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Introduction

1 Immigration and Ethnic Minorities:
Political and Societal Concepts

1.1 Germany

1.1.1 Germany as a de facto Immigration Country

1.1.2 The Multicultural City of Frankfurt am Main

1.2 Israel

1.2.1 The Melting Pot Maintained: Immigration and
Absorption of Jews and Differentiation of
Other Ethnic Minorities

1.2.2 City of Cultural Diversity: Tel Aviv/Jaffo

1.3 United States

1.3.1 The United States as an Immigrant society

1.3.2 Minorities as a Majority: San Francisco

2 Idiosyncrasies in Three »Western« Countries: Drug History,
Treatment Systems and Prevalence of Illicit Substance Use

2.1 Germany

2.1.1 Illicit Substance Use—a West German Phenomenon?

2.1.2 From Abstinence-Dogmatism to Experimental Harm-
Reduction: Evolution of the Drug Treatment System

2.2 Israel

2.2.1 The Jewish Sober Ethos to Fade?—
Prevalence of Illicit Drug Use in Israel

2.2.2 A Unique and Recent History:
The Israeli Drug Treatment System

2.3 United States

2.3.1 An Upward or Downward Trend?—
Prevalence of Drug Use in the U.S.

2.3.2 The Summer of Love, the Drug Scares
and Beyond: Evolution of Drug Scenes
and the Drug Treatment System in the U.S.

2.4 Comparative Conclusions

3 Substance Abuse among Ethnic Minorities—
Prevalence, Distribution and Patterns

3.1 Germany

3.2 Israel

3.3 United States

4 Roadblocks and Other Barriers:
What Prevents Ethnic Minorities from
Entering Drug Abuse Treatment in Germany?

4.1 Under-Utilization of Mainstream Services

4.2 Identified Barriers to Accessing Treatment

4.3 Outpatient Drug Services and Ethnicity in Frankfurt

4.3.1 Options for Outpatient Treatment
and Service Utilization

4.3.2 From Low-Threshold Service into Counseling?

5 Hidden Populations in Need?—Access to Drug
Treatment for Ethnic Minorities in Israel

5.1 A National Perspective

5.2 Empirical Observations:
Outpatient Drug Treatment in Tel Aviv/Jaffo

5.2.1 The Treatment Providers’ Point of View

5.2.2 The Clients’ Point of View

6 Ethnic and Cultural Sensitivity in Outpatient
Drug Abuse Services in the United States: A Case Study

6.1 Ethnic Groups and Drug Treatment in San Francisco

6.2 A Treatment Philosophy from the 60s—
Suitable for the Millenium-Zeitgeist?
Case Study of the Haight Ashbury Free Clinics’
Outpatient Substance Abuse Services

6.2.1 History and Evolution

6.2.2 Current Realities

7 Towards Multicultural Competencies in Outpatient
Drug Services: Discussion and Results from a
Transnational Perspective

7.1 Inhibiting Factors in Politics and Society

7.2 Considerations for Organizational Development

7.2.1 Models

7.2.2 Organizational and Individual Competencies

7.2.3 Conclusions

References

Appendices

Abbreviations
List of figures
List of tables

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