A.	For the Latino community, what works really comes down to messages based on the family unit. Our culture is oriented toward a responsibility toward children and family. Some people may not do certain things for themselves, but they may do it if it will help their children, their grandchildren, or other family members. This is a different approach from what seems to work in the general community, where the messages that resonate best are about individual responsibility and self-help. The family-oriented messages are at the core of responsiveness to messages concerning prevention in the Latino community and other collective societies. For example, in tobacco prevention we were able to let young people see how the messaging of the industry was affecting their younger siblings. The young people weren’t upset that they were being targeted themselves, but they were angry that their siblings were being targeted. One key factor we need to realize is that whether we’re talking about alcohol, drugs, tobacco, or gambling, whatever the reasons are that led you to the addiction, they are usually part of other issues that are going on in a person’s life. Many times in addiction, denial is a major factor. People with addictions develop certain tolerance levels. Whether it’s alcohol or drugs or gambling, that tolerance level keeps getting higher and higher. It can lead to a progression. However, people in denial think they can quit at any time and that they are not really addicted. That’s why some self-help groups, like Alcoholics Anonymous, start with people saying, “Hi, I’m an alcoholic.” People need to recognize that they have a problem. That’s usually the first step in healing.
Q.	What explains the gap, as AARP Segunda Juventud’s study showed, between awareness of addiction as a problem and the willingness to address the problem?
A.	To move from awareness to treatment in these kinds of addictions, the individual has to show a desire to change. It is consistent and persistent desire to change that will move them to different levels of readiness. Something has to click, and that’s why a policy or a community norm change or a voluntary business approach is so important. In addictions, one often faces situations that are beyond the individual’s control. Family members often find themselves at a loss as to what to do. In these cases, new government or voluntary policies or business approaches could help. For instance, if people are drinking too much, laws in some states say bartenders have a responsibility to not serve them another drink. With gambling, we’re a bit away from the massive education campaigns and polices that are needed to bring about this kind of legal or voluntary policy change. Working together with the Native American tribal leaders who own gambling establishments is going to be a major key to this. When it comes to secondhand smoke exposure and voluntary tobacco policies, for example, we need to be respectful of American Indian tribal sovereignty. The American Indian community has suffered many abuses itself for years. Now they’re making a lot of money through gambling establishments, many where smoking is still allowed. They don’t want to give up potential revenues despite the addiction problems it may cause or perpetuate. So the shift here has to be at a voluntary policy level or a business approach through which the tribes see it is in their financial interest to change. This takes it beyond just an issue of caring for the well-being of their workers and patrons.
Q.	How do you see addiction treatment strategies evolving?
A.	Treatment needs to be a comprehensive approach that includes communities, individuals, and the family. And it also has to come from the grassroots level. Mothers Against Drunk Driving was very successful because it didn’t only say “Don’t drink and drive.” It also provided alternatives as to what to do, such as “Friends don’t let friends drive drunk.” When we begin to be our “brother’s keeper,” we probably have a much better chance at success, because we begin to do things because we really care about each other. Many of these addictions are a cry for help at a deep existential level. As a society, we need to listen. For the longest time, we’ve been focusing on the psychological conditions behind addiction. We need a more comprehensive approach where you’re treating the individual psychologically, physically, and spiritually, as well as the family and the community the individual comes from. Oftentimes we don’t have the support systems around us that are nurturing and caring for us as a society. The treatment and recovery movement is very strong and has helped a lot of people. But it needs resources and support so these kinds of treatment programs can work better and be accessible to more people and their families in need.