Assessing Middle Eastern American Attitudes Towards Substance Use Disorders

Assessing Middle Eastern American Attitudes Towards Substance Use Disorders Introduction: Substance use disorders (SUD) among Middle Eastern and North African (MENA) populations remain largely understudied, despite evidence of high prevalence rates and lower rates of treatment engagement. Unique cultural conceptualizations and beliefs surrounding substance use disorders may perpetuate stigma, further contributing to disparities in access to and utilization of treatment services. This study aims to explore the attitudes and perspectives of individuals from MENA communities regarding substance use disorders, with the goal of identifying and addressing barriers to treatment. Methods: An anonymous bilingual Qualtrics survey was administered, gathering responses from Middle Eastern and North African (MENA) participants as well as non-MENA participants (n = 162, ages 18 and older). The survey assessed participants' attitudes across multiple dimensions, including stigma toward substance use disorders, perceptions of treatment modalities, and expectations regarding recovery and future outcomes. Data analysis was conducted using SPSS, employing a variety of statistical techniques to examine group differences and associations. These included Chi-squared tests to evaluate categorical variables, Pearson bivariate correlations to explore relationships between continuous variables, and ANCOVA and t-tests to assess mean differences while controlling for covariates. Results: Stigma towards substance use disorders was significantly higher among non-MENA participants under a one-sided test (p = 0.042), but not under a two-sided test (p = 0.083). MENA participants were significantly less likely to agree with harm reduction as a treatment approach (p = 0.006). However, there was no significant difference between MENA and non-MENA participants in their likelihood of using harm reduction resources (p = 0.737), suggesting a potential gap between ideological attitudes and practical behaviors. MENA participants were significantly more likely to align with the Choice Model of addiction, emphasizing personal responsibility, compared to non-MENA participants (p = 0.002). Religious support was also significantly preferred by MENA participants (p = 0.003). Additionally, a significant positive correlation was found between aligning with the Choice Model of addiction and preferring religious support (p < 0.001). Discussion: Our study reveals significant cultural differences in attitudes toward substance use disorders, particularly among MENA participants, who were more likely to align with the Choice Model of addiction, which views substance use disorders as the result of deliberate choices made by individuals and favors religious support in treatment. These findings suggest that cultural and religious frameworks strongly influence how addiction and recovery are conceptualized in MENA communities. Interestingly, while MENA participants expressed lower agreement with harm reduction ideologies, their likelihood of engaging with harm reduction resources was similar to that of non-MENA participants, indicating a disconnect between attitudes and practical behaviors. This gap highlights opportunities to design interventions that address ideological barriers while leveraging existing openness to resource utilization. These insights highlight the importance of integrating cultural values, such as faith-based support and personal ideologies, into treatment approaches to reduce stigma and improve treatment engagement in MENA populations.