Session: The Context of Substance Use and Mental Health in Diverse Populations (Society for Social Work and Research 29th Annual Conference)

Background and Purpose: Substance use (SU) and substance use disorders (SUD) are more prevalent among persons with psychotic disorders than those who do not have these conditions. Substance use treatment outcomes are worse for persons with comorbid psychotic disorders and substance use disorder. Engagement in substance use may serve as a potential mechanism to cope with long-term and immediate distress induced by socio-political hardship (poverty, discrimination, immigration) and major disasters (deadline hurricanes, pandemics) among people of diverse populations when tangible assistance is not immediately available. Despite surging research on SU and SUD, more evidence is needed to fill gaps such as (a) identifying complex factors that protect against substance use recurrence among clients with comorbid mental disorders; evaluating the role of traumatization in the association between early life mistreatment and current SU and SUD among minorities; and conducting prospective studies for long-term impacts of SU and SUD on PTSD among disaster workers.

Methods: In this panel, Study-1 used a national sample of adults with psychotic disorders who received services from outpatient substance use treatment programs to investigate sociodemographic and treatment-related factors associated with 1) substance use recurrence during treatment and 2) successful treatment completion (N=1956). Study-2 investigated a theory-driven conceptual model on the association between childhood mistreatment (CM) with adult posttraumatic disorder (PTSD) and SUD, with a specific focus on the impact of perceived discrimination in Latinx nationwide (N=2554) and additional subgroup differences. Study-3 aimed to use Bayesian structural equation modeling (Bayesian-SEM) and newly acquired follow-up data to reveal the overtime impact of SU for coping on traumatization of student volunteers, a group that has been understudied in research on catastrophic disasters, alongside protective factors.

Results: Study 1 results suggest that substance use specific self-help group attendance is linked with facilitating positive treatment outcomes, possibly due to healthy social reinforcement that supports reduced substance use. Results from Study 2 indicated that Latinx individuals who were exposed to trauma were at an increased likelihood of developing a SUD as adults when adjusting for discrimination and other covariates. In Study 3, no significant protective factors for PTSD were identified, highlighting the need for future research to examine protective factors of long-term traumatization following natural disasters.

Conclusions and Implications: The above findings suggest the need for considering treatment-related, culturally sensitive, and prospective designs in future investigation of SU and SUD. Findings also indicate the need of considering environmental, racial, social, and political issues to enhance assessment and intervention for underserved populations. Moreover, key gaps in the literature remain regarding determinants of positive substance use treatment outcomes for persons with psychotic disorders, the influence of trauma exposure and discrimination on SUD among Latinx individuals, and factors that can alleviate traumatization experienced by disaster-relief volunteers. Further study is needed to investigate factors that promote reduced substance use and alleviate the impact of trauma victimization on substance misuse among diverse populations.