Addiction Among Different Races in the U.S.


Drug addiction’s impact is felt across all demographic groups. However, some subsets of the American population are disproportionally affected by substance abuse, and access to addiction treatment does unfortunately differ, often by race and gender.1

To better understand addiction and its impact on different demographic groups in the U.S., we sometimes look at the effect that substance abuse has on different races that make up the U.S. population.

As of 2018, around 20.3 million people 12 years old or older reported having a substance use disorder in the past year.2 In this article, you’ll learn more about:

  • The demographic breakdown of races in the U.S.
  • How substance abuse affects different races in the U.S., including white, Hispanic, Black Americans, as well as American Indian and Native Hawaiian people.
  • Treatment considerations.

Demographic Breakdown of the U.S.

diverse group of people in a circle showing their handsAs of July 2019, the demographic breakdown by race in the United States was as follows:3

  • White: 60.1%
  • Hispanic or Latino: 18.5%
  • Black or African American: 13.1%
  • Asian American: 5.9%
  • American Indian or Alaskan Native (AIAN): 1.3%
  • Native Hawaiian and Other Pacific Islander (NHOPI): 0.3%

The 2018 National Survey on Drug Use and Health (NSDUH) is a comprehensive collection of data that details substance use in the U.S. by many different demographic markers. When broken down by U.S. citizens with a substance use disorder in the past year aged 12 or older and race in 2018, we see that:4

  • White: 7.7%
  • Hispanic or Latino 7.1%
  • Black or African American 6.9%
  • Asian American: 4.8%
  • American Indian or Alaskan Native: 10.1%
  • Native Hawaiian and Other Pacific Islander: 9.3%

Read on to learn more about how substance abuse affects different races in the U.S.

Substance Abuse Among White Americans

The United States Census Bureau defines white Americans as people in the U.S. who can trace their ancestry to Europe, the Middle East, or North Africa.3 Because this demographic covers a large swath of people, white people are the largest race in the country.

Below you’ll find the percentages of 12-year-old or older white Americans who used these substances in the past year:4

  • Illicit Drug Use: 20.2%
    • Marijuana: 16.5%
    • Cocaine: 2.1%
    • Methamphetamine: 0.8%
    • Misuse of Prescription Stimulants: 2.2%
    • Benzodiazepines: 2.3%
    • Opioids (includes heroin and prescription pain relievers): 3.8%
  • Tobacco: 29.4%
  • Alcohol use: 67%

The use of some of these substances, including tobacco and alcohol, does not mean that they have a substance use disorder.

According to the 2018 NSDUH, 7.7% of white Americans aged 12 or older had a substance use disorder or any kind in the past year.4

White Americans, and specifically white men, experience the highest rates of opioid misuse and deaths from opioid overdose. Over 35,000 white Americans died from opioid overdose in 2018.5 Part of this could be that there is not effective addiction treatment in rural areas—92% of addiction treatment facilities are in urban locations.6, 7

In general, white Americans have fewer barriers to treatment than some other races in the U.S. However, Americans of any race in rural areas, those in poverty, and those with no health insurance coverage have a difficult time accessing addiction treatment.7, 8

People with ancestry from Cuba, Mexico, Puerto Rico, and South or Central America in the U.S. are called Hispanic or Latino Americans, though this subset of the American population is a diverse mixture of individuals from various ethnicities, languages, and cultures.3 This is the second largest race demographic in the country, and the fastest growing.

Below you’ll find the percentages of 12-year-old or older Hispanic or Latino Americans who used these substances in the past year:4

  • Illicit Drug Use: 17.1%
    • Marijuana: 13.6%
    • Cocaine: 1.9%
    • Methamphetamine: 0.7%
    • Misuse of Prescription Stimulants: 1.4%
    • Benzodiazepines: 1.9%
    • Opioids (includes heroin and prescription pain relievers): 3.7%
  • Tobacco: 19.6%
  • Alcohol use: 57.9%

According to the 2018 NSDUH, 7.1% Hispanic or Latino Americans aged 12 or older had a substance use disorder or any kind in the past year.4

There has been a significant increase in marijuana use among Hispanic Americans aged 26 and up. This could be in part to the legalization of marijuana at a state level among some states. Note that the federal government still classifies marijuana as an illicit substance.9

Substance abuse occurs more frequently among Latino Americans who also have a co-occurring mental health disorder, no matter the age. It’s also common for someone from this population group who abuses one substance to abuse multiple substances, as well as have mental health disorders. Unfortunately, co-occurring substance use and mental health disorders among Latino Americans is associated with suicidal thoughts, plans, and attempts.9

Hispanics have a strong sense of family that often differs from the white American nuclear family. 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.10

In general, Latino Americans have worse outcomes in addiction treatment programs, though little is known as to why, largely because the issue hasn’t been studied well.11

Substance Abuse Among Black Americans

The U.S. Census Bureau categorizes African or Black Americans as people who have origins in any of the Black racial groups from Africa.3

Below you’ll find the percentages of 12-year-old or older Black Americans who used the following substances in the past year:4

  • Illicit Drug Use: 20.8%
    • Marijuana: 17.8%
    • Cocaine: 1.8%
    • Methamphetamine: 0.2%
    • Misuse of Prescription Stimulants: 0.9%
    • Benzodiazepines: 1%
    • Opioids (includes heroin and prescription pain relievers): 3.8%
  • Tobacco: 27.2%
  • Alcohol use: 57.3%

According to the 2018 NSDUH, 6.9% of African Americans aged 12 and older had a substance use disorder in the past year.4

The survey presented some positive trends, including a decline in alcohol use among Black Americans in middle and high school since 2015—around a 25% reduction. Prescription opioid misuse has also seen a significant decline across all measured age groups in this subset.4

Similar to many other subsets of the population in the United States, Black Americans are seeing a significant increase in marijuana use in the last 3 years, particularly among the 26 and older crowd. Even though there’s a noticeable increase in use, there hasn’t been a similar rise in marijuana use disorder.4

Black Americans are seeing a disturbing trend in mental health disorders, including an increase in mental health illnesses, depressive episodes, suicidal thoughts, and co-occurring disorders. In fact, substance use and mental health disorders are very closely linked.4

Perhaps the most eye-opening trend among African Americans is the lack of treatment for substance use disorders: 88.7% diagnosed with a SUD did not seek out or receive addiction treatment.4

Discrimination and social pressures may play a role in substance abuse within the Black community. A study published by Purdue University found that 90% of those surveyed reported daily discrimination. A regular barrage of unfair treatment like this can lead to self-coping behaviors, sometimes resulting in substance abuse. Those reporting the highest levels of discrimination in this study were also more likely to report a substance use disorder.12

Substance Abuse Among Asian Americans/NHOPI

Although the U.S. Census Bureau, as well as the 2018 National Survey on Drug Use and Health, collects data on Asian Americans and Native Hawaiian and Other Pacific Islanders separately, the NSDUH provides its analysis of these two groups combined.

These demographics have seen fairly significant increases in:13

  • Alcohol use disorder for 18 to 25-year-olds between 2016-2018.
  • Marijuana use among adults 26 and older.
  • Marijuana use by women, in both the 18 to 25-year-old and 26-and-older age categories.
  • Cocaine use among 18 to 25-year-olds.
  • The misuse of prescription stimulants in the 18 to 25-year-old age category.

Similar to other minorities, Asian/NHOPI addiction treatment is abysmally low: 96.2% of people in these demographic sets do not receive any kind of treatment for their substance abuse disorders.

The following sections include specific information about both demographics.

Asian Americans

People with ancestry in the Far East, Southeast Asian, and the Indian subcontinent are considered Asian Americans by the U.S. Census Bureau.3

Below you’ll find the percentages of 12-year-old or older Asian Americans who used the following substances in the past year:4

  • Illicit Drug Use: 11.2%
    • Marijuana: 8.9%
    • Cocaine: 1.4%
    • Methamphetamine: 0.2%
    • Misuse of Prescription Stimulants: 1.6%
    • Benzodiazepines: 0.7%
    • Opioids (includes heroin and prescription pain relievers): 1.4%
  • Tobacco: 12.8%
  • Alcohol use: 53.6%

According to the 2018 NSDUH, 4.8% of Asian Americans aged 12 and older had a substance use disorder in the past year.4

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 are sometimes considered a “model minority,” that is, they are often depicted as successful, willing to work hard, and are considered less likely to be involved in crime or substance abuse.14

This outlook on Asian Americans can even be held within its own communities.14

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.15

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.15

Native Hawaiian and Other Pacific Islanders

The U.S. Census Bureau categorizes Native Hawaii and Other Pacific Islanders (NHOPI) as any of the original people from Hawaii, Guam, Samoa, or other Pacific Islands.3

Below you’ll find the percentages of 12-year-old or older NHOPI who used the following substances in the past year:4

  • Illicit Drug Use: 21.2%
    • Marijuana: 17.7%
    • Cocaine: 1.6%
    • Methamphetamine: 1.8%
    • Misuse of Prescription Stimulants: 1.4%
    • Benzodiazepines: 8.4%
    • Opioids (includes heroin and prescription pain relievers): 1.4%
  • Tobacco: 33.6%
  • Alcohol use: 54.3%

According to the 2018 NSDUH, 9.3% of Native Hawaiians and Other Pacific Islanders aged 12 and older had a substance use disorder in the past year.4

NHOPIs 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 economies.16

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. NHOPIs 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.16

American Indians and Alaskan Natives Substance Abuse

The U.S. Census Bureau defines American Indians as any of the original people of North, South, and Central America who continue to maintain tribal affiliation or community attachment.3

Below you’ll find the percentages of 12-year-old or older American Indians and Alaskan Natives (AIAN) who used the following substances in the past year:4

  • Illicit Drug Use: 28.5%
    • Marijuana: 23%
    • Cocaine: 1.9%
    • Methamphetamine: 2.4%
    • Misuse of Prescription Stimulants: 1.4%
    • Benzodiazepines: 1.5%
    • Opioids (includes heroin and prescription pain relievers): 5.8%
  • Tobacco: 44%
  • Alcohol use: 55%

According to the 2018 NSDUH, 10.1% of American Indians and Alaskan Natives aged 12 and older had a substance use disorder in the past year.4

Marijuana is the most used illicit substance among AIAN. A reminder that while marijuana is legal to use in some states, it is still considered an illegal drug at the federal level.4

AIAN have seen significant increases in methamphetamine use in members of the demographic aged 26 and up, as well as increases in major depressive episodes in 18 to 25-year-olds, and specifically women in this age group. In good news, there has been a significant decline in cocaine use in the 18-25 subset of American Indians and Alaskan Natives.4

Substance abuse in minority populations may be considered the result of acculturation, or the assimilation into a new culture. 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.17

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.18

Treatment Considerations

diverse group of people in addiction treatmentMinority 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.

It is important not to generalize and assume that people of specific races all need the same thing; 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.19

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.19

American Addiction Centers’ facilities like Sunrise House understand the need for personalized, individualized treatment plans. Some locations even offer translators if necessary. Call 973-862-4820 to learn more about what we can do for you or your loved one.

 

References:

  1. National Institute on Drug Abuse. (2019). Access to addiction services differs by race and gender.
  2. Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. United States Census Bureau. (2019). QuickFacts United States.
  4. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  5. Kaiser Family Foundation. (2018). Opioid overdose deaths by race/ethnicity.
  6. National Rural Health Association Policy Brief. (2017). Treating the rural opioid epidemic.
  7. Substance Abuse and Mental Health Services Administration. (2017). National Survey of Substance Abuse Treatment Services (N-SSATS): 2016. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  8. Tolbert, J., Orgera, K., Singer, N., & Damico, A. (2019). Key facts about the uninsured population.
  9. Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. (2018). 2018 National Survey on Drug Use and Health: Hispanics, Latino or Spanish origin or descent.
  10. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. (2009). Substance abuse treatment: addressing the specific needs of women. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  11. Alvarez, J., Jason, L.A., Olson, B.D., Ferrari, J.R., & Davis, M. I. (2007). Substance abuse prevalence and treatment among Latinos and Latinas. Journal of Ethnicity in Substance Abuse 6(2), 115-141.
  12. Purdue University. (2012). Study: unkindness linked to alcohol, drug abuse in black populations.
  13. Substance Abuse and Mental Health Services Administration: U.S. Department of Health and Human Services. (2018). 2018 National Survey on Drug Use and Health: Asians/Native Hawaiians and Other Pacific Islanders (NHOPI).
  14. Moloney, M., Hunt, G., & Evans, K. (2008). Asian American identity and drug consumption: from acculturation to normalization. Journal of Ethnicity in Substance Abuse 7(4), 376-403.
  15. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. (2006). Substance abuse: clinical issues in intensive outpatient treatment Treatment Improvement Protocol (TIP) series, no. 47. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  16. Wong, W. & Barnett, P.G. (2010). Characteristics of Asian and Pacific Islanders admitted to U.S. drug treatment programs in 2005. Public Health Reports 125(2), 250-257.
  17. Abbott, P. & Chase, D.M. Culture and substance abuse: impact of culture affects approach to treatment.
  18. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. (2018). Behavioral health services for American Indians and Alaska Natives, Treatment Improvement Protocol (TIP) 61. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  19. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. (2006). Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: Center for Substance Abuse Treatment.

 



About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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