Potential participants provided informed consent electronically before beginning the survey. The survey elicited data on socio-demographic characteristics, past 5-year alcohol and drug use histories, and lifetime and past 5-year substance abuse treatment utilization. Recent SUD was measured using 22 items that assessed DSM-5 diagnostic criteria for AUD and DUD (Grant et al., 2015; Grant et al., 2016), using a past 5-year timeframe. Participants who reported 2 or more AUD and/or 2 or more DUD symptoms were characterized as having a recent SUD.
The prevalence of comorbidities among Hispanics suggests the need for integrated assessments and treatment for substance use and co-occurring disorders in settings serving Hispanic populations. Finally, given the high rate of alcohol use disorder (AUD) as primary SUD diagnosis among Hispanics (e.g., Brooks et al., 2013, Campbell et al., 2017, Carroll et al., 2009, Sanchez et al., 2015), pharmacotherapies such as naltrexone should be considered. Among the studies that reported baseline characteristics of their samples by race/ethnicity category, four studies found that Hispanics who use substances were less educated compared to other groups (Brooks et al., 2013, Campbell et al., 2017, Pagano et al., 2018, Sanchez et al., 2015). In a study including seven CTN protocols, Brooks et al. (2013) found Hispanics were less likely to be female (12.9% of Hispanic sample was female compared to 42.0% for non-Hispanic Blacks and 45.2% for non-Hispanic Whites). Likewise, Campbell et al. (2017) found that Hispanics were less likely to be currently employed compared to non-Hispanic whites, while Brooks et al. (2013) found Hispanics were more likely to have full-time employment. Compared to non-Hispanic Whites, Hispanics were also more likely to reside with a sexual partner and report better quality of life in vitality and emotional well-being (Brooks et al., 2013, Wu et al., 2010).
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Three CTN studies provided findings specific to HIV/risky sex behaviors among Hispanic substance users. Hispanics exhibited higher scores on HIV risk, risky injection drug use, and had higher levels of unprotected sexual behaviors. Second, Brooks et al. (2013) found that while Hispanic individuals were less likely to report trading sex relative to their non-Hispanic Black or non-Hispanic White counterparts, they were more likely to report having unprotected sex while trading sex. In comparison to non-Hispanic Blacks and non-Hispanic Whites, Hispanic participants were found to have the highest total HIV drug risk score, despite a lower likelihood of self-reported injection drug use.
Substance Use Disorder Statistics for the Hispanic Community
Both substance abuse and acute withdrawal from drugs and alcohol can have life-threatening consequences for people without access to quality treatment and a social safety net. Having a meaningful conversation about the intersection of race, racism, and substance abuse first requires explaining what is meant by the term “racial health disparities”. When it comes to alcohol consumption within the Hispanic community, there are variations among different subgroups.
In this study, women with greater acculturation were more likely to be current drinkers and at higher risk for alcohol use disorders. These results are consistent with findings from a comprehensive review of 32 studies focused on acculturation and alcohol use among Latinos 15. In this study Zemore (2007) reports that among all studies reviewed, there was a consistent association between higher acculturation and higher odds of drinking among women.
These four communities are diverse and provide adequate representation for comparing the different Hispanic/Latino heritage groups. This previous section has described findings on drinking and AUD among U.S. racial/ethnic groups. This epidemiological evidence demonstrates the considerable alcohol-related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Data from the 2002–2008 NSDUH have demonstrated the heterogeneity of Asian Americans in drinking practices.
Looking at Cultural Differences
We undertook the present qualitative study to collect more in-depth data to enhance our understanding of specific barriers to specialty substance abuse treatment that may explain Latino-White disparities. The TPB posits that intention is the closest antecedent of a given behavior, and intention to engage in that behavior (here, treatment seeking) is predicted or influenced by an individual’s attitudes, subjective norms, and perceived control towards the behavior. We used the TPB to explore in depth how barriers within these domains may contribute to Latino’s decisions to not seek specialty treatment for a substance abuse problem. This is the first qualitative study that hispanic alcoholism and rehab rates examined barriers to specialty treatment by race/ethnicity among a sample of White, Black, and Latino participants with recent SUD.
3.2 Drug use
Zemore et al., (2014) reported on data from the NAS on the effects of both race/ethnicity and gender on alcohol treatment utilization among Whites, Blacks, and Hispanics with a lifetime AUD. Among men, Hispanics less likely to use specialty treatment and Alcoholics Anonymous (AA) than Whites. Among women, Blacks and Hispanics utilized any services, specialty treatment, and AA less than Whites. Weisner et al. (2002) analyzed data from a Northern California county and reported that compared to Whites, Blacks were almost three times more likely to have received treatment and Hispanics were half as likely. Oleski et al. (2010) also reported that Blacks and Hispanics with a lifetime AUD were about 1.7 times more likely than Whites to seek help. In contrast, Alvanzo et al. (2010) reported null findings for differences in time between first drink and alcohol-related service use across Whites, Blacks, and Hispanics.
Further, Blacks and Hispanics with higher problem severity were less likely than Whites to receive treatment. Among individuals with an AUD, Hispanics were less likely than Whites to use alcohol/drug treatment programs or receive help from health professionals (physician, psychiatrist, psychologist, or social worker). At higher levels of severity, Blacks and Hispanics with an AUD were also less likely to use certain types of services (mental health, self-help). Contradictorily, Keyes et al. (2008), found no evidence of differential treatment utilization of alcohol treatment services between Whites and Blacks. Within the subjective norms domain, we found that stigma and perceived lack of family support were significant treatment barriers for Latinos. Interestingly, Latinos emphasized the importance of anonymity (i.e., not being seen using treatment) as a means of avoiding being stigmatized.
Statistical analyses
Third, the NSDUH reported data for persons 12+ years of age whereas the NESARC included data from adults 18+ years of age. Socioeconomic factors, such as income levels, education, and employment status, influence ethnic differences in alcohol consumption. Additionally, individuals from lower-income neighbourhoods may have less access to alcohol counselling resources, leading to higher consumption rates. For instance, drinking starts at an earlier age in traditional Puerto Rican culture, and there is less stigma surrounding alcohol in Puerto Rico compared to the contiguous US. The National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) is a collaboration of researchers and treatment providers who develop, refine, and evaluate novel interventions for the treatment of substance abuse. Two decades of NIDA CTN research offers a unique opportunity to examine differences in substance abuse treatment outcomes for racial and ethnic minority populations (Burlew et al., 2009, Burlew and Sanchez, 2017, Carroll et al., 2007).
Not Equal: Racial Disparities In Addiction/Substance Abuse Treatment
Hispanic Americans experience greater consequences of substance abuse compared to their non-Hispanic counterparts. Despite this, they have less access to treatment and must wait longer to access such services. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 91% of Hispanic Americans with a substance use disorder are unable to receive treatment at a specialty facility.
- Returning to why Cuban Americans appear less prone to abuse or become dependent on alcohol, in comparison to Puerto Ricans’ or Mexican Americans’ higher likelihood, the answer may be more cultural in origin.
- A recent systematic scoping review of research on Black participants in the CTN highlighted important issues critical to understanding and treating substance misuse among Black people (Montgomery, Burlew, Haeny, & Jones, 2019).
- There is also an increased understanding of the potentially protective effects of neighborhoods such as social cohesion, social support, and collective efficacy (Hong et al., 2014; Shell et al., 2013; Frank et al., 2007; Vega et al., 2011).
- Further, Blacks and Hispanics with higher problem severity were less likely than Whites to receive treatment.
- The purpose of this study was to gain a better understanding of barriers to specialty substance abuse treatment among Latinos.
- First, limiting this review to the CTN resulted in a small number of studies, potentially excluding other studies relevant to Hispanic populations in substance abuse treatment.
When comparing the representativeness of a clinical trial sample to national samples of the target population, McClure et al. (2017) found that participants in a cannabis cessation trial had a greater portion of Hispanic participants than expected based on national data. Latinos were significantly more likely to report attitudinal and subjective norm barriers than their White and Black counterparts. Data by race/ethnicity from the 2014 NSDUH show that a slightly higher percentage of Whites (21.9%) than Blacks (19.1%) and Hispanics (19.3%) who were in need of treatment actually received it (SAMHSA, 2015a). Proportions for American Indians/Alaskan Natives, Native Hawaiians/Pacific Islanders, and Asians were not reported due to low precision in the estimates.
Smoking rates are also typically higher for Hispanic and Latino youths compared to black and white teens. Each group has its own cultural differences as well as unique challenges that may impact the likelihood of developing a substance use disorder as well as obtaining treatment for it. Calling the number is free and confidential, but treatment services may involve costs depending on your insurance coverage and the level of care required. When you call the number listed on this ad, your call will be answered by Treatment X, a licensed addiction treatment provider and paid advertiser on AddictionResource.net.
- Overall, these findings underlie the importance of tailoring research and intervention programs to examine socio-economic and sex-specific factors contributing to alcohol use among Hispanics/Latinos.
- Hispanics significantly underutilize substance abuse treatment and are at greater risk for poor treatment outcomes and dropout.
- Twenty-six percent of new HIV diagnoses in 2016 were among Hispanic and Latino populations.
- One plausible explanation is the relationship of acculturative stress and alcohol use examined in other studies 32.
- Interestingly, Latinos emphasized the importance of anonymity (i.e., not being seen using treatment) as a means of avoiding being stigmatized.
- Fundamentally, the studies conducted in the CTN over the past twenty years, while improving the inclusion of minorities in clinical trials, have struggled with many of the fundamental structural barriers which perpetuate disparities in treatment access and completion for Hispanic populations.
It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery. Wu et al. (2010) reported that 91.3% of Hispanic adults in opioid detoxification treatment were using nicotine/tobacco while Sanchez et al. (2015) reported that 87.1% of Hispanic adults in residential treatment for stimulant use disorders were using cigarettes/other tobacco. Among Hispanic smokers, those with less education and those reporting opioids as their primary drug of use reported more cigarettes per day.
Lee and colleagues (2013) found that the prevalence of past 30-day binge drinking was highest among Korean Americans (24.8%), followed by Filipino and Japanese Americans (14.5% and 14.2%, respectively), Asian Indian Americans (10.1%), and finally Chinese Americans (8.1%). They further showed that among past 30-day drinkers, Japanese Americans had the highest number of past-month drinking days (8.8), followed by Korean and Asian Indian Americans (7.1 and 6.9, respectively), then Chinese Americans (5.7) and Filipino Americans (5.1). On those drinking days, all groups consumed an average of just over 2 drinks per day (range of 1.7 for Chinese Americans to 2.6 for Korean Americans; Lee et al., 2013). Among people who needed substance use treatment, there were no statistically significant differences by race or ethnicity in the percentages who actually received treatment, ranging from 18.9% of Black Americans to 25.3% of Hispanic Americans.
