Acculturation and drug use disorders among Hispanics in the U.S.

Abstract

The authors' objective was to examine the relationship between degree of acculturation across five different dimensions of acculturation and risk of drug use disorders (DUD) among US Hispanics.

Data were derived from a large national sample of the US adult population, the National Epidemiological Survey on Alcohol and Related Conditions, collected using face-to-face interviews. The sample included civilian non-institutionalized U.S. population aged 18 years and older, with oversampling of Hispanics, Blacks and those aged 18–24 years. Interviews of more than 34,000 adults were conducted during 2004–2005 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. A total of 6359 subjects who identified themselves as Hispanics were included in this study. Acculturation measures used in this study assessed:, time spent in the U.S., age at immigration, language preference, social network composition, and ethnic identification.

Among Hispanics, there was an inverse relationship between five complementary dimensions of acculturation and DUD. Moreover, this relationship showed a significant gradient across all acculturation dimensions and DUD.

The prevalence of DUD increases with acculturation in Hispanics, across several measures of acculturation in a dose–response relationship. Hispanic cultural features and values exert a protective effect on risk of DUD. Preservation and promotion of Hispanic values may be an important component of preventive interventions for Hispanics.

Introduction

Hispanics are the largest and fastest-growing ethnic minority group in the U.S. Census Bureau 2007). Although the prevalence of drug use disorders (DUD) among Hispanics is lower than among non-Hispanic Whites (Huang et al., 2006) the Hispanic population is very heterogeneous and data on overall prevalence may conceal important variations among different Hispanics subgroups. In particular, previous research suggests that the prevalence of psychiatric disorders among Hispanics, especially DUD increases with the degree of acculturation (Alegria et al., 2006, 2007b; Blake et al., 2001; Grant et al., 2004b; Ortega et al., 2000; Turner and Gil, 2002; Vega et al., 1998, 2004). Acculturation refers to the changes that occur as a result of the direct and continuous contact of individuals to a culture different from their own (Redfield et al., 1936). This dynamic process is known to involve individual changes and adaptive outcomes at the psychological and socio-cultural levels (Ward et al., 2001). However, acculturation is a multidimensional construct that has been measured differently across studies (Alegria et al., 2007a; Vega et al., 1998). For example, early studies used language as a measure of acculturation and found it a powerful and reliable predictor of risk of substance and drug use disorders (Ortega et al., 2000; Vega et al., 1998). More recent studies have found that Hispanics who immigrated to the US prior to 6 years of age or have lived in US for 13 years or longer had similar risk of SUD than US-born Hispanics of the same age (Alegria et al., 2007b), suggesting that time spent in the US and assimilation to US society may be more important than nativity per se (Alegria et al., 2007a; Gfroerer and Tan, 2003; Vega et al., 2004). Another set of studies has hypothesized that the protective effect of Hispanic culture against various substances is due to strong social networks and highly cohesive families (Gloria and Peregoy, 1996; Ojeda et al., 2008). Therefore, it is important to investigate which dimensions of acculturation are associated with an increased risk for DUD among Hispanics. Moreover, whether there is a dose–response relationship between degree of acculturation across its different domains and risk for DUD is not known. A greater knowledge on these associations may serve to inform specific preventive interventions that take into account the specific aspects of the acculturation process in the development of psychiatric disorders, like DUD.

We sought to build on prior research by examining the relationship between DUD and acculturation in Hispanics drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Specifically, we sought to investigate: 1) the sociodemographic characteristics associated with DUD among Hispanics in a national sample; 2) the relationship between risk of DUD prevalence and degree of acculturation across different dimensions of acculturation, 3) Whether there is a dose–response relationship between all acculturation domains and risk for DUD.