical addiction therapies, such as screenings or medication-assisted treatment (MAT), than purely emotional recovery methods alone.

There is still significant progress to be made in Pacific Islander addiction treatment services, but awareness and understanding of these issues are growing at a rapid pace.

Resources For Pacific Islanders Seeking Addiction Care

The resources below can help you or a loved one with finding substance abuse treatment, mental health services, and other support.

These resources are available for Pacific Islanders looking for addiction care services:

The following resources seek to advance healthcare among Pacific Islanders:

Here you’ll find mental health resources for Pacific Islanders:

This page does not provide medical advice. See more

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These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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