July 16, 2009

Substance Use Treatment Need and Receipt among Hispanics

Hispanics comprise the largest minority group in the United States. They currently represent an estimated 13 percent of the U.S. population and are expected to represent more than one quarter of the total U.S. population by 2050.¹ Therefore, understanding and planning for the health care needs—including the substance use treatment needs—of this growing population are increasingly important. The National Survey on Drug Use and Health (NSDUH) collects information on substance use treatment need and receipt among Hispanics.

NSDUH includes questions about ethnicity and race. First, respondents are asked about their Hispanic origin, then, when applicable, to identify the Hispanic ethnic grouping that best describes them;² additional questions are asked about race. For this report, respondents identifying themselves as Hispanic were assigned to the Hispanic group regardless of their racial identification. For brevity's sake, we refer to the Hispanic-Mexican group as "Mexicans," the Hispanic-Puerto Rican group as "Puerto Ricans," the Hispanic-Central or South American group as "Central or South Americans," the Hispanic-Cuban group as "Cubans," and the Hispanic-Other group as "other Hispanics." All survey respondents were asked if they were born in the United States, and responses to this question were used to differentiate U.S.-born versus foreign-born Hispanics. All findings in this report pertain strictly to residents of the United States, not to persons living in other countries. No information is collected on citizenship; thus, no inferences can be made in this regard.

NSDUH classifies persons as needing treatment for a substance use (i.e., alcohol or illicit drug) problem if they met the criteria for dependence or abuse or if they received substance use treatment at a specialty facility in the past year.³ Substance use treatment at a specialty facility is defined as treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient services only), and mental health centers; it excludes treatment received in an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient.

This issue of The NSDUH Report examines the need for and receipt of alcohol and illicit drug use treatment among Hispanics aged 12 or older; data are presented by ethnic subgroup and nativity (i.e., whether or not persons were born in the United States).⁴ All findings in the report are annual averages based on combined 2002 to 2007 data.

An estimated 8.3 percent (2.6 million) of Hispanics aged 12 or older were in need of alcohol use treatment in the past year, and 3.4 percent (1.1 million) were in need of illicit drug use treatment. Among Hispanics, past year need for treatment varied by ethnic subgroup and nativity. The prevalence of need for alcohol use treatment was higher among Mexicans (9.2 percent) than among Puerto Ricans (7.7 percent), Central or South Americans (6.8 percent), other Hispanics (6.4 percent), and Cubans (5.2 percent) (Figure 1). The need for illicit drug use treatment was higher among Puerto Ricans (6.1 percent) than among Cubans (3.6 percent), Mexicans (3.3 percent), other Hispanics (2.6 percent), and Central or South Americans (2.2 percent). Hispanics born in the United States were more likely than their counterparts who were not born in the United States to meet the criteria for need for alcohol use treatment (10.1 vs. 6.7 percent) and for illicit drug use treatment (5.5 vs. 1.5 percent) (Figure 2).

Figure 1. Need for Alcohol and Illicit Drug Use Treatment in the Past Year among Hispanics Aged 12 or Older, by Ethnic Subgroup: 2002 to 2007

Figure 2. Need for Alcohol and Illicit Drug Use Treatment in the Past Year among Hispanics Aged 12 or Older, by Nativity: 2002 to 2007

Of the 2.6 million Hispanics in need of alcohol use treatment in the past year, 7.7 percent received treatment in a specialty facility; 15.1 percent of the 1.1 million Hispanics in need of illicit drug use treatment received treatment in a specialty facility. Among persons in need of treatment in the past year, Puerto Ricans were more likely than those in any other Hispanic ethnic subgroup to have received alcohol use treatment in a specialty facility; they were also more likely to have received illicit drug use treatment (Figure 3). About 1 in 6 Puerto Ricans (16.6 percent) in need of alcohol use treatment received treatment at a specialty facility compared with 7.2 percent of Mexicans, 4.7 percent of other Hispanics, and 3.2 percent of Central or South Americans. Over one quarter (27.9 percent) of Puerto Ricans in need of illicit drug use treatment in the past year received treatment at a specialty facility compared with 13.0 percent of Mexicans, 8.9 percent of other Hispanics, and 6.6 percent of Central or South Americans.

Figure 3. Receipt of Substance Use Treatment at a Specialty Facility in the Past Year among Hispanics Aged 12 or Older in Need of Treatment,* by Ethnic Subgroup:** 2002 to 2007

Among persons in need of illicit drug use treatment, Hispanics born in the United States were more than twice as likely as those who were not born in the United States to have received treatment in a specialty facility (17.4 vs. 7.6 percent) (Figure 4). The difference in the rate of alcohol use treatment among Hispanics born in the United States and Hispanics not born in the United States was not statistically significant (8.9 vs. 6.1 percent).

Figure 4. Receipt of Substance Use Treatment at a Specialty Facility in the Past Year among Hispanics Aged 12 or Older in Need of Treatment,* by Nativity: 2002 to 2007

The growing number of Hispanics in the United States will have an impact on the substance abuse treatment system for many years to come. The findings in this report show that many Hispanics in the United States were in need of substance use treatment in the past year, but few of these persons received treatment in a specialty facility. Additionally, this report shows that ethnic subgroup and nativity are important factors in the need for and receipt of substance use treatment among Hispanics. Specifically, Mexicans had a relatively high need for alcohol use treatment, but relatively low receipt of treatment compared with other Hispanic subgroups. Puerto Ricans in need of treatment were more likely than those in other Hispanic subgroups to have received treatment in a specialty facility. Hispanics born in the United States who were in need of illicit drug use treatment were more likely than those who were not born in the United States to have received treatment in a specialty facility. These findings highlight the need for continuing efforts to eliminate disparities in treatment access and utilization and for research on additional factors that may be related to treatment need and receipt among Hispanics (e.g., geographic characteristics, socioeconomic status, and acculturation).