Prevalence and Correlates of Co-Occurring Substance Use and Mental Health Conditions Among Aging Mexican American Injecting Heroin Users

Background and Purpose. Mexican Americans are more likely to be of low socioeconomic status, have lower education levels, and limited access to healthcare, factors that place them at risk for substance use and mental health disorders such as depression and/or anxiety. Mexican American men are more likely to have these co-occurring disorders than non-US born Mexican men and Mexican American women. This research aims to estimate the prevalence and describe the correlates of co-occurring substance use and mental health conditions among aging Mexican-American heroin injecting men.

Methods. Data for the current analysis comes from a larger study of Mexican-American injection heroin users (N=227). For this paper, participants were categorized into co-occurring condition and non-co-occurring condition groups.  This dependent variable was created using two mental health screeners (Center for Epidemiological Studies Depression Scale for depression and Perceived Stress Scale for anxiety) and self-reported use of illicit drugs in the previous 30 days (e.g., heroin, cocaine, crack, etc). Respondents who met the cutoff scores for either depression (CESD) or anxiety (PSS) and had used illicit drugs in the last 30 days were included in the co-occurring conditions group. Selected covariates associated with the dependent variable were examined using chi-squares. These covariates include years of incarceration, lifetime traumatic events and various sociodemographic variables.

Results. Findings suggest that respondents with co-occurring conditions were more like to experience traumatic events than those respondents without co-occurring conditions. Statistically significant associations were found between illness or injury to a close family member (p<.001), death of partner, parent or child (p<.002), and experiencing a loss (p<.030) and co-occurring conditions. Additionally, findings revealed that respondents incarcerated for longer periods of time were significantly less likely to have co-occurring substance use and mental health conditions. Those who spent 5 years in prison (57%) were more likely to have co-occurring conditions than those who spent 5 to 10 years in prison (55%), and both of those groups would have an even greater risk of co-occurring conditions than those who spent 15 to 20 years in prison (18%). However, the decrease in likelihood of co-occurrence was not present for those respondents who spent 20 or more years incarcerated.

Conclusion/Implications. These findings may be explained by the access to healthcare, social service and drug prevention programs, education, consistent meals, and exercise facilities that are available in prison. The majority of these respondents originate from impoverished communities where there is limited access to services that may provide a buffering effect from co-occurring conditions. However, there seems to be a point in their incarceration history where more time spent in prison does not provide a “protective” effect. Future research will further examine these relationships using multiple regression models.