Drug use and service utilization among Hispanics in the United States

Mancini, Michael A.; Salas-Wright, Christopher P.; Vaughn, Michael G.

doi:10.1007/s00127-015-1111-5

Cited by 29 publications

(16 citation statements)

References 61 publications

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“…The authors point to several documented barriers to substance use disorder treatment among Hispanics, such as family factors, insurance/costs, linguistic and cultural factors, and the fit of service need with existing programs. The lifetime prevalence of use of heroin (as well as other drugs) was greater among U.S.-born relative to immigrant Hispanics after controlling for confounders, a finding that corroborates those of previous studies (Mancini et al, 2015). Data from an urban sample of the Treatment Episode Data Set-Discharges, a national census of annual discharges from substance use disorder treatment facilities, indicate that Hispanics and blacks are less likely to complete outpatient treatment relative to their white counterparts.…”

Section: Treatment-related Disparitiessupporting

confidence: 84%

“…Data from the National Epidemiologic Survey on Alcohol and Related Conditions show that both U.S.-born and immigrant Hispanic people who use drugs are less likely than their non-Hispanic white counterparts to have used any type of substance use disorder treatment (Mancini et al, 2015). The relationship between nativity and utilization of substance use disorder services varied among Hispanic groups, with utilization by Puerto Ricans being higher among those born on the island of Puerto Rico relative to those born in the continental United States.…”

Section: Treatment-related Disparitiesmentioning

confidence: 99%

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Pain Management and the Opioid Epidemic

Bonnie¹,

Ford²,

Phillips³

2017

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Years of sustained, coordinated, and vigilant effort will be required to contain the present opioid epidemic and ameliorate its harmful effects on society. At least 2 million people have an opioid use disorder (OUD) involving prescription opioids, and almost 600,000 have an OUD associated with heroin (HHS, 2016). These numbers are likely to increase in the coming years, regardless of what policies are put in place. Follow-up studies of individuals receiving treatment for OUD involving heroin (e.g., Hser et al., 2001) find very high rates of premature mortality (in the neighborhood of one-third) due to overdose or other complications of the disorder. Thus, even if the nation ramps up treatment availability substantially and immediately, death rates will climb and quality of life will be dramatically reduced for many people for years to come. Likewise, the continued progression of still more people from prescription opioid use to OUD will demand sustained and coordinated effort to establish and implement the scientifically grounded policies and clinical practices necessary to reshape prescribing practices and reduce the occurrence of new cases of prescription opioid-induced OUD. 1 What should be done to contain the opioid epidemic and to prevent new cases of iatrogenic addiction and associated overdose, death, and other harms? The purpose of this chapter is to review available evidence on strategies that have been used to address the problems of opioid misuse, OUD, 1 Vigilance will also be needed to reduce the risk of similar problems in the future with other classes of medications for which there exists demand for clinical uses other than the indicated conditions and/or active black markets for their resale. 269RCTs, however, are rare for policies that require implementation at the level of an entire jurisdiction, nor are they ethically permissible in many policy contexts. In the absence of RCTs, other sources of evidence are needed to estimate the counterfactual outcome distribution under different strategies. One such source of evidence is the collection of data on individuals who happen to receive the strategies of interest as part of their routine care, often from electronic health records. The so-called observational analyses based on such data are attempts to emulate the RCT that cannot be conducted (the target trial). In these observational analyses, however, the comparability of the groups receiving each strategy is not guaranteed. In the real world, for example, the restricted opioid prescription policy might more likely be applied to individuals visiting providers in urban health care settings who also received other interventions to reduce the risk of addiction. As a result, a direct comparison of the outcome distribution between those who received each strategy would be confounded by the concomitant interventions.Observational analyses attempt to eliminate bias due to confounding by adjusting for all measured prognostic factors that are distributed differentially between the groups. For example, the ...

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Section: Treatment-related Disparitiessupporting

confidence: 84%

Section: Treatment-related Disparitiesmentioning

confidence: 99%

Pain Management and the Opioid Epidemic

Bonnie¹,

Ford²,

Phillips³

2017

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“…It is plausible that perceived racial/ethnic or drug use discrimination among monolingual Spanish speakers differs from individuals who are bilingual (English/Spanish); therefore, future research on this topic should include both mono- and bilingual Hispanic participants. Additionally, the finding reported by Mancini et al of higher lifetime prevalence of illicit drug use among U.S. born versus foreign born Hispanics suggests that nativity is an important characteristic to examine in future work (Mancini, Salas-Wright, & Vaughn, 2015). …”

Section: Discussionmentioning

confidence: 99%

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

McKnight

Shumway²,

Masson³

et al. 2017

Journal of Ethnicity in Substance Abuse

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People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency rooms (ERs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs’ use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N =192) recruited from Methadone Maintenance Treatment Programs (36%), HIV Primary Care Clinics (35%) and Syringe Exchange Programs (29%) in New York City (n = 88) and San Francisco (n = 104). The Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care questionnaire was utilized to assess perceived institutional racial/ethnic and drug use discrimination.. Perceived institutional discrimination was examined across race/ethnicity and by regular use of ERs, having a regular doctor and consistent health insurance. Perceived interpersonal discrimination was examined by race/ethnicity. Perceived interpersonal drug use discrimination was the most common type of discrimination experienced in health care settings. Perceptions of institutional discrimination related to race/ethnicity and drug use among Non-Hispanic Whites did not significantly differ from Non-Hispanic Blacks or Hispanics. A perception of less frequent institutional racial/ethnic and drug use discrimination in health care settings was associated with increased odds of having a regular doctor. Awareness of perceived interpersonal and institutional discrimination in certain populations and the impact on health care service utilization should inform future intervention development to help reduce discrimination and improve health care utilization among PWUDs.

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“…Importantly, however, a growing body of research on the “immigrant paradox” suggests that such concerns are likely ill-founded. Indeed, the bulk of evidence to date indicates that, despite experiencing greater social disadvantage compared to US-born Americans, immigrants in general are less likely to take part in violence and crime [8–11], misuse alcohol and drugs [12–14], and experience a wide array of adverse behavioral and health outcomes [15–18]. That stated, one important caveat should not be overlooked: evidence also suggests that the protective effects of nativity tend to decrease as individuals spend longer amounts of time in the US, particularly among those who immigrate during early childhood [19, 20].…”

Section: Introductionmentioning

confidence: 99%

An “immigrant paradox” for adolescent externalizing behavior? Evidence from a national sample

Salas-Wright

Vaughn

Schwartz

et al. 2015

Soc Psychiatry Psychiatr Epidemiol

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Purpose Recent decades have witnessed a rise in the number of immigrant children in the United States (US) and concomitant concerns regarding externalizing behaviors such as crime, violence, and drug misuse by immigrant adolescents. The objective of the present study was to systematically compare the prevalence of externalizing behaviors and migration-related factors among immigrant and US-born adolescents in the US. Method Data on 12 to 17 year olds (Weighted N in thousands = 25,057) from the National Survey on Drug Use and Health (NSDUH) R-DAS between 2002 and 2009 were used. The R-DAS online analytic software was employed. Prevalence estimates and 95 % confidence intervals were calculated adjusting for the complex survey sampling design. Results Compared to their US-born counterparts, immigrant adolescents—particularly those between the ages of 15 and 17 years—are significantly less likely to be involved in externalizing behaviors. In addition, later age of arrival and fewer years spent in the US were associated with reduced odds of externalizing behavior. Supplementary analyses indicate that the link between nativity and externalizing behavior may be primarily driven by differences between US-born and immigrant youth who self-identify as non-Hispanic black or Hispanic. Immigrant adolescents are also more likely to report cohesive parental relationships, positive school engagement, and disapproving views with respect to adolescent substance use. Conclusions This study extends prior research on the “immigrant paradox” to externalizing behavior among adolescents using a nationally representative data source. Findings highlight the importance of examining age, age of arrival, duration, and race/ethnicity in the study of nativity and externalizing.

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Drug use and service utilization among Hispanics in the United States

Cited by 29 publications

References 61 publications

Pain Management and the Opioid Epidemic

Pain Management and the Opioid Epidemic

Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization

An “immigrant paradox” for adolescent externalizing behavior? Evidence from a national sample

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