The 2010 U.S. Census published by the Centers for Disease Control and Prevention (CDC) reported that 36.3 percent of the US population was a part of an ethnic or racial minority, which often includes the following groups:
- Asian American
- Latino or Hispanic
- African American or Black
- Native Hawaiian and Other Pacific Islander (NHOPI)
- White or Caucasian
- American Indian or Alaska Native
In 2013, the National Survey on Drug Use and Health (NSDUH) estimated that 21.6 million Americans, over age 11, abused or were dependent on drugs or alcohol. Different races may view substance abuse and treatment differently, and facilities offering care for mental health and substance abuse should therefore be culturally sensitive in order to provide optimal results.
SAMHSA publishes the following information on minority groups’ past-month (considered current) illicit drug abuse in 2014:
- NHOPIs: 15.6 percent
- American Indians and Alaska Natives: 14.9 percent
- African Americans: 12.4 percent
- National Average: 10.2 percent
- Hispanics: 8.9 percent
- Asian Americans: 4.1 percent
Substance Abuse among Minority Populations
While about 60 percent of those admitted to publicly funded substance abuse treatment programs in 2008 were for white or Caucasian individuals, according to the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that minority groups or people of color may suffer from substance abuse or mental health disorders at high rates part due to difficulties accessing care, the right kind of care not being available, and environmental, social, and financial concerns may be barriers to treatment.
Alcohol usage may be highest among Caucasians, with 57.7 percent reporting current alcohol consumption (or drinking alcohol in the past month), as published by the 2013 NSDUH. This was followed by multiracial individuals, or those of at least two races, at 47.7 percent; African Americans at 43.6 percent; Hispanics at 43 percent ; NHOPIs at 38.4 percent; and American Indians or Alaska Natives at 37.3 percent. Asians drank the least in the past 30 days at a rate of 34.5 percent of the population.
Binge drinking is a pattern of potentially dangerous alcohol consumption that raises one’s blood alcohol concentration (BAC) to 0.08 g/dL or above, which usually means about four drinks for a woman or five for a man in a two-hour timespan.
Binge drinking rates for the different races in 2013 as indicated by NSDUH were as follows:
- NHOPIs: 24.7 percent
- Hispanics: 24.1 percent
- Whites: 24 percent
- American Indians and Alaska Natives: 23.5 percent
- Blacks: 20.1 percent
- Multiracial individuals: 19.6 percent
- Asian Americans: 12.4 percent
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Native Hawaiian and Other Pacific Islanders and Asian Americans
Native Hawaiian and Other Pacific Islanders tend to abuse substances at rates much higher than the national average and higher than other minority groups. This may be due to the fact that many live on islands that may have limited care available and depressed economics. In addition, easy and regular access to drugs and alcohol at a young age may be common, and NHOPIs may be less likely to seek healthcare than other population groups. According to the journal Public Health Reports, Asians and Pacific Islanders may abuse stimulant drugs more often than other ethnic groups, as these drugs are common in their cultures. These drugs may be affordable and easy to obtain.
Asian Americans seem to have the lowest rates of substance abuse; however, statistics may not paint a complete picture as this group may often be underrepresented in data models. Asian Americans may be considered a “model minority,” Journal of Ethnicity in Substance Abuse publishes, even within its own ranks.
Drug or alcohol abuse may be viewed as aberrant or unusual to the culture, thereby stigmatizing substance-abusing individuals and potentially making it less likely that Asian Americans will seek treatment for addiction. Culture constraints may dictate that substance abuse and addiction is something to be handled within the family. Family dysfunction may be considered a private affair and not up for discussion publicly or even within the family, creating a potential social stigma that may act as a barrier to treatment, SAMHSA’s Treatment Improvement Protocol (TIP) reports.
American Indians and Alaskan Natives
Substance abuse in minority populations may be considered the result of acculturation, or the assimilation into a new culture. This can be the case for families or individuals who immigrate to America and begin to take on the characteristics of the new society. Stress related to the division between their native culture and American culture may increase the potential for substance abuse and dependency, Psychiatric Times publishes. Native American elders, for example, believe troubles with substance abuse occur when individuals lose connection to their culture and heritage. Individuals who are closely connected to both sets of cultural values have fewer difficulties with alcohol or drug concerns.
In 2010, Native Americans, according to SAMHSA, had the highest rate of drug-induced death of any other race or ethnic group at 17.1 percent. American Indians and Alaska Natives also have high rates of mental illness, with rates of co-occurring substance abuse or dependence and mental illness of 8.8 percent in the past year (based on 2014 data by SAMHSA). This is much higher than the national average of 3.3 percent. This racial minority group also had higher rates of young adult (those 15-24) suicide at levels 2.5 times those of the general population.
A general mistrust of outside healthcare providers and cultural differences may prevent American Indians and Alaskan Natives from seeking mental health and/or substance abuse treatment. This group tends to be less likely to enter into treatment programs and may instead focus on traditional healing methods, the National Alliance on Mental Illness (NAMI) reports. More than a quarter of this ethnic population group lives in poverty as well, which is double the national average, according to NAMI. Increased access to care and holistic offerings may be helpful for treatment models when addressing this minority group.
African Americans and Hispanics
Substance abuse and dependency may be more common in impoverished socioeconomic groups, people with less education, and those living in urban areas, as may involvement within the criminal justice system. Ethnic-minority groups may be likely to commit crimes as a result of drug abuse and are more likely than Caucasians to be mandated to substance abuse treatment in consequence, Psychiatric Services publishes.
Discrimination and social pressures may play a role in substance abuse within the black community. As a study published by Purdue University found that 90 percent of those surveyed reported daily discrimination, this is a cause for concern. Individuals within these communities and racial groups may feel that they have no choice or chance to improve their standings; they, therefore, may see substance abuse as natural and a part of everyday life.
Hispanics have a strong sense of family that may differ from the traditional American nuclear family. The Hispanic view of family is likely to include a large extended family and potentially even close family friends with the mentality that problems stay within that unit and may not be acknowledged publicly.
Hispanic culture places women in a special place as the matriarchs of the family unit and has strict sanctions against women drinking. Those born within the US or who immigrated at a young age may have higher rates of substance abuse than those born abroad or immigrating later in life, as the stress of acculturation and attempts to conform to a new society may increase drug and alcohol usage, SAMHSA’s TIP publishes.
Co-occurring mental health issues may also be common in this demographic, as 80 percent of Hispanic or Latina women in a substance abuse program who were surveyed reported childhood abuse and 76 percent had mental health concerns, TIP reports. Spirituality religion may be extremely important to the Hispanic and Latino community and may therefore be an important aspect to be considered during treatment and recovery.
It is important not to generalize specific races as all needing the same thing, as each person is an individual. While certain considerations for particular cultures or ethnicities may be made, each person will respond to treatment differently and has unique needs for care and recovery. Professionals who are in tune with cultural beliefs and traditions can be beneficial in understanding what types of treatment may be best.
A person’s level of acculturation, spiritual and religious beliefs, and primary language are all factors to be considered and accommodated during treatment and recovery. Social stigmas may need to be carefully dispelled and cultural sensitivity is vital.