Immigrant and Refugee Needs Assessment 
Defining Substance Abuse in Cambodian and Sudanese Refugee Communities in Maine
August 2006

Problem Statement 
•	There has been little research done on substance abuse in these two communities, this study was an exploration into looking at how these communities define substance abuse.  The study looks at acculturation, family bonding, family management and family attitude towards substance use.  The purpose of this study is to determine how best to engage these communities in the future, what strategies worked and what didn’t. In addition the study looked at what each community knows about substance abuse.

Definitions
•	Acculturation. The modification of the culture of a group or individual as a result of contact with a different culture. (www.dictionary.com)
	
•	*Refugee: A refugee is a person unable or unwilling to return to his or her native country due to a well-founded fear of persecution or because the person's life or freedom would be threatened.

•	*Immigrant--Permanent Resident Alien - an alien admitted to the United States as a lawful permanent resident. Immigration usually involves having a choice to leave ones homeland.    *(www.uscis.gov)

Background Information

•	 Sudan consists of two different regions with very different cultures; to the North they are Arab Islamic. In the South there are many tribes with different languages, religions and culture. There are 400 tribes in Sudan, with134 different living languages. 

•	There has been civil war in Sudan since 1955 with a peace accord being signed in 2005. Approximately 4.5 million people have been displaced, 2 million estimated dead. In the 1990s Sudanese refugees began coming to Maine, there are now approximately 2400 Sudanese representing about 19 of the 400 tribes. Many Sudanese spent years living in refugee camps prior to coming to Maine.

•	 The Vietnam War sparked war in Cambodia in 1975 which led to the Khmer Rouge persecuting millions of Cambodians based on differing ideological beliefs. Peace was finally reached in 1998. Cambodians speak primarily Khmer and French. Most Cambodians practice Buddhism. 

•	Cambodian Refugees began coming to Maine in the early 1980s, about 1200 people have settled in Maine.

Findings

	  Acculturation
•	 Youth have acculturated to American society far better than their parents. Parents see this as a rejection of Cambodian and Sudanese culture, which is leading their youth to make poor choices. One Sudanese woman said: “they (UN) took from one war and dropped us into another war, a cultural war against our families". 

•	 Both communities stressed that the culture of America is leading to a break down of their families; most of this is attributed to laws that protect children. They feel their ability to manage their families is being restricted by those laws.

•	 Sudanese youth often tell their parents they are Americans now, free to live their lives without parental interference.

•	Schools are viewed as being part of the problem when it comes to youth not listening to parents or misbehaving. Both communities felt the school provided little to no discipline for their children and that school staff often side with the children against the parents. 

•	They believe American culture does not support families.

Family Bonding/Family Management 
•	Both communities see family bonding as an important factor in keeping their kids safe. 

•	Most adults in these communities work long hours, seventy hours over six days a week, leaving little time for family or recreation. They believe there needs to be more programs to keep children busy and thus keep them from engaging in ‘bad’ behavior. 

•	Sudanese and Cambodians alike feel they no longer know how to manage their families given Maine laws. 

Family Attitude towards Substance Use
•	Most Cambodian families allow youth to drink if they can behave and a parent is present. Alcohol is present at many ceremonies and functions. The dangers of drinking too much are shared with the community before each ceremony.

•	The Sudanese frown on drinking while a man is a teenager.  Alcohol is used in exchange for someone helping you and is consumed only after people have finished working; it is not an everyday event. They generally do not drink in front of their children or keep alcohol in the home. In Sudan the traditional beer has lower alcohol content than in the US. The community is organized with each tribe having elders who make decisions or discuss community issues. 

Understanding of Substance Use
•	The major substances used in the Cambodian community appear to be alcohol, marijuana and tobacco. The community said they did see some cocaine and heroin use. In addition gambling was mentioned as being a popular past time amongst Cambodians.

•	The Sudanese see alcohol and limited use of marijuana amongst youth.

•	Both Communities expressed the need for the community to learn more about substance use and drug identification. They stated they do not know how to begin dealing with substance abuse in their communities.

Working with the Community        
•	In working with these communities we found people willing to talk openly about delicate issues, we found face to face discussions worked far better than surveys or questionnaires. Each community did not just discuss the problems they are facing but came with ideas on how to ‘fix’ things. They want to be included in decisions that impact their community.

•	We found it important to go to where community members live and not to expect them to come to you. In addition, it is essential to have people representing these communities on staff when providing services to these communities.

•	People tended to arrive at meeting after the time the meeting was scheduled. People often said yes when we made suggestions, this is not always a sign of agreement, but often a sign of respect. 

Other Findings
•	Domestic violence was raised often by the Sudanese community, issues again around cultural understanding of domestic abuse and how each Sudanese versus Americans would handle these family issues.

•	Sudanese raised issues about Maine environment promoting the use of alcohol, for example food is sold in the same place as alcohol. They said if someone wished to drink in Sudan they had to go to a bar, where only alcohol is served then the police could watch for youth who might be trying to sneak in.

For general information call: 207-842-2995 ext 109
Technical questions related to statistical methods should be directed to:
Amanda Lonsdale
Day One
188 State Street
Portland, ME, 04101

Funding for the study from SAMHSA, Center for Substance Abuse Prevention, Strategic Prevention Framework State Incentive Grant.