Age, trauma exposure, and acculturation may all contribute to addiction in Hispanics. Lack of insurance, fear of deportation, and language barriers can make it hard for them to get help. Finding bilingual recovery programs that involve family members can increase the likelihood that Hispanics will engage in treatment.
Which Drugs Are Abused by Hispanics/Latinos?
Statistics show that members of the Hispanic American community may be more likely to abuse certain drugs, including:
- Alcohol. Even though many Hispanic Americans choose to abstain from alcohol, statistics show that those who do drink often do so to a much greater degree than non-Hispanic Americans.3
- Marijuana. In a 2011 survey, 50% of Latino teens said they had used marijuana in the past year, compared to 35% of whites and 40% of blacks.17
- Cocaine. Rates of use may differ by ethnic group. For example, the Hispanic Health and Nutrition Examination Survey reports that Puerto Rican men and women had higher rates of cocaine use than Mexican and Cuban American men and women.1
- Opioids, such as heroin, or prescription painkillers, such as hydrocodone. Data provided by the Substance Abuse and Mental Health Services Administration’s (SAMSHA) Drug and Alcohol Services Information System shows that Latinos were more likely to be admitted to substance abuse treatment due to opioid abuse than non-Hispanic Americans.1
How Is This Group Affected by Substance Abuse?
Regardless of ethnic background, alcohol and drugs can harm people who abuse them. But the Hispanic community may be particularly vulnerable to additional consequences, such as:
- A higher risk for liver disease, such as cirrhosis. Despite lower rates of alcoholism, Hispanics may have an increased chance of developing alcohol-related liver disease than non-Hispanic whites. This may be due to the fact that Hispanics who drink tend to drink in greater amounts than whites.5 Additionally, out of all ethnic groups, white Hispanic men show the highest rates for developing cirrhosis.3
- An increased likelihood of recurring problems with alcohol dependence. The National Institute on Alcohol Abuse and Alcoholism reports that roughly 9.5% of Hispanics experience alcohol dependence at some point in their lives, and about 13.8% of non-Hispanic whites do. But 33% of Hispanics who develop alcohol dependence have persistent problems as opposed to 22.8% of non-Hispanic whites.3 In addition to increased alcohol consumption among Hispanics who choose to drink, a higher rate of binge drinking seems evident in this population.5
- An increased rate of drunk driving and DUIs. Statistics from 1992 to 2002 show that the number of Hispanic women receiving a citation for DUI increased. Also, among Hispanics who drink, Mexican American men and women and South/Central American men are most likely to receive a DUI.3
- Incarceration. Hispanics accounted for 43% of drug offenses in 2000 and were more likely to be incarcerated for these offenses.6
- Crime. One national survey showed that Hispanics who were in substance abuse treatment were also more likely to have engaged in crimes.1
- Health problems due to alcohol and drug abuse. This may be due to the fact that Hispanic Americans traditionally underuse physical and mental health services and therefore may not receive adequate preventive care or appropriate treatment when problems develop.7
Why Does This Group Abuse Substances?
Some of the possible causes of substance abuse and addiction among the Hispanic American population include:
- Family history of substance abuse problems. Addiction may have a genetic component, and having a family history of substance abuse can increase the likelihood that a person may develop a similar problem.
- Increased likelihood of mood and anxiety disorders. Studies have shown that Hispanic Americans with substance abuse disorders also tend to have co-occurring anxiety and mood disorders, such as depression.1
- Acculturation issues. Although studies are still examining the exact effects of this phenomenon, acculturation issues may increase the likelihood of a person developing a substance abuse disorder.1 Interestingly, studies have shown that as Hispanics become more acculturated, they may also be more likely to drink alcohol.3 According to the Hispanic Health and Nutrition Examination Survey, U.S.-born Latinos and Latinas were more likely to use marijuana and cocaine than men and women who were born in Mexico or Puerto Rico.1
- Younger age. Hispanic youth display an increased likelihood to engage in illicit drug abuse compared to non-Hispanic youth.2
- Marital status. Unmarried Hispanic Americans may be more likely to report substance abuse.1
- Unemployment and poverty. Being unemployed and/or subjected to higher levels of poverty has been linked to increased alcohol abuse in Hispanic Americans.1
- Exposure to traumatic events. A number of studies have demonstrated a correlation between witnessing traumatic events and substance abuse in Hispanic people.1
What Are the Symptoms of Addiction?
Being aware of the signs and symptoms of addiction can help you or someone you love get help. Awareness and admitting a problem are the first steps toward recovery. Some of the symptoms of addiction include:
- Being unable to control drug or alcohol use. For example, people may drink more than they intended or use drugs more frequently than they say they will.
- Disregarding important activities. People with an addiction may ignore activities they previously enjoyed or withdraw from social contact.
- Increased risk-taking behaviors. People with an addiction may engage in unsafe or risky behaviors (such as driving while impaired).
- Relationship problems. People may act aggressively toward loved ones who try to confront them about their addiction. They may also behave unpredictably and have more frequent altercations with friends and family members.
- Deteriorating appearance. People with an addiction may neglect hygiene and appear unkempt.
- Tolerance. This means that a person requires more frequent or increased amounts of a substance to obtain the desired results.
- Withdrawal. People may experience physical and psychological symptoms, such as tremors, insomnia, or depression, if they try to stop using. So they continue to use as a way of avoiding withdrawal symptoms.
- Continuing to use despite negative consequences. A person who is addicted may ignore or deny the financial, social, physical, legal, psychological, and occupational repercussions of the drug or alcohol use.8
Why Do Some Hispanics/Latinos Have Trouble Accessing Treatment?
Combined data collected from 2003 to 2011 show a growing need for and limited access to substance abuse treatment in the Hispanic community. In fact, a Substance Abuse and Mental Health Services Administration (SAMHSA) report found that:
Hispanics aged 12 or older were more likely to require substance abuse treatment in the past year than non-Hispanics. Furthermore, Hispanics were less likely than non-Hispanics to have received treatment at a specialty facility in the past year, with rates around 9.0% vs. 10.5%.9
Additional data from the National Survey on Drug Use and Health indicates that 3.1 million Hispanics needed but did not receive treatment during that time period.9
Some of the potential barriers to substance abuse treatment in the Hispanic community include:
- Lack of access. For a number of reasons, some Hispanic Americans may feel that rehab is difficult to access. They may lack knowledge about substance abuse disorders, may feel put off by treatment centers where only English is spoken, or may lack financial resources to pay for treatment.7
- Lack of insurance and ability to pay. According to a report written by the Henry J. Kaiser Family Foundation, nonelderly Hispanics have the highest uninsured rate, with 32% lacking coverage, followed by American Indians/Alaska Natives (27%), blacks (21%), Asians/Pacific Islanders (18%), and whites (13%).10 This may be the result of a lack of employer-funded or other types of private health coverage, but even when a person has Medicaid, the gap is not completely eliminated.
- Lack of Hispanic providers or providers who are culturally competent. Knowledge of cultural differences and awareness of values that are important to members of the Hispanic community are essential when it comes to providing effective treatment.7 Even Spanish-speaking providers don’t always understand these concepts.
- Language barriers in 12-step groups and in rehabs. Proper recovery requires fully understanding and engaging in the treatment process, so treatment in a person’s native language is ideal for processing trauma or other significant events that may have led to the development of an addiction.7
- Refusal to admit that they have a problem. SAMHSA data from 2003 to 2011 indicates that among Hispanics needing but not receiving treatment, only 5.6% perceived a need for treatment.9
- Fear of deportation. Undocumented Latinos may be afraid of attention from immigration authorities if they engage in treatment.11
- Lack of familiarity with treatment. People may lack awareness of the available treatment options, payment possibilities, and access avenues.
- Tendency to rely on family. Hispanic Americans tend to involve family members (including a wide extended family network) in health care decisions. Additionally, they expect treatment providers to be warm and friendly and to inquire about their well-being and the well-being of their family.7 Sensing that providers don’t appreciate the current family dynamic may be off-putting.
What Are Some of Their Special Needs in Treatment?
Awareness of the unique needs of the Hispanic American community is essential for providing effective treatment and for retention in treatment. According to a report by the Center for Substance Abuse Research:
When Mexican Americans were offered treatment within an ethnicity-specific program, they were 11 times more likely to return for a second session, than when they were offered services in a mainstream program not tailored to Mexican Americans and their surroundings.12
Some of the special needs that providers should understand and address include:
- Emphasis on spirituality. Many Latinos are often very connected to their religion and place great importance on their spiritual values. Although mainstream medicine might often distinguish the body, mind, and spirit, Latinos often tend to have a more holistic viewpoint when it comes to health and treatment.13
- Family involvement. Many Hispanic Americans have very strong family bonds that often extend beyond the nuclear family. Providers can accommodate these values by offering extra family therapy or allowing family members to be present for appointments.13
- Services in Spanish and providers who speak Spanish. In order to be fully accessible to members of the Hispanic American community, treatment providers should be able to offer recovery programs in a person’s native tongue.7 Data from the Center for Behavioral Health Statistics and Quality show that in 2010, nearly 94% of the facilities that provided services in a language other than English had staff counselors available to provide services in Spanish.14
- Respect. Respect can play an important role in whether a Hispanic/Latino person engages with and remains in treatment. For example, providers should address their clients properly by using señor to refer to Mr., señora for Mrs., and señorita for Miss, even if the provider does not speak Spanish.13
What Types of Rehab Programs Are Available?
A variety of addiction recovery programs are available, including:
- Detox programs. For many people, detox is the first step on the path to recovery. It is not a form of treatment but rather a process that aims to eliminate the substance from a person’s body while minimizing withdrawal symptoms. People may opt for medical detox, which offers medication and the intervention of professional medical staff, or social detox, which focuses on peer and social support, to help them through the withdrawal period.
- Inpatient programs. In this form of rehab, people live at a residential treatment center, generally between 30 and 90 days (sometimes longer). Inpatient rehab programs offer a wide range of therapies, such as individual and group counseling, family therapy, and 12-step groups.
- Outpatient programs. People who prefer to live at home may attend outpatient programs. Although they provide many of the same therapies, outpatient recovery programs are less intensive and lack the round-the-clock supervision of inpatient programs. People may attend treatment up to several times per week, depending on the level of care required.
- State-funded programs. Many addiction treatment programs receive local, state, and/or federal funding, which can help lower the cost of treatment. In 2008, 13.7% of those admitted to publicly funded substance abuse treatment programs were of Hispanic origin.15
- Programs run by charities and nonprofits. Many charities and nonprofit organizations, such as the Salvation Army or Catholic Charities, offer treatment based on a sliding scale, which means a reduced fee based on income and ability to pay.16
- 12-step programs. Programs such as Narcotics Anonymous and Alcoholics Anonymous offer free support groups based on the 12 steps of recovery. People work through these steps with the assistance of a sponsor, draw strength from a higher power, share their experiences with the group, and gain support from others who have been in their shoes.
How to Locate a Culturally Competent Provider
Cultural competence means the ability to understand and interact with, as well as respect and honor, the values of people from different cultures. Some of the ways a person can locate a culturally competent provider include:
- Asking questions. When considering a substance abuse treatment program, ask questions: Are Spanish-speaking providers available? Does this organization frequently treat patients from multicultural backgrounds?
- Reading online reviews. Online reviews of substance abuse treatment programs provide information from program alumni about whether their cultural values were addressed and respected during the treatment process.
- Doing research. Call treatment programs or call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Hotline at 1-800-662-HELP (4357). This hotline offers referrals to treatment programs and information in English and Spanish. They are available 24/7, 365 days a year.
- Talking to other people. Asking trusted friends and members of the community can provide insight about treatment programs.
What Are the Payment Options for Rehab?
If you have insurance, your carrier may cover at least part of the cost of treatment. If not, you may be able to manage the cost of treatment in other ways, such as:
- The SAMHSA Behavioral Health Treatment Services Locator. You may be able to find low-cost or free rehabs in your area on this website; you can also call the National Hotline at 1-800-662-HELP (4357).
- Public insurance programs. If you don’t already have insurance, you may be eligible for public programs such as Medicaid or Medicare. To determine your eligibility and to obtain assistance, you can visit the USA.gov website, HealthCare.gov website (forms are available in English and Spanish), Medicaid.gov website, or contact your state through this website. Additionally, the federal government has a variety of resources that can help you determine which state or federal programs you may be eligible for.
- Sliding scale or payment programs. Many rehabs know that the cost of treatment can prevent people from getting help. For this reason, some rehabs offer a sliding scale, in which the fee you are charged is based on your income and/or ability to pay. You are usually required to provide proof of income (such as pay stubs or proof of public assistance). Some rehabs may also offer payment programs, which may allow you to pay off the cost of treatment in installments.
- Rehab scholarships. A rehab scholarship or grant may offer a way for qualified people to pay for treatment. Some scholarships are offered by private programs, while others may be available through state-run programs. You can contact treatment centers directly to inquire about their forms of financial aid, or you can also call the SAMHSA hotline at 1-800-662-HELP (4357).
The following resources may also be of assistance to those seeking culturally specific substance abuse treatment.
- SAMHSA has a variety of downloadable pamphlets available. Some of the topics include:
- Drogas, alcohol y VIH/SIDA: Una Guía para su salud (Drugs, Alcohol, and HIV/AIDS: A Guide for Your Health). This pamphlet explains the dangers of HIV transmission among people who use drugs and focuses on the importance of substance abuse treatment.
- El Tratamiento para el Abuso de las Drogas y el Alcohol (Alcohol and Drug Treatment: How it Works, and How It Can Help You). This pamphlet explains how substance abuse treatment works for people who are involved in the criminal justice system.
- Información sobre la Buprenorfina (The Facts about Buprenorphine for Treatment of Opioid Addiction). This pamphlet explains how the medication buprenorphine can help people struggling with addiction to opioid drugs.
- Información sobre la Naltrexona – 2011 (The Facts about Naltrexone for Treatment of Opioid Addiction). This pamphlet provides information about naltrexone, a medication that is also used to treat opioid addiction and alcohol addiction.
- The National Latino Behavioral Health Association is an advocacy organization that strives to eliminate disparities in funding and access and improve the quality of services for Latinos.
- The National Alliance on Mental Illness offers information specific to Latino mental health.
- Mental Health America offers Spanish-language pamphlets and screening tools related to a wide range of mental health topics.
- 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.
- Rodriguez, C. (2013). Hispanic teens more likely to use drugs, study says. CNN.
- National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol and the Hispanic community.
- Nelson, S. (2017). “Latinos got 77 percent of federal pot sentences last year.” U.S. News and World Report.
- National Institute on Alcohol Abuse and Alcoholism. Minority health and health disparities.
- Michigan State University. (2004). Report: US criminal justice system unfair, unjust for Hispanics.
- Flores, V. (2011). Cultural elements in treating Hispanic/Latino populations.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2012). Need for and receipt of substance use treatment among Hispanics.
- Henry J. Kaiser Family Foundation. (2013). Health coverage by race and ethnicity: The potential impact of the Affordable Care Act.
- Pagano, A., & NIDA Postdoctoral Fellow. (2014). Barriers to drug abuse treatment for Latino migrants: Treatment providers’ perspectives. Journal of Ethnicity in Substance Abuse, 13(3), 273-287.
- Center for Substance Abuse Treatment. Drug abuse among Hispanics: A brief evidence-based guide for providers.
- Addiction Technology Transfer Center (ATTC) Network. (2015). Desk reference: Cultural elements in treating Hispanic and Latino populations.
- Center for Behavioral Health Statistics and Quality. (2012). Substance abuse facilities with services in Spanish are available in all regions for Hispanic clients admitted to treatment in 2010.
- National Institute on Drug Abuse. (2011). Treatment statistics.
- Frank, R. & Salkever, D. (1994). Nonprofit organizations in the health sector. Journal of Economic Perspectives, 8(4), 129-144.
- The Partnership at Drugfree.org. (2012). The Partnership Attitude Tracking Study: Hispanic Teens and Parents.