The fastest-growing population in the United States is comprised of Hispanic/Latino residents; between 2000 and 2010, this group accounted for 16.3% of the total population as well as nearly 1/2 of the growth of the US population (Flores, 2011.) In regards to the problems of substance and alcohol use and abuse among Latinos in the US, there has been a significant mismatch between the needs of the population and the service models that are accessible to them. The result is that there is inadequate access to and participation in programs addressing drug and alcohol problems, low retention numbers in these programs, and a significant absence of successful community methods. Such programs would assist in minimizing cultural barriers and promoting the use of culturally-appropriate, science-based treatments that are adequate for use with Latino clients. This paper will address the impact of Latino culture on the use and abuse of alcohol and drugs, taking the perspective that certain aspects of the culture may reinforce the tendency to use drugs or alcohol, and are at times influenced by factors such as gender and cultural values..
Given the tremendous numbers of Latinos in the US, estimated to be 15 million, it is essential that researchers of substance abuse and providers of treatment pay sufficient attention to the prevalence and treatment of drug and alcohol use among this population (Alvarez, 2007.) Surveys conducted by the National Household Surveys on Substance Abuse in the 1990s demonstrate that statistics regarding substance use and abuse among Latinos are no different from those of the general population in the US. More recent studies have indicated that Latinos report slightly lower use of illicit drugs during their lifetimes than people of European and African American descent. In addition, numbers regarding alcohol dependence and binge drinking among Latinos is virtually identical to those of European and African American backgrounds.

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Some research has demonstrated that there are significant gender differences in the prevalence rates of substance use and abuse that are particularly evident in the Latino population. Generally, Latin women are more likely than Latin men to refrain from using alcohol and illicit drugs, and are also less likely to drink heavily and develop dependence on alcohol (Alvarez, 2007.) It appears that certain cultural norms which discourage the use of substances by women may protect Latinas from becoming involved in substance use and abuse and becoming dependent because abstinence is promoted. There is also evidence that there is a relationship between having adopted US cultural values and use of alcohol or drugs among Latinos. That is to say that Latinas who were either born in the United States or lived in the United States prior to the age of 18 and identify with US values tend to engage in h heavier eavy alcohol use than Latina women who were born in other countries, speak Spanish, visit their country of origin on a regular basis, and hold on to their Latin American values. This particular research supports the notion that cultural values among this population are not a predictor of alcohol or illegal use of drugs.

Nevertheless, the Latino population is not immune from engaging in the use of illegal drugs and alcohol, and is in need of significant treatment interventions at rates that mirror those of the overall US population. Data compiled in the early 21st century have shown that on the average, 8.3% of Hispanics 12 years of age or older need alcohol treatment during a one-year period, and 3.4% require treatment for illicit drug use (Flores, 2011.) In regards to Hispanics, the need for treatment of alcohol use is greatest among Mexicans, and the need to engage in drug treatment for using illegal substances is highest among the Puerto Rican population.

One of the theories about cultural factors affecting substance use and abuse among Latinos regards traditional gender roles, i.e. the concept of machismo may encourage substance abuse among Latin men. However, two studies did not find a relationship between the use of alcohol or drugs among Latinos and the adoption of traditional roles regarding gender. Therefore, although cultural values may encourage abstinence among Latinos, research has not proven a correlation between gender roles and substance abuse among Latinos.

Certain aspects of Latino culture must be considered in providing healthcare in general, and specifically in regards to treatment for substance abuse or use. The values of respect, the family, personal relationships, spirit, and trust are highly regarded within the culture, and for culturally competent practice to be implemented it is essential to respect those values. According to Latino traditions, many people may be included in what is considered to be a family, such as extended relatives including grandparents, cousins, godparents, aunts, and uncles. Frequently, family involvement is essential in the provision of healthcare and treatment for substance abuse. This may take the form of inclusion of relatives in medical appointments or treatment sessions. In addition, respect in this culture implies mutual and reciprocal deference, dictating appropriate deferential behavior towards others related to age, gender, social status, economic status, and power (Flores, 2011.) Addressing substance-abuse issues would require, for example, older adults to be respected by younger ones, males by females, adults by children, employers from employees, etc.

Considering the context of substance abuse treatment for Latinos, personal relationships are crucial so that this population frequently relies on organizations that are based in their communities for their care. Latinos have expectations that their health providers are warm, personal, and friendly, and express a genuine interest in helping their patients. Medical professionals are expected to greet patients personally, asking about that person’s current well-being as well as that of his or her family. Trust according to the Latino culture must be established so that gradually when a provider clearly respects the culture of a patient and demonstrates sincere interest trust will be enhanced. Trust translates into the provider being seen as focusing on the best interests of his or her patients. Finally, Spirit is another important value in the Latino community, and respects the view of Latinos that health is regarded from a synergistic perspective, as evidenced by the continuum of the body, mind, and spirit as a holistic force to be treated (Flores, 2011.)

There are a wide range of strategies to address the problem of substance abuse in the Latino population, and strive to minimize and/or eliminate the use and abuse of illegal substances. These interventions include:

Strengthening bonds within Latino families by offering mutual respect between individuals, examining traditional gender roles in an effort to change those that seem to reinforce substance abuse such as the macho aspect of Latino culture, and helping parents to establish their credibility as leaders (Center for Substance Abuse Prevention.)
Understanding the forces that have an impact on Latino families, including an environment that is culturally pluralistic: when families are experiencing either over- acculturation or under-acculturation by children and parents respectively. These changes may create behavioral problems, specifically substance abuse, in Latino teens.
Providing community-based programs in Latino communities that address addiction and recovery, with an emphasis on prevention.
Addressing critical obstacles, both institutional and cultural, to substance abuse interventions. Such barriers include a scarcity of substance abuse treatment that accommodates a range of Latino individuals, lack of providers who are fluent in speaking Spanish, and an approach to care that is rather fragmented.
Finally, it is tremendously important to provide family support and education programs to prevent and address substance abuse within Latino community.

The problem of substance abuse within the Latino community is an undeniable problem facing this population as evidenced by statistics that confirm this phenomenon. The use and abuse of illegal drugs and alcohol are at times reinforced by gender expectations and roles as well as commonly held attitudes specific to that culture among others. Substance abuse needs to be addressed in a significant way in these communities, and as stated there are many strategies to be implemented that would address and ideally minimize and/or eliminate the problem.

    References
  • Alvarez, J., Jason, L., Olson, D., Ferrari , J., & Davis, M. (2007). Substance abuse prevalence and treatment among Latinos and Latinas. Journal of Ethnicity and Substance Abuse, 115- 141.
  • Center for Substance Abuse Prevention. (n.d.). A Hispanic/Latino approach to substance abuse prevention. Rockville: National Coalition of Hispanic Health and Human Service Organizations.
  • Flores, V. (2011, August 19). Cultural elements in treating Hispanic/Latino populations. Retrieved from ATTC.net: http://www.attcnetwork.org/learn/education/documents/Cultural.Elements.in.Treating.Hispanic.Latino.Populations.pdf