Understanding barriers to specialty substance abuse treatment among Latinos

Pinedo, Miguel; Zemore, Sarah E.; Rogers, Shannon M.

doi:10.1016/j.jsat.2018.08.004

Cited by 75 publications

(61 citation statements)

References 73 publications

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“…These disorders among immigrants are often viewed as a sign of weakness, shame or a lack of willpower, which often results in ambivalence about seeking timely help; either the person delays or does not seek treatment at all. 45,47,48 Further, in recent studies on immigrants, fear of being negatively perceived within their community, especially family resistance, discouraged them from seeking treatment even though they were willing to get help, 31,36 which concurs with the participants' experiences in our study. In addition to stigma, our participants mentioned experiences of discrimination and unfair treatment from HPs which lowered their treatment engagement.…”

Section: Discussionsupporting

confidence: 82%

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

et al. 2020

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Immigrants are considered at risk of psychological distress and therefore involvement in substance abuse, due to a variety of pre- and post-migration factors. Further, there is lower treatment engagement, a higher dropout rate, and less frequent hospitalizations among this group compared to the general population. There are few studies on the subjective understanding of co-occurring substance use disorder (SUD) and mental health disorder (MHD) among immigrants in Norway. This qualitative study aims to explore the treatment experiences of immigrant men living with co-occurring SUD and MHD. Within a collaborative approach, individual interviews were conducted with 10 men of immigrant background, living with co-occurring SUD and MHD, who had treatment experiences from the Norwegian mental health and addiction services. Data were analyzed using a systematic text condensation. The analysis yielded 6 categories where participants described their treatment experiences in mental health and addiction services in Norway as: lack of connection, lack of individually tailored treatment, stigma and discrimination preventing access to treatment, health professionals with multi-cultural competence, care during and after treatment, and raising awareness and reducing stigma. A significant finding was the mention by participants of the value of being seen and treated as a “person” rather than their diagnosis, which may increase treatment engagement. They further mentioned aftercare as an important factor to prevent relapse. This study provides an enhanced understanding of how immigrant men living with co-occurring SUD and MHD experienced being treated in Norwegian healthcare settings. These experiences may add to the knowledge required to improve treatment engagement.

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Section: Discussionsupporting

confidence: 82%

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

et al. 2020

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“…Among individuals with moderate/severe AUD, treatment utilization has been found to vary over the lifetime, peaking at ages 18, 33, and 44 and increasing as more time passes since AUD onset (Evans-Polce and Schuler, 2016). It is often underutilized by those of racial/ethnic minorities, especially Latinos and those of Hispanic descent (Pinedo, Zemore, and Rogers, 2018). One study found that individuals aged 45+ had a higher rate of treatment utilization and were older when they received their first alcohol-related service than those under age 45 (Alvanzo et al, 2014).…”

Section: The Need To Study Generational Differencesmentioning

confidence: 99%

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Bourdon

Tillman

Francis

et al. 2020

Alcoholism Clin & Exp Res

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Background There are gaps in the literature on service use (help‐seeking and treatment utilization) for alcohol problems among those with alcohol use disorder (AUD). First, policy changes and cultural shifts (e.g., insurance) related to AUD have occurred over the last few decades, making it important to study generational differences. Second, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations can inform public health and research endeavors. The current study examined service use for alcohol problems among individuals with AUD. The aims were as follows: (i) to describe service use for alcohol problems; (ii) to assess generational differences (silent [b. 1928 to 1945], boomer [b. 1946 to 1964], generation X [b. 1965 to 1980], millennial [b. 1981 to 1996]) in help‐seeking and treatment utilization; and (iii) to examine sex differences across generations. Methods Data were from affected family members of probands who participated in the Collaborative Study on the Genetics of Alcoholism (N = 4,405). First, frequencies for service use variables were calculated across generations. Pearson chi‐square and ANOVA were used to test for differences in rates and types of service use across generations, taking familial clustering into account. Next, Cox survival modeling was used to assess associations of generation and sex with time to first help‐seeking and first treatment for AUD, and time from first onset of AUD to first help‐seeking and first treatment. Interactions between generation and sex were tested within each Cox regression. Results Significant hazards were found in all 4 transitions. Overall, younger generations used services earlier than older generations, which translated into higher likelihoods of these behaviors. Regardless of generation, younger females were less likely to use services than males. Conclusions There are generational and sex differences in service use for alcohol problems among individuals with AUD. Policy and clinical implications are discussed.

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“…Between 2017-2018, we recruited 54 participants with SUD to participate in qualitative study aimed at examining barriers to treatment (21). Participants were recruited via nationwide online ads for qualitative interviews.…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

“I Don’t Feel Like I Have a Problem Because I Can Still Go To Work and Function”: Problem Recognition Among Persons With Substance Use Disorders

Rogers

Pinedo

Villatoro

et al. 2019

Substance Use & Misuse

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Background.-Persons with substance use disorders (SUD) who do not recognize their substance use as problematic are less likely to perceive needing treatment and less motivated to seek help. Factors that contribute to problem recognition among persons with SUDs are poorly understood. Objective.-To explore in-depth factors that may explain why those who meet diagnostic criteria for SUD do not perceive to have a substance abuse problem. Methods.-We recruited 54 participants with recent (i.e., past-5-year) SUD for qualitative interviews. Interviews were coded to identify prominent themes that were linked to problem recognition. Results.-We identified two prominent themes that contributed to problem recognition: modifying substance use behaviors to avoid adverse consequences and internalized stigma. Participants who reported adjusting their alcohol and drug use in ways that would not interfere with important life responsibilities, especially work-responsibilities; described those with alcohol and drug problems negatively; and associated treatment with personal defeat less likely to perceive having a substance use problem. Conclusions/Importance.-These findings can be used to inform intervention strategies aimed at increasing problem recognition among substance using populations. Such strategies may

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Understanding barriers to specialty substance abuse treatment among Latinos

Cited by 75 publications

References 73 publications

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

Treatment Experiences with Norwegian Health Care among Immigrant Men Living with Co-Occurring Substance Use- and Mental Health Disorders

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

“I Don’t Feel Like I Have a Problem Because I Can Still Go To Work and Function”: Problem Recognition Among Persons With Substance Use Disorders

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