Drug Use and Service Utilization Among Hispanics in the United States

Purpose: Patterns of illicit drug use and substance abuse treatment utilization for U.S.-born and foreign-born Hispanics reveal a complex array of risk and protective mechanisms within and across Hispanic subgroups. A closer examination of these patterns may lead to the development of service models that are more culturally relevant and may contribute to a reduction of ethnic disparities that exist in substance abuse treatment.

In this study, we examine the drug use patterns and service utilization rates of U.S.-born and foreign-born Hispanics across 5 ethnic subgroups (Mexican American, Cuban American, Puerto Rican, Central American and South American) using data from Wave 1 (2002-2003) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC is a nationally representative sample of 43,093 non-institutionalized U.S. residents aged 18 years and older.

Methods: Hispanic respondents in the NESARC were categorized as being of Mexican (n = 3,556), Puerto Rican (n = 785), Cuban (n = 346), Central American (n = 513), or South American (n = 381) origin.  We provide adjusted prevalence estimates and 95% confidence intervals for lifetime drug use among U.S.-born and immigrant Hispanics by subgroup and drug type and for lifetime prevalence of utilization of six different services among Hispanic drug users by Hispanic subgroup. We then conduct a series of logistic regression analyses to compare the lifetime prevalence of service utilization of U.S.-born (n = 743) and immigrant (n = 280) Hispanic drug users with that of non-Hispanic white drug users (n= 5,754).  Finally, we use adjusted odds ratios to contrast the lifetime prevalence of service utilization among U.S.-born and Hispanic immigrant drug users in the United States.

 

Results: Lifetime prevalence of drug use was greater among U.S.-born Hispanics than Hispanic immigrants after controlling for age, gender, income, education, urbanicity, parental history of drug use problems and lifetime DSM-IV mood/anxiety disorders. Hispanic drug users were less likely than non-Hispanic white drug users to have utilized any form of substance abuse treatment  (U.S.-Born AOR = 0.89, Immigrant AOR = 0.64) and more likely to have utilized family or social services (U.S.-born AOR = 1.17, Immigrant AOR = 1.19). Compared to U.S.-born Hispanic drug users, Hispanic immigrant drug users were less likely to have used any form of substance abuse treatment (AOR = 0.81) and were more likely to have utilized family or social services (AOR = 1.22).

 

Implications: The heterogeneity of the Hispanic population and the evidence that U.S.-born and immigrant Hispanic subgroups differ in regard to drug use patterns and service utilization indicate the need for culturally relevant service models that address the differential treatment needs of ethnic subgroups.  These findings support the expansion of primary and secondary prevention models that seek to preserve and promote the unique cultural values and language of ethnic Hispanic subgroups in the U.S.  They also suggest the need for the development of service models tailored to meet the unique social, cultural and linguistic needs of these subgroups at the community level.