A scoping review was utilized to determine what has been learned from the CTN about Hispanic populations with substance use disorder. A systematic search was conducted within the CTN Dissemination Library and nine databases. TEDS data also indicate that there is variation in the primary substance used at admission across race/ethnicity (Table 5). Among all racial/ethnic groups, the majority of admissions were due to alcohol alone or in combination with a secondary drug. Among American Indians/Alaska Natives, both opiates and marijuana/hashish were the second most common drug.
Sample characteristics
To our knowledge, the HCHS/SOL study is the largest contemporary study to examine alcohol use and contributing factors among diverse Hispanic/Latino heritage groups. Results from this study show that prevalence and patterns of alcohol use vary among Hispanics/Latinos of diverse heritage, as well as by sex. Given the growing numbers of Mexican background individuals in the US, more research is needed to further examine factors that may contribute to at-risk alcohol use among this group.
- However, the effectiveness of these interventions may be limited to specific factors such as alcohol use (MET; Carroll et al., 2009) or cultural match (Suarez-Morales et al., 2010).
- For instance, substance use treatment is frequently triggered by pressures from family, friends, employers, and the legal system (Weisner and Schmidt, 2001; Weisner et al., 2002).
- Drug and alcohol abuse affects millions of people in the United States each year, according to data compiled by U.S. federal health agencies.
- According to a study published in the journal Alcohol and Alcoholism, Puerto Rican men and women are the heaviest drinkers among Hispanic Americans.
- Lastly, in terms of perceived control, a minority of Latinos reported logistical barriers to treatment.
- Rates of alcohol dependence (5.3%) and binge drinking (24.6%) among Hispanics are similar to those of European Americans and slightly higher than those of African Americans.
For instance, 7.1% of Hispanic Americans have a substance use disorder, compared to 7.4% of the total population. Hispanic Americans also report lower rates of lifetime illicit drug use (37.7%) than European (54.5%) and African Americans (45.9%). They are second to non-Hispanic whites in alcohol use and binge drinking (42.9% and 44.4%, respectively) and have higher experimental drug use rates compared to other ethnic groups, including marijuana (39.9%), cocaine (9.4%), ecstasy (14%), and methamphetamines (5.7%). Over half (58%) were women, 40% had greater than a high school education, 23% were U.S. born (including mainland and U.S. territories), 25% preferred English as their first language, 50% were working either full or part-time, and 49% were married or living with a partner. Almost 30% were former drinkers (33%women, 27%men), and 52% were current drinkers (41%women, 63%men). Overall, 26% had no risk for alcohol use disorder (AUD) (39%women, 14%men), 65% were low risk for AUD (56%women, 74%men), and 9% were at-risk for AUD (5%women, 12.2%men).
- However, the role that biology and genetics play in health differences among racial groups has been increasingly challenged in recent years.
- Women are drinking more often, and greater amounts, it should be noted, so that gap is shrinking.
- Importantly, Latinos were more likely to report attitudinal and subjective norm barriers than their White and Black counterparts.
Racial Disparities In Substance Abuse And Addiction Treatment
The following section examines the extent to which racial/ethnic minorities have access to and utilize these treatment programs. Eligible participants were then purposively sampled to ensure equitable distribution across race/ethnicity, gender, disorder type (AUD or DUD), and substance use severity. Given the objective of our study, participants who reported never using specialty treatment were specifically targeted. The interviewer first contacted selected participants via email to schedule an interview, and then followed up via telephone if necessary. Three unique attempts were made to contact the selected participant and conduct the interview before drawing a replacement, if necessary.
Racial prejudice, discrimination, and microaggressions, for instance, can cause acute and chronic stress for communities of color. This can appear in the workplace, medical settings, education, and by way of microaggressions in other social settings. Misinterpreting the role that race has to play in the underlying causes of health disparities does a disservice to the process of meaningfully addressing health-related inequalities. Recognizing the ways non-white Americans are disproportionately affected by these health disparities, however, can build a pathway to greater understanding and developing solutions. Acknowledging the unique struggles that marginalized populations can face in health spaces does not discount the distressing experiences of people who aren’t similarly marginalized. Someone more versed in traditional American cultural mores may be more receptive to traditional treatments.
We identified important barriers that may influence Latinos’ decisions to avoid specialty treatment. Latinos were the only racial/ethnic group to report cultural barriers as reasons for not seeking help for an alcohol or drug problem. Many barriers—and particularly those within the areas of attitudes and subjective norms–were also more pronounced in Latinos’ narratives than in those of Black and White participants.
2.4. Perceived Treatment Need
The ethnic diversity within the umbrella term “Asian Americans” may also disguise or make it more difficult to identify the specific risk factors and rates of addiction among ethnic subgroups. Native Americans are also at increased risk for several other health issues, including high rates of suicide, mental illness, diabetes, and heart disease. Factors believed to contribute to this include disproportionate rates of discrimination, access to healthcare, historical trauma, poverty, and high levels of unemployment. National data shows that Black Americans are more likely than other racial groups to seek and receive treatment at a specialty facility. Rates of recovery among Black Americans following treatment, however, are lower than the general population. Non-white populations are less likely to be referred to addiction treatment and are less likely to have the financial resources to pay for treatment.
Full-text review of the remaining 56 studies excluded an additional 32 studies for not meeting inclusion criteria, yielding a total of 24 studies included in the review. For example, evidence suggests that American Indians/Alaska Natives are more comfortable with services that integrate tribal customs, traditions, and spirituality (Venner et al., 2016; Novins et al., 2011Spicer et al., 2007). Among Asian Americans, fear of shame or losing face has been identified as a barrier to treatment receipt (Masson et al., 2013). There are several strategies alcohol and drug rehab centers can implement to make this happen. Black Americans are more likely to be arrested, convicted, and incarcerated for drug-related crimes than white Americans, despite having similar rates of illicit drug use.
Asian Americans And Substance Abuse
Building on these findings, large, representative studies should be conducted to confirm our findings. Key challenges exist in addressing disparities in substance abuse treatment outcomes which include understanding the complexity of patterns of use and differences in adherence to treatment (Galea & Rudenstine, 2005). Issues such as mechanisms of change, correlates of drug use, and the presence of comorbid mental and physical disorders also vary for specific subgroups (Burlew et al., 2009, Sanchez et al., 2015). Hispanics often avoid specialty treatment due to barriers stemming from perceived lack of treatment efficacy, recovery goals, stigma, lack of social support, cultural factors, and family conflict (Fish et al., 2015, Pinedo, 2019, Pinedo et al., 2018). Racial and ethnic differences in access and utilization of treatment are confounded by income, insurance, severity of the disorder and interaction with the criminal justice system (Lê Cook & Alegría, 2011). Given these mixed findings and the rapid growth and diversity of Hispanics/Latinos in the U.S., more current research is needed to examine the relationship between various social factors and drinking patterns in this population.
Within the attitudes domain, key barriers to specialty treatment among Latinos were related to culture, treatment efficacy, recovery goals, and perceived treatment need. Latinos may feel discouraged from using health services that are perceived as not being culturally appropriate even if Spanish language services are provided (Alegría et al., 2006; Pagano, 2014). For instance, in one intervention study aimed at curbing heavy drinking, 95% of Latinos reported that having the counselor understand their culture (e.g., discussing cultural life/upbringing, cultural norms) helped them talk about their drinking (Lee et al., 2011). Developing culturally-tailored treatment services may be a critical and viable strategy to increase utilization among Latinos. A handful of other studies have focused on examining differences in hypothesized substance abuse treatment barriers by race/ethnicity (instead of using a treatment barriers scale). However, it remains to be determined how these factors relate to specialty substance abuse treatment and if they differ by race/ethnicity.
Every case is unique, but Latinas, for example, appear less likely to develop substance use disorders. While cultural differences and a bit of outsider status — against the dominant white culture — may drive some Latinos and Hispanics to use, their focus on family, respect, spirituality, and gender roles may also shield them from addiction. Puerto Rico’s legal drinking age is 18 (Puerto Ricans are U.S. citizens, too), and both Mexican and Puerto Rican cultures often celebrate with food and alcohol. If they encounter such food and drinks at family parties, youngsters may consider consuming them normal behavior. It may feel neat and tidy to lump all Hispanics and Latinos (or Latinas, for women, or the gender-neutral Latinx) together into one category, but that is an oversimplification in particular when it comes to life-or-death matters such as treating drug and hispanic alcoholism and rehab rates alcohol abuse. While the Latino and Hispanic populations may be climbing, so is addiction in those populations.
At a time of reducing National Institutes of Health budgets, the tension between the costs of studying larger and more representative samples of diverse racial/ethnic groups, and more economically efficient and smaller but non-representative samples is quite real. The path ahead calls for a variety of methodological strategies to further advance research. Mobile device-based data collection offers a strategy that is both effective and economic. Online data collection with a first stage of randomly selected panels of respondents also offer economic advantages over face-to-face and telephone interviewing. For instance, in spite of growing numbers and dispersion, Mexican Americans are still largely concentrated in the Southwest (Pew Research Center, 2014).
These data indicate that admission to alcohol treatment is complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals’ sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers and the legal system, and the overall organization of the treatment system. When viewed as a whole, American Indians appear to drink more and have higher rates of AUD compared to other racial/ethnic groups (SAMHSA, 2015a; Dawson et al., 2015). Many people who struggle with substance abuse and addiction require weeks, months, or even years of professional support to achieve full recovery. On a population level, Asian Americans have lower rates of drug and alcohol abuse compared to other racial and ethnic groups. Hispanics are also incarcerated at disproportionately high rates and have less access to specialty treatment services, especially those that are culturally competent.
People of all racial and ethnic backgrounds may share common risk factors, such as a family history of substance abuse, co-occurring mental illness, and early exposure to drugs and alcohol. Research suggests that acculturation plays a role in alcohol consumption among Hispanic women. As Hispanic women become more acculturated to American society, they may be more inclined to adopt the social norms of their host society, including drinking alcohol. This could be due to increased social acceptance and a willingness to participate in behaviors that may have been previously considered taboo.
