Contextual and Cultural Influences of Opiate Abuse among U'S' Hispanics

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Contextual and Cultural Influences of Opiate
Abuse among U.S. Hispanics

• Avelardo Valdez, Ph.D.
• University of Houston
• Graduate School of Social Work
• Office for Drug and Social Policy Research

National Hispanic Science Network, National
Conference Miami 2005
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Substance Use is A ComplexPhenomena
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Universe of Determinants

• Genes
• Physiologic factors
• Traits/personality
• Psychosocial factors
• Neighborhood factors
• Societal factors

Source Yonette, T. NHSN, Summer Res. Institute,
2005
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Drug Abuse Research and the Social Environment

• Drug abuse research has focused largely on
  individual risks.
• There is a need to focus and extend this research
  to understand an individuals susceptibility to
  opiate use in interaction with the social
  environment, especially among U.S. Hispanics.

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Opiates

• Substances isolated from the opium poppy or
• synthetic relatives include
• morphine
• codeine
• heroin
• methadone
• oxycodone
• The most common used opiate among
• Hispanics is heroin.

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Focus of Todays Presentation

• Patterns and trends of Heroin use among U.S.
  Hispanics
• Contextual factors associated with IDU
• Cultural factors associated with IDU

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Heroin Use Patterns and Trends among U.S.
Hispanics
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Lifetime Heroin Use by Race/Ethnicity 2003
Source Youth Risk Behavior Surveillance System
2003
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ADAM of Arrestees Testing Positive for Heroin
by Sites Adult Male 2000-2003
Highest
Lowest
Cities with at least 30 of the arrestee
population Hispanic
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Admissions for Heroin Abuse by Race/Ethnicity
2003 (Percent Distribution)
Source Treatment Episode Data Set (TEDS) 2003
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Hispanic Admissions According to Primary
Substance Abuse 2003 Distribution (n238,090)
Source Treatment Episode Data Set (TEDS) 2003
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Why is there a high prevalence rate of heroin use
among Hispanics?
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CONTEXTUAL FACTORS
Source Don Normark. 1999. Chavez Ravine, 1949 A
Los Angeles Story. Chronicle Books.
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HISTORICAL INFLUENCES

• Importance of ecological context in linking
  Hispanics and heroin use.
• Hispanic urban settlement patterns in and around
  vice districts.
• This deviance containment is a historical feature
  of minority communities (Reckless 1933, Osofsky
  1963, Kornblum 1993).
• As a result, this has
• Shaped early perceptions of drug use, crime, etc
• Created cultural patterns of learning and,
• Illegal Opportunities.

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San Antonios Vice District, 1911
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San Antonios High Density MA Residential Areas
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Ethnic Specific Puerto Rican Drug Injection
Pattern

• IDU among Puerto Ricans (PR) began after their
  migration and during and after WWII.
• IDU spread among PR in NYC (1950-60s)
• PR migrate out of NYC (i.e. Chicago) in the
  1960s and increase opportunity in drug trade.
• Return migrants to island appear to be primary
  source of transferring IDU knowledge and
  practice.

Source Singer, M. 1999. Why do Puerto Rican
Injection Drug Users Inject So Often?
Anthropology And Medicine 6(1)31- 58.
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Source Don Normark. 1999. Chavez Ravine, 1949 A
Los Angeles Story. Chronicle Books.
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CONTEMPORARY ECONOMIC INFLUENCES

• Persistent Poverty
• Overall, the burden of poverty has
  disproportionately affected U.S. born Hispanics
  vs. immigrants.
• Low Educational Attainment
• Example of a social institution shaping the
  nature and consequences of low income Hispanic
  neighborhoods.
• Disparities in Health Care Drug Treatment
  Utilization
• Economic circumstances limit access to health
  care.

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STRUCTURAL INFLUENCES

• Social Isolation
• Decrease in conventional norms (Sampson Wilson
  1995 Andersen 1999 Vigil 1988).
• Drug Policy
• Disproportionately target poor Hispanic
  minorities.
• Drug Markets
• Stimulated the creation of thriving illicit
  markets with reduced prices and higher purity of
  heroin (Valdez 2005).

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CULTURAL FACTORS
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CULTURAL INFLUENCES

• Cholo Identity
• Tecato subculture with a distinct street
  identity, distinct street-based criminal social
  networks (Valdez et al. 2000).
• Intergenerational Transmission
• Familismo (traditional vs. cholo family context)
  (Castro Alarcon 2002 Moore 1991)
• Gender Roles
• Machismo / hypermasculinity (Jorquez 1984
  Quintero Estrada 1998)

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Etiological Model of Heroin Use among U.S.
Hispanics
Contextual Factors

• Cultural
• Factors
• Cholo Identity
• Intergenerational
• Transmission
• Gender Roles

Injecting Heroin Use
Historical Influences
Economic Influences
Structural Influences
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Conclusion

• Future research on opiate use among
• Hispanics needs to take into
• consideration these contextual and
• cultural factors in explaining
• tolerance,
• addiction, and
• physical dependence
• given their etiological importance.