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Surveying for Substance Use Disorders in a free Health Clinic Setting

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Final presentation for the Scaife Advanced Student Medical Seminar by Miranda Greiner

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Surveying for Substance Use Disorders in a free Health Clinic Setting

  1. 1. Surveying for Substance UseDisorders among Latinos ina Free Health Clinic SettingA preliminary assessment.Miranda GreinerUniversity of Kansas School of MedicineMaya Health Alliance VolunteerScaife Fellow July 2012
  2. 2. JayDoc Free Health Clinic Jayhawk + Doctor = JayDocNote: I had nothing to do with the creation of this name.
  3. 3. NCDs(Noncommunicable Diseases) Versus SUDs (Substance Use Disorders)
  4. 4. National Survey on Drug Use and Health 2010: Adult Hispanics (Latinos) 2.5 million (8.7%) Latino adults in need of treatment foran alcohol use problem within past year Higher rates of binge alcohol use among Latino adults Higher rates of co-morbid mood and anxiety disorder inwomen and U.S.-born Latinos/as Higher rates of past month alcohol use, binge alcoholuse, and illicit drug use compared to those not born in theU.S.
  5. 5. Substance Use Disorder Treatment in Hispanic (Latino) Population  Less access to care  Wait longer to access SUD services  Unsatisfied with SUD services once they do enter treatment  Poorer outcomes after substance abuse treatment compared to European Americans
  6. 6. Variables that Predict Rates of Substance Use and Abuse among Latinos  Gender differences  Cultural values  Language  Heterogeneity in Latino groups Place of birth
  7. 7. Gender Differences Latinas are more likely to abstain from alcohol and illicitdrugs compared to Latinos. Latinas are less likely to abstain from alcohol if theyassociate more with U.S. cultural values.
  8. 8. Cultural Values  Dignity and respect  Spirituality and religion  Family support  “Personalismo”  “Simpatia”  Gender roles (patriarchy)
  9. 9. Relationship between English Proficiency and Substance Use and Abuse Adaptation to U.S. values with English proficiency Spanish-speakers reluctant to report substance use andabuse in surveys Loss of connection to family and culture with Englishproficiency Stresses related to minority status among individualsseeking acceptance in U.S. culture
  10. 10. Nature and Severity of Substance Use and ProblemsFunctional Integrative MotivationAnalysis of Treatment forSubstance Model Change Use Client Strengths and Resources
  11. 11. ReferencesADA (American Diabetes Association). Jan. 2011. [www.diabetes.org]Alvarez, J., Jason, L. A., Olson, B. D., Ferrari, J. R., & Davis, M. (2007). Substance abuse prevalence and treatment amongLatinos and Latinas. Journal Ethnic Substance Abuse, 6(2): 115-141.Amaro, H., Cortés, D., & Cacari-Stone, L. Improving Research on Hispanic Drug Abuse: Key Strategies for Policy Makers.Amaro H., Whitaker, R., Coffman, G., Hereen, T. (1990). Acculturation and marijuana and cocaine use: Findings from H-HANES 1982-1984. American Journal of Public Health, 80; 54-60 [PubMed: 9187583].Black, S., Markides, K. (1993). Acculturation and alcohol consumption in Puerto Rican, Cuban American, and Mexican-American women in the United States. American Journal of Public Health, 83; 890-893 [PubMed: 8498630].Burrow-Sanchez, J., Martinez, C., Hops, H., & Wrona, M. (2011). Cultural accommodation of substance abuse treatment forLatino adolescents. Journal Ethnic Substance Abuse, 10(3): 202-225.Caetano, R. (1993). Ethnic minority groups and alcoholic anonymous: A review. In: McGrady, B. S.; Miller, W. R., editors.Research on Alcoholics Anonymous: Opportunities and Alternatives. New Brunswick, NJ: Rutgers Center on Alcohol Studies; 209-231.Caetano, R. (1994). Drinking and alcohol related-problems among minority women. Alcohol Health and Research World, 16; 233-241.Caetano, R. (1994). Drinking and alcohol related-problems among minority women. Alcohol Health and Research World, 16; 233-241.Caetano, R., & Clark, C. (1998). Trends in alcohol-related problems among Whites, Black and Hispanics: 1984 – 1995.Alcoholism: Clinical and Experimental Research, 22; 534-538.Caetano, R., Ramisetty-Mikler, S., & McGrath, C. (2004). Acculturation, drinking, and intimate partner violence amongHispanic couples in the United States: A longitudinal study. Hispanic Journal of Behavioral Sciences, 26; 60-78.
  12. 12. References continuedDovidio, J. F. & Fiske, S. T. Under the radar: how unexamined biases in decision-making processes can contribute to healthcare disparities. May 2012. American Journal of Public Health. Vol 102. No. 5. 945-952.Flores, Victor. Cultural Elements in Treating Hispanic/Latino Populations. August 2011. Caribbean Basin and Hispanic ATTC:Unifying science, education, and services to transform lives.Hernandez, L., Eaton, C, Fairlie, A., Chun, T., &Spirito, A. (2010). Ethnic group differences in substance use, depression, peerrelationships and parenting among adolescents receiving brief alcohol counseling. Journal Ethnic Substance Abuse; 9(1): 14-27.Hispanic Workgroup at NIDA (National Institute on Drug Abuse) [http://www.drugabuse.gov/]Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangus, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of GeneralPsychiatry, 62, 593-602.Lee, C. S., López, S., Hernández, L., Colby, S., Caetano, R., Borrelli, B., & Rohsenow, D. (July 2012). A cultural adaptation ofmotivational interviewing to address heavy drinking among Hispanics. Cultur Divers Ethnic Minor Psychol. 2011 July, 17(3):317-324.Miller, William R., Forceheimes, Alyssa A., & Zweben, Allen. (2011). Treating Addiction: A Guide for Professionals. TheGuilford Press, New York, NY.Moyers, T. B., & Miller, W. R. (1993). Therapists’ conceptualizations of alcoholism: Measurement and Implications forTreatment. Psychology of Addictive Behaviors, 7, 238-245.National Hispanic Science Network [http://www.nhsn.med.miami.edu]Rosa, M., Babino, R., Rosario, A., Martinez, N., & Aijaz, L. (2011). Challenges and strategies in recruiting, interviewing, andretaining recent Latino immigrants in substance abuse and HIV epidemiologic studies. The American Journal of onAddictions, 21: 11-22.
  13. 13. References continuedSAMHSA Screening, Brief Intervention, Referral to Treatment [SBIRT]. [http://www.samhsa.gov/prevention/sbirt/]Schinke, S., Moncher, M., Palleja, J., Zayas, L., & Schilling, R. (1988). Hispanic youth, substance abuse, and stress:implications for prevention research. Int J Addict, 23(8): 809-826.Schomerus, G., Corrigan, P.W., Klauer, T., Kuwert, P., Freberge, H. J., & Lucht, M. (2011). Self-stigma in alcoholdependence: Consequences for drinking-refusal self-efficacy. Drug and Alcohol Dependence, 114(1), 12-17.Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M. G., & Angermeyer, M. C. (2011). The stigma ofalcohol dependence compared with other mental disorders: A review of population studies. Alcohol & Alcoholism, 46(2),105-112.Substance use among Hispanic adults. National Survey on Drug Use and Health. SAMHSA (June 2010).Szapocznik, J., Prado, G., Burlew, A. K., Williams, R., & Santisteban, D. (2007). Drug abuse in African American andHispanic adolescents: culture, development, and behavior. Annual Review of Clinical Psychology, 3: 77-105.Unger, J. B., Ritt-Olson, A., Wagner, K. D., Soto, D.W., & Baezconde-Garbanati. Parent-child acculturation patterns andsubstance use among Hispanic adolescents: a longitudinal analysis. (2009). Journal of Primary Prevention, 30: 293-313.Unger, J. B., Ritt-Olson, A., Soto, D. W., & Baezconde-Garbanati. (2007). Parent-child acculturation discrepancies as a riskfactor for substance use among Hispanic adolescents in Southern California. Journal of Immigrant Minority Health, 11: 149-157.
  14. 14. AcknowledgementsThank You to the IRETA staff, theScaife Foundation, and allpresenters who contributed to thisprogram. I especially thank eachone of you for installing spirit intothe field of treating addictions.
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