S6 E3: Tarang Series: Clinical Perspectives and Personal InsightS6 E3: Tarang Series: Clinical Perspectives and Personal Insight
Addiction Medicine Podcast
Two AANHPI clinicians share professional and personal perspectives on addiction, shame and recovery, emphasising culture, language and connection. The conversation highlights barriers to care and stresses the need for culturally responsive, community-rooted support.
43:33•28 May 2026
Clinical Voices, Cultural Silence: Addiction and Recovery in AANHPI Communities
Episode Overview
- Addiction is often only acknowledged in AANHPI families once it disrupts work, income or reputation, leaving many struggles hidden and unnamed.
- Cultural, language and structural barriers mean AANHPI people are less likely to access behavioural health services, even when problems are severe.
- Addiction frequently involves behaviours such as gambling, workaholism, sex and financial issues alongside or instead of substance use.
- With AANHPI clinicians making up a very small share of the mental health workforce, many services miss crucial context such as colonialism and diaspora experience.
- Connection, safety and honest conversation—whether in peer groups, community settings or clinical care—are central to meaningful recovery.
“The opposite of addiction is not sobriety, it’s connection.”
What insights can experts and survivors share about addiction? This conversation brings together clinical experience and lived reality to look at substance use and mental health in Asian American, Native Hawaiian and Pacific Islander (AANHPI) communities. Host Pooja Mehta chats with Dr. Noel Ramirez, founder of Mango Tree Counselling and Consulting and senior lecturer at Columbia University, and Dr. Mariel Rayataza, physician and executive director of the National Asian Pacific American Families Allied for Substance Awareness and Harm Reduction.
Both share Filipino roots and talk openly about how culture, immigration and family expectations shape attitudes to addiction. You’ll hear vivid examples of how silence around alcohol and other addictions shows up: in families where “the only time I would hear addiction… was when it got in the way of earning,” in communities where language for mental health simply doesn’t exist, and in youth suicide statistics that hint at pain no one feels able to name.
The guests talk about shame, “saving face”, and the way trauma from war, displacement and racism can land in the body when there are no words for it. Clinically, they flag gaps in care: very few AANHPI therapists, rushed medical appointments, psychiatrists who only have time for prescriptions, and evidence-based treatments that ignore caste, colonialism, colourism and diaspora stories. They argue that without this broader context, “best practices fall flat”. At the same time, there’s hope.
The episode highlights harm reduction, medication-assisted treatment like Suboxone, and a broader view of addiction that includes gambling, workaholism, sex and financial compulsions. Both guests credit recovery spaces, peer support and storytelling with changing their own lives. Underneath it all runs one simple theme: connection. As Ramirez puts it, many in recovery say “the opposite of addiction is not sobriety, it’s connection.” If that’s true, what small step towards connection could you take today—for yourself, your patients, or your community?
Do you want to link to this podcast?
Get the buttons here!
More From This Show
The latest episodes from the same podcast.
Related Episodes
Similar episodes from other shows in the catalogue.