It is also possible that the higher proportion of patients with schizophrenia and schizoaffective disorder in this study is associated with lower rates of substance use due to a limited access to substances. Although schizophrenia was found to be a protective factor of substance use in this study as well as in other studies , having psychiatric disorders such as depression and anxiety is generally considered to increase vulnerability to substance use. Specifically, anxiety patients may seek drugs such as marijuana to relieve their anxious or depressive symptoms as a coping mechanism.These self-medicating behaviors may be more common among untreated patients with underlying psychiatric disorders,and in turn, co-occurring substance use can aggravate the severity of their psychiatric symptoms . In this study, however, the relationship between anxiety and more alcohol, stimulant, and marijuana use was unable to support this explanation due to the very low rate of anxiety disorder among Asian Americans.
It is obvious that co-occurring substance use leads to difficult psychiatric treatment, higher treatment costs, and longer hospital stays.Studies have shown that substance users receiving care for their substance use showed decreased depressive symptoms and integrated treatment programs improved patients’ psychiatric symptoms.Although co-occurring substance users are considered a highly vulnerable population, treatment services such as psychiatric outpatient visits and substance abuse treatment programs are still inadequately used . Especially for Asian Americans, there may be other potential issues regarding the underutilization of mental health services such as lower English proficiencies,grow lights for cannabis stigma around having or being diagnosed with psychiatric disorders, cultural beliefs about receiving psychiatric care, limited access to health care services, and discrimination within health care systems . Therefore, these barriers should be addressed in health care systems and efforts should be made to increase access to psychiatric mental health services for Asian Americans at individual, community, and policy levels. This study used a cross-sectional design to examine predictors of co-occurring alcohol, stimulant, and marijuana use of Asian Americans with psychiatric disorders receiving residential treatment services; therefore, a causal relationship cannot be assumed.
The sample of this study came from residential treatment programs only in the San Francisco Bay area where Asian Americans and the homeless are over represented, resulting in a limited representation of the US population. In addition, this study did not examine Asian subgroup differences in the prevalence of and risk factors of substance use; therefore, it may overlook important factors such as levels of acculturation, length of residence in the US ,and immigration generation. Variables reflecting socioeconomic status such as income level and current or past job which are possible risk factors of psychiatric disorders and substance use were not included in this study because most participants were homeless due to their lower level of functioning related to their psychiatric disorder prognosis. This study’s sample was mostly diagnosed with severe psychiatric disorders such as schizophrenia and schizoaffective disorder, which may have led to biased findings. Lastly, findings from this study indicated that there may be patterns of poly substance use among Asian Americans with psychiatric disorders; however, this study did not look at the prevalence of and risk factors of poly substance use, indicating the need for future research study.Aside from using marijuana, are there any substantial differences between regular marijuana users and the general population?
What do these friendship networks suggest about relations with non-users? Are there any differences between illegal marijuana users and licensed medical marijuana users? Finally, can individual-level factors explain the varying rates of medical marijuana patient participation between geographic areas? This study addresses these questions using a survey of marijuana users in Oregon—a location ripe for investigation along these lines. Oregon has one of the highest rates of marijuana use in the US, with the most recent estimate indicating that 14.09% of individuals over 12 years old have used marijuana in the last year. Oregon is also home to one of the oldest medical marijuana pro-grams in the US, established in 1998, just two years after the first was created in California, and publishes county- level counts of medical users dating back to 2005.