As of July 2013, there were approximately 54 million people of Hispanic descent living in the United States, accounting for 17 percent of the total population of America. Hispanics are, by far, the largest ethnic minority in the United States, and this has given social scientists, researchers, and statisticians a wealth of information and resources to study.[1] One area of study is on the topic of the Hispanic community and addiction, discovering how substance abuse and dependence impacts immigrants from Latin America, the factors that put them at risk, and what can be learned from the epidemic.
The body of work on the topic of the Hispanic community and addiction stems from the sheer scope of figures available from immigrants from Central and South America to the United States.
Since 1980, individuals from Mexico represent the largest non-native population in America, making up 28 percent of the 41 million foreign-born individuals in the US.[2]
Therefore, notwithstanding that more recent studies on the topic have included immigrants from Asian countries in their focus because the rate of Asian immigration has now outpaced immigration from Latin American countries, Hispanics and Latinos are still the biggest ethnic minority group in the United States, and the majority of research on the topic of ethnicity, nationality, immigration, and addiction looks at the patterns and risks of Hispanic communities living in America.[3]
The Implications of Immigration
America as “a nation of immigrants” is a popular catchphrase among politicians and pundits, but the actual definition of “immigrant” is more layered than most people might imagine. To understand the substance abuse challenges facing various Hispanic communities, it’s important to fully comprehend the full scale of what immigration entails.
From a social science perspective, “immigration” is actually a three-stage process that involves an individual and his/her family making the decision to leave their home country (in the case of voluntary immigration), actually arriving in their destination country, and then the attempt at settling down and acclimatizing to their new surroundings.
To that effect, the National Institute on Alcohol Abuse and Alcoholism explains some of the problems that foreign students, workers, and their spouses might face as a result of their immigration from one country to another.[4] Most non-immigrants may be familiar with the more obvious and publicized problems:
- Racism and discrimination
- Language and communication barriers
- Difficulties in adapting to local customs (culture shock)
These issues can cause significant difficulty and trauma for many immigrants, but transplants face a number of other concerns that are chronic, not as visible, and traumatic enough to put them at risk for developing the stress, anxiety, or depression that precedes self-medicating with controlled substances:
- Persecution based on religion or ethnicity
- Fear of deportation
- Inability to see friends or relatives in their home country
- Ineligibility to receive medical insurance due to legal status
- Lack of legal protection and rights
- Restrictions placed on employment and freedom of movement
- Trauma as a result of involuntary migration (such as asylum, human trafficking, etc.)[5]
Acculturative Stress
When an individual undergoes cultural and psychosocial changes from trying to adapt to a new, unfamiliar culture, the parameters of this change can be expressed in the form of a scientific model (a collection of ideas and concepts that explain how the real world works). The relevant model here is known as the acculturative stress model.[6]
In examining the phenomenon, The Counseling Psychologist explains that Hispanics who come to the United States face a number of strong, debilitating, and lifelong sources of stress,[7] and researchers explained in the journal of Cultural Diversity and Ethnic Minority that the acculturative stress model is what is used to understand and describe the mental health disorders that an individual might develop as a result of the aforementioned immigrant stressors.[8]
Acculturation is commonly thought of from a negative perspective – an immigrant not being able to communicate clearly with non-immigrants, or experiencing closed doors as a result of their status as an immigrant – but positive acculturation among at-risk demographics for substance abuse (such as spending time with native-born college students, one in four of whom meet the medical criteria for an addiction problem[9]) can nonetheless lead to the development of a drug or alcohol problem.
The journal Alcoholism: Clinical and Experimental Research found that Latina woman who spoke English more than they did Spanish and associated more with Americans than other Hispanics – who had high levels of acculturation, in other words – drank more than women who were not as acculturated.[10]
Social Norms and Gender
The study was authored by an associate scientist at the Alcohol Research Group who explained that her findings in terms of social norms. People wear clothing that lets them fit in with those around them, or they might express opinions that will be accepted – and, in turn, will make them feel accepted – by the group they want to join. Similarly, Latina immigrants in the United States who want to acculturate will change their thoughts and behaviors regarding the consumption of alcohol, in order to better meet the social norms regarding drinking. Latina women who do not want to change their habits or attitudes toward drinking are therefore less likely to acculturate.[11]
That being said, the risk could go both ways. Speaking to The Fix, the director of the Center for Multicultural Mental Health Research at Harvard Medical School said that members of the Latino community who are isolated and alone may turn to substance abuse to alleviate the symptoms of their depression.[12]
The focus on gender is found in other research on the subject of addiction in Hispanic communities. The traditional culture across Hispanic countries, explains the National Institute on Alcohol Abuse and Alcoholism, frowns on women imbibing alcoholic beverages in casual or social settings (consuming alcohol in small family gathering is acceptable).
Hispanic men, on the other hand, face no such restrictions.[13] However, as the Alcoholism: Clinical & Experimental Research journal reported, Latina women with a higher level of acculturation tended to drink more than other Latina women who did not acculturate.
This may be partly due to Latina women rubbing shoulders with American women, who are drinking alcohol at higher rates than ever before, and who do not face the same gender roles and restrictions as Latina women do in their native countries. This sense of freedom and liberation may be appealing to Latina women, which might embolden them to drink with little regard for their health.[14]
But, as stated, some women choose not mingle with their American neighbors and peers. A study conducted by Oregon State University found that Hispanic immigrants who eschewed American norms and traditions in favor of retaining their own ethnic cultural values were 13 times less likely to report using drugs or dangerously drinking. The study found that Hispanic immigrants who chose to adopt American lifestyles were more likely to abuse drugs and alcohol.
Recent Arrivals and Language
The study’s lead author explained that Hispanic immigrants who are new to the United States are more family-oriented, and therefore less permissive when it comes to substance abuse. Conversely, Hispanics who have been living in the United States for a period of time are wealthier and have more job stability, which may influence them to succumb more easily to the peer pressure and encouragement of coworkers and friends to drink or use drugs.[15] They may also simply have more spending money that they are tempted to use on regular drinking or drug abuse, whereas a new immigrant has less freedom to spend his or her money on frivolities.
Hispanics who move to the United States face a greater risk for developing an addiction than Hispanics who stay behind in their home country.[16] Research indicates that the age of an Hispanic immigrant may be a risk factor in determining whether or not they start to abuse drugs and alcohol – specifically, the younger the immigrant, the greater the chance that they will adopt the comparatively laxer American attitudes toward experimenting with controlled substances.
Another Alcoholism: Clinical and Experimental Research study conducted on the topic interviewed Mexican-American adults either who lived on the American border with Mexico, or who lived in cities with large immigrant populations. The study found that Hispanics who moved to the United States at 12 years old or younger had a much higher likelihood of using drugs. Hispanics who arrived in the United States after the age of 12 had a reduced possibility of picking up harmful substance abuse habits.
In examining the difference, the researchers posited that the development of a sense of self and identity around that age, as well as the belief (or lack thereof) in preserving cultural values, may have some determination in whether a Hispanic immigrant would start using drugs at a young age.[17]
Language can be one of the biggest factors in determining the acculturation of an immigrant. According to Health Psychology, the use of English among Hispanics and Asians was specifically identified by the researchers as being one of the factors that connected immigrants with developing a lifelong smoking habit.[18]
Similarly, the Journal of Ethnicity in Substance Abuse cited preexisting studies that reported on how Hispanics who preferred to converse in English developed higher rates of addiction and substance abuse than Hispanics of similar age who opted to respond to questions in Spanish (or their respective native language), visited their home country regularly, or otherwise maintained their foreign values.[19]
Barriers to Treatment
In fact, says the National Institute on Alcohol Abuse and Alcoholism, when Hispanics choose to drink, they tend to have higher rates of alcohol consumption than non-Hispanics. As a result of this, 33 percent of Hispanics who become dependent on alcohol have recurring or chronic problems as a result of their addiction; by comparison, only 22.8 percent of non-Hispanics will have a similar struggle.[20]
This may be because, while Spanish-speaking 12-Step programs do exist, they are less common, and many Hispanics who are struggling with alcoholism or other addictions may not be aware that they can (or even should) seek help for their problems.[21]
Furthermore, cultural attitudes toward substance abuse and seeking help may preclude some Hispanics from acknowledging that they have an addiction problem and taking the necessary steps to address it.
Legal status (or lack thereof), poverty, lack of access to medical services (33 percent of Latinos lack health insurance[22]), and simply not knowing anyone in their new country may also be factors that impede Hispanics from joining a support group or checking into a treatment facility. Some states simply do not have rehabilitation programs that focus on issues specific to Hispanics, such as their respective language, cultural differences, family units, religious dynamics, risk factors, etc.
Drinking Across Hispanic Communities
Of course, there are also many differences within the Hispanic community, and the drinking patterns and rates across the various Hispanic communities and nationalities can differ a great deal. According to the U.S. Census Bureau, people of Hispanic or Latino descent hail from Cuba, Mexico, Puerto Rico, South or Central America (except Brazil), or a related Spanish culture.[23]
The journal of Alcohol and Alcoholism found, to that effect, that Puerto Rican men and women tend to be the heaviest of all Hispanic drinkers (they are almost three times more likely to develop alcohol use disorders than Caucasian Americans, partly because drinking often starts at an early age in traditional Puerto Rican culture, and alcohol has an even smaller stigma in Puerto Rico that it does in the United States).[24] Of Hispanic men, Cubans drink the least; and of Hispanic women, Mexicans drink the least. Beer is the preferred beverage across all Hispanic nationalities, with wine coming in second.
Among all categories of Hispanics, Cubans (and Cuban-Americans) have a less than one percent chance of developing a substance abuse disorder, especially when compared to Hispanics of other national origins. An assistant professor of family medicine at Michigan State University opines that this may be because Cubans (and their Cuban-American descendants) are thought of as political refugees in the United States, and thus face less legal and acculturative opposition to their settlement.
They face “no immigration laws” because of their entry as asylum seekers, and they are thus able to quickly and efficiently go about enrolling in school, getting jobs, and otherwise occupying their lives in such a way that the issue of substance abuse never comes up.
Mexicans and Mexican-Americans, on the other hand, have the association (unfair or not) of being considered illegal immigrants, with more limited options to join mainstream American society. They may face prejudice and discrimination from Americans and even other Hispanics for their perceived illegal status, and their attempts to go to school or get a job may be met with skepticism as to their legal eligibility to do so.[25]
In addition, a sociology professor at the University of Texas at Austin tells FOX News that children who attempt to illegally cross the US-Mexico border are at risk for physical and sexual assault, hunger, and kidnapping by human traffickers and drug smugglers. Such experiences carry a strong possibility of festering trauma (that may eventually lead to depression and substance abuse), which is exacerbated by acculturative difficulties on the American side of the border – or, in a worst-case scenario for the children, arrest and detention by United States Border Patrol.[26]
How Can These Risks Be Avoided?
While immigration will never be a fully stress-free process, there are certain conceptual changes that can be affected to minimize the substance abuse risk factors that immigrant and first-generation Hispanics face.
The report in Alcohol and Alcoholism on the subject of rates of alcohol use among Hispanic subgroups concluded by stating that “the practice of categorizing Hispanics as a homogenous ethnic group […] is not only inappropriate, but also hinders a better understanding of [alcohol use disorder] prevention, treatment and rehabilitation,” especially when one considers that Hispanics – and not merely “Hispanics,” but Hispanics from Mexico, Cuba, Puerto Rico, South America, and Central America – comprise the largest ethnic minority group in the United States.
Controlling and minimizing the risks for these groups of people entails taking into account their diverse and unique cultural backgrounds and realities. Understanding that traditionalism plays a large part in Puerto Rican attitudes towards drinking, for example,[27] or that Mexicans have a number of significant stress and risk factors that may cultivate a drinking problem, can go a long way into tackling the causes behind the high rates of substance abuse that individuals within these respective nationalities face, as opposed to thinking of all Latinos with uniform and standard immigration and addiction problems.[28]
Citations
[1] “Hispanic or Latino Populations.” (September 2014). Centers for Disease Control and Prevention. Accessed February 3, 2015.
[2] “Mexican Immigrants in the United States.” (October 2014). Migration Policy Institute. Accessed January 7, 2015.
[3] “In a Shift, Biggest Wave of Migrants is Now Asian.” (June 2012). The New York Times. Accessed January 8, 2015.
[4] “Immigrants, Refugees and Alcohol.” (March 2005). National Institute on Alcohol Abuse and Alcoholism. Accessed January 6, 2015.
[5] “Substance Abuse.” (n.d.) Anxiety and Depression Association of America. Accessed February 3, 2015.
[6] “The Influence of Acculturation on Drug and Alcohol Use in a Sample of Adolescents.” (December 2008). Addictive Behavior. Accessed January 6, 2015.
[7] “Acculturative Stress: The Experience of the Hispanic Immigrant.” (January 1995). The Counseling Psychologist. Accessed February 3, 2015.
[8] “Discrimination, Acculturation, Acculturative Stress and Latino Psychological Distress: A Moderated Mediation Model.” (January 2013). Cultural Diversity and Ethnic Minority Psychology. Accessed January 6, 2015.
[9] “Wasting the Best and the Brightest: Alcohol and Drug Abuse on College Campuses.” (May 2007). CASAColumbia. Accessed February 3, 2015.
[10] “Re-examining Whether and Why Acculturation Relates to Drinking Outcomes in a Rigorous, National Survey of Latinos.” (May 2006). Alcoholism: Clinical and Experimental Research. Accessed January 6, 2015.
[11] “Alcohol and the Hispanic Community.” (December 2015) National Institute on Alcohol Abuse and Alcoholism. Accessed May 21, 2018.
[12] “Addiction on the Rise in the Hispanic Community.” (November 2014). The Fix. Accessed February 3, 2015.
[13] “Alcohol and the Hispanic Community.” (July 2013). National Institute on Alcohol Abuse and Alcoholism. Accessed February 3, 2015.
[14] “The Alcoholism Gender Gap: Why Are More U.S. Women Becoming Problem Drinkers?” (September 2011). International Business Times. Accessed January 8, 2015.
[15] “U.S. Culture Boosts Hispanic Immigrants’ Substance Abuse Risk.” (August 2007). HealthDay. Accessed January 7, 2015.
[16] “Acculturation and Substance Use: Social Influence as a Mediator Among Hispanic Alternative High School Youth.” (October 2014). Journal of Health and Social Behavior. Accessed January 7, 2015.
[17] “Study: Immigration at Young Age for Latinos May Increase Addiction.” (May 2014). Arizona Public Media. Accessed February 3, 2015.
[18] “English Language Use as a Risk Factor for Smoking Initiation Among Hispanic and Asian-American Adolescents: Evidence for Medication by Tobacco-Related Beliefs and Social Norms.” (September 2000). Health Psychology. Accessed February 3, 2015.
[19] “Substance Abuse Prevalence and Treatment Among Latinos and Latinas.” (March 2011). Journal of Ethnicity in Substance Abuse. Accessed January 7, 2015.
[20] “Alcohol and the Hispanic Community.” (n.d.) National Institute on Alcohol Abuse and Alcoholism. Accessed February 3, 2015.
[21] “Pastor Boes of Vida Church Offers Some Solutions to Substance Abuse.” (January 2015). La Presna. Accessed February 3, 2015.
[22] “The National Hispanic and Latino ATTC.” (March 2013). Addiction Technology Transfer Center Network. Accessed February 3, 2015.
[23] “The Hispanic Population: 2010.” (May 2011). U.S. Census Bureau. Accessed February 3, 2015.
[24] “Incidence of Alcohol Use Disorders Among Hispanic Subgroups in the USA.” (June 2014). Alcohol and Alcoholism. Accessed February 3, 2015.
[25] “Not All Hispanics Are The Same When It Comes To Drinking.” (September 2014). ScienceDaily. Accessed February 3, 2015.
[26] “Unaccompanied Immigrant Minors at High Risk for Trauma, Experts Say.” (October 2014). FOX News. Accessed February 3, 2015.
[27] “Cultural Influences and Alcoholism: A Study of Puerto Ricans.” (September 1985). Alcoholism: Clinical and Experimental Research. Accessed February 3, 2015.
[28] “Risk Factors for Secondary Depression Among Mexican Americans and Non-Hispanic Whites. Alcohol Use, Alcohol Dependence, and Reasons for Drinking.” (March 1993). The Journal of Nervous Mental Disease. Accessed February 4, 2015.
