Hispanic Heritage Month!! Implications for Substance Use Disorders Treatment and Recovery

National Hispanic Heritage Month recently ended. It is a celebration of American citizens whose ancestors came from Mexico, the Caribbean, Central and South America. This is the only celebration that begins and ends in the middle of two months! The celebration begins September 15th as numerous Latin American Countries achieved independence on that date.

Hispanics have experienced a great deal of historical trauma both in the United States, the Caribbean Islands, Central and South America. There is a link between historical trauma and substance use disorders. We have learned from the Native American Wellbriety movement that cultural celebrations which increase cultural pride can be a substance use disorders protective factor and help increase recovery rates.

Hispanics are the fastest growing community in the United States. It is predicted that by the year 2050 they will be the largest cultural group in the country. As demographic shifts continue to occur, history reveals that we can expect an increase in racial tension leading to greater trauma and the potential for increased substance use.

Organizations such as Hispanic/Latino Behavioral Health Center of Excellence and the National Hispanic & Latino Mental Health Technology Transfer Center, are playing a major role in increasing culturally responsive and evidence based approaches for working with Hispanics with substance use disorders. We are also seeing an increase of Latino/Hispanic substance use disorders specialists in key leadership positions in the substance use disorders profession. This will help tremendously as well.

In the future there will need to be an increase in the number of bilingual/bicultural professionals who are able to serve Hispanic communities. Special emphasis will need to be placed upon substance use disorders prevention, treatment and recovery for recent migrants who have fled Central and South America escaping trauma.

Personally, I feel a special kinship with Latino/Hispanic Communities. When the Africans were brought to the ‘New World’ to be enslaved, millions were first brought to the Caribbean Island, Central and South America. They are our brethren! I also attended a high school in which 70% of my classmates were Latino/Hispanic and was able to witness the richness of the culture up close.

I hope you have enjoyed Hispanic Heritage Month.

Graduation: From Marijuana to Crack and Opioids

For years I specialized in working with African American adolescents who primarily smoked marijuana. Most began smoking marijuana between the ages of 11 to 13 and just about all made a declaration that marijuana was not addicting and that they would never use real addictive drugs like crack and heroin. When asked the reasons they would never use crack or heroin, they would say things like:

My aunt smoked crack and she sold her body for pennies to buy more crack

 or 

My uncle used heroin and overdosed in an alley with a needle in his arm.

Evidence indicates that in spite of the declaration of marijuana only, many of these youth will graduate to cocaine, opioids and other drugs as they age and as addiction progresses. Many of these youth begin experimenting with xanax, molly and other pills. When they turn 21, they celebrate adulthood by buying their own liquor, legally for the first time. As they enter emerging adulthood many will begin to add stimulants like cocaine, Oxycotin and heroin to their menu of drugs.

One study found that if an adolescent smokes marijuana for over 200 days in a year, they become more vulnerable to stimulant and opioid dependence. I have seen this in clinical practice and have talked with colleagues who have also witnessed this phenomenon.

For states which legalize marijuana, legalization begins at age 21. For teens who begin smoking marijuana before age 16 they become more vulnerable to mental health symptoms and a permanent drop in IQ caused by early marijuana use. In addition, many youth who start smoking marijuana at young ages do so to medicate childhood trauma and are at an increased risk of addiction. Many African American adolescents have said to me, “There is gun violence and gangs in my community. Of course I smoke marijuana to deal with that!”  Once the addiction process has set in, they become more vulnerable to cocaine and opioid dependence, in spite of the early declaration, “I'll never use those drugs!”

For African American adolescents, prevention of stimulant and opioid dependence can involve addressing marijuana use as early as possible including primary and secondary prevention. Early treatment for those whose marijuana use has been diagnosed as early stage dependence is also recommended. Addressing the trauma which often precedes substance use is of the upmost importance.