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 hispanic alcoholism and rehab rates for treatment.
Looking at Cultural Differences
In one study, Feaster and colleagues (2010) reported measurement invariance across racial/ethnic group (e.g., across Hispanic, Black, or White families) for baseline assessments related to family functioning and adolescent problem behaviors. Korte et al. (2011a) completed a review of substance abuse outcome measures used in CTN studies including the use of urine drug screens (UDS), self-report, and corrected self-report measures. While most forms of substance abuse outcome measures were highly correlated, some measures statistically advantaged non-Hispanic White women, Black women, and Hispanic men which could lead to erroneous conclusions concerning the efficacy of an intervention with these groups. First, and importantly, the NESARC studies failed to provide data that differentiated between Asian Americans and Native Hawaiian/Pacific Islanders. This is problematic because significant differences in drinking in relation to tribe and geographic region have been identified (Whitesell et al., 2012; O’Connell et al., 2005, Beals et al., 2005, Beals et al., 2003; Koss et al., 2003).
Building Recovery Community – Cultural and Linguistic Appropriate.
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.
The rate for Puerto Ricans was 7%, followed by South/Central Americans (6%), Puerto Ricans (4%), and Cuban Americans (3%; Jetelina et al., 2016). Among women, Puerto Ricans drank more, binged (4+ drinks within a 2-hour period) more frequently, and had a higher prevalence of past 12-month DSM-IV alcohol dependence than women of other national groups (Caetano et al.,2009; Ramisetty-Mikler et al., 2010). A limitation of HABLAS is that data were collected in five metropolitan areas of the U.S., thus rural Hispanic populations were not represented. Two high-risk consumption patterns that contribute to alcohol-related problems include binge and heavy drinking (Naimi et al., 2003; Rehm et al., 2003).
Racial/Ethnic Discrimination
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available. Having access to a full continuum of care, including outpatient support, can be very important for supporting people on their recovery journeys. Addiction treatment centers must also take concrete steps to create treatment environments that are inclusive, culturally competent, and accessible to communities of color. A study by the Centers for Disease Control and Prevention (CDC) found that 4.1% of Pacific Islanders reported psychological distress in the previous 30 days compared to 1.5% of Chinese Americans and 1.1% of Japanese Americans. Pacific Islanders in the U.S. also report a higher instance of mental illness than other racial groups, including Asian Americans. Black Americans are more likely than other racial groups to be referred to inpatient addiction treatment through criminal justice settings.
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.
2. Attitudes toward Specialty Treatment
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.
- Among women, Blacks and Hispanics utilized any services, specialty treatment, and AA less than Whites.
- Chea and colleagues (2008) analyzed data on any lifetime DSM-IV AUD from the 2002–2003 NLAAS and found that prevalence rates varied widely across national groups.
- TEDS data also indicate that there is variation in the primary substance used at admission across race/ethnicity (Table 5).
- White admissions increased slightly and Black admissions decreased by nearly 5%, comprising about a fifth of all admissions in 2012.
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.
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).
Understanding Barriers to Specialty Substance Abuse Treatment among Latinos
- Combined 2003–2010 NSDUH data comparing Hispanics and non-Hispanics indicated that among those 12+ years of age who met criteria for substance abuse or dependence, 9% of Hispanics versus 10.5% of non-Hispanics received treatment (SAMHSA, 2012b).
- However, people of color (POC), especially those who are low-income, are more likely to experience disparities in access to care compared to their white counterparts.
- It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
- All other reported values (means and prevalence rates) were weighted to account for the disproportionate selection of the sample and to at least partially adjust for any bias effects due to differential nonresponse in the selected sample at the household and person levels.
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.
Alcohol and Drug Abuse Among the Latino Population
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.
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.
Focusing data collection with this group in large Southwestern cities and some carefully selected rural areas can answer research questions with generalizability and can provide important results for local public health officials. Such a strategy can be similarly applied to research on other Hispanic and Asian national groups, Pacific Islanders, Native Americans, and Alaskan Natives. Two interrelated frameworks serve to explain the relationship between minority status in the U.S. and alcohol-related behaviors. One is a framework referring to social disadvantage, encompassing both racial discrimination and poverty (Mulia et al., 2008).