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Caetano R, Vaeth PA, Gruenewald PJ, Ponicki WR, Kaplan Z. Alcohol use disorder among Whites and Hispanics on and off the U.S./Mexico border in California. J Ethn Subst Abuse 2024; 23:520-536. [PMID: 35951655 PMCID: PMC9918594 DOI: 10.1080/15332640.2022.2108953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
This paper examines whether U.S./Mexico border residence in California is related to the prevalence of DSM-5 alcohol use disorder (AUD) among Whites and Hispanics. Household survey data were obtained from 1,209 adults (59.7% female) 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample, with data collected on the phone or online. Results show that AUD rates were not different between border and non-border location and between Whites and Hispanics. AUD was negatively associated with higher income ($20,000 to $60,000: AOR=.38; 95%CI=.17-.86; p<.01-more than $60,000: AOR=.27; 95%CI: .09-.81; p<.01) and poor risk perception (AOR=.86; 95%CI=.78-.94; p<.01). AUD was positively associated with continued volume of drinking (AOR = 1.05; 95%CI = 1.01-1.09; p<.01), drinking in Mexico (AOR = 4.28; 95%CI = 1.61-11.36; p<.01), marijuana use (AOR = 4.11; 95%CI = 1.73-9.77; p<.01), and impulsivity (AOR = 1.55; 95%CI = 1.23-1.94). Efforts to prevent AUD in the population in California, and especially among those who live close to the border with Mexico, should take into consideration factors such as impulsivity, marijuana use, border crossing to drink in Mexico, all of which increased risk of AUD.
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Affiliation(s)
| | | | | | | | - Zoe Kaplan
- Prevention Research Center, Berkeley, CA, USA
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Caetano R, Vaeth PAC, Gruenewald PJ, Ponicki WR, Kaplan Z. Alcohol and cannabis use and co-use among Whites and Hispanics on and off the U.S./Mexico border in California. J Ethn Subst Abuse 2024:1-17. [PMID: 38795010 DOI: 10.1080/15332640.2024.2354320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024]
Abstract
This paper examines self-reported rates of drinking and cannabis use and co-use among White and Hispanic adults randomly selected in four counties in California: Imperial on the border; and Kern, Tulare, and Madera in California's Central Valley. Co-use was significantly higher among the U.S. born than among those born abroad, and in the Central Valley than on the border. Co-users were heavier drinkers, had higher rates of alcohol use disorder, other alcohol problems, and a positive history of illicit drug use than drinkers only.
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Affiliation(s)
- Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Patrice A C Vaeth
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - William R Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Zoe Kaplan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
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Caetano R, Vaeth PAC, Gruenewald PJ, Ponicki WR, Kaplan Z. Contexts of Drinking- and Alcohol-Related Problems Among Whites and Hispanics on and off the US/Mexico border in California. J Racial Ethn Health Disparities 2024; 11:264-272. [PMID: 36735186 PMCID: PMC9897614 DOI: 10.1007/s40615-023-01517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/13/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND This paper examines the association between drinking context use by Whites and Hispanics on and off the US/Mexico border and alcohol problems. METHODS Data come from a household sample of 1209 adults 18 to 39 years of age resident in Imperial County on the California/Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Data were collected on the phone or online and analyzed with an ordinal generalized linear model. RESULTS The pattern of statistically significant associations between the frequency and the volume of drinking in different contexts varies across problem types. Furthermore, some contexts of drinking are associated with problems in more than one area. For instance, frequency of drinking at bars/pubs is associated with social problems, risky sex, and fights, but not with injuries. Injuries are associated with the frequency of drinking at home alone or with family and at restaurants. Volume of drinking at bars/pubs is also significantly associated with three different contexts: social problems, injury, and fights. But the volume of drinking at the home of friends or relatives is associated with fights only. Border location is an effect modifier, changing the effect of frequency of drinking at bars and pubs from protective to a factor of risk for social problems and fights. CONCLUSION These results provide support for the social ecology of drinking and micro environmental factors or risk. The effect of border location on frequency of drinking in bars/pubs underlines the importance of the macro environment in problem generation.
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Affiliation(s)
- Raul Caetano
- Prevention Research Center, 2030 Addisoon Street, Suite 410, Berkeley, CA, 94704, USA.
| | - Patrice A C Vaeth
- Prevention Research Center, 2030 Addisoon Street, Suite 410, Berkeley, CA, 94704, USA
| | - Paul J Gruenewald
- Prevention Research Center, 2030 Addisoon Street, Suite 410, Berkeley, CA, 94704, USA
| | - William R Ponicki
- Prevention Research Center, 2030 Addisoon Street, Suite 410, Berkeley, CA, 94704, USA
| | - Zoe Kaplan
- Prevention Research Center, 2030 Addisoon Street, Suite 410, Berkeley, CA, 94704, USA
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Palau CB, Akikuni M, Latsky-Campbell B, Wagner J. The Drug Overdose Epidemic in the U.S.-Mexico Border Region: Shifts, Progression, and Community Characteristics. Subst Use Misuse 2023; 59:184-192. [PMID: 37888899 DOI: 10.1080/10826084.2023.2267110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVE Previous studies show the reach of the current drug overdose epidemic into the U.S.-Mexico border region, albeit with a unique border-specific wave pattern compared to national waves and a delayed onset of fentanyl involvement (Wave I: 2002-2011, Wave II: 2012-2016, and Wave III: since 2017). The objective of this study is to examine the community predictors and the progression of overdose deaths across the U.S-Mexico border-specific epidemic waves. METHOD Descriptive epidemiological profile of border communities across the unfolding of the opioid epidemic, integrated data from the CDC-WONDER multiple causes of death data set, the CDC SVI, Uniform Crime Report, and the Behavioral Risk Factor Surveillance System. Using spatially adjusted Bayes rates by border-specific epidemic waves, we provide a descriptive profile of the spatial unfolding of the drug overdose epidemic. Negative binomial regression models assessed community predictors of overdose deaths across waves. RESULTS Spatial analysis identified moderate to steep increases in drug overdose deaths over the three waves along the border. The impact and unfolding of the epidemic in the U.S.-Mexico border region were not uniform and affecting communities with differing severity and timing. Our study also finds support for social vulnerability and community violence as predictors of overdose deaths over the current wave of the epidemic. CONCLUSION Findings suggest that more disadvantaged U.S.-Mexico border communities may encounter increasing rates of overdose death over the coming years. Interventions need to target not only the supply side but also the underlying social root causes for sustainable overdose prevention.
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Affiliation(s)
- Citlaly B Palau
- Department of Social Sciences, Texas A&M International University, Laredo, Texas, USA
| | - Mika Akikuni
- Department of Social Sciences, Texas A&M International University, Laredo, Texas, USA
| | | | - Jascha Wagner
- Department of Social Sciences, Texas A&M International University, Laredo, Texas, USA
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Caetano R, Vaeth PA, Gruenewald PJ, Ponicki WR, Kaplan Z. Drinking and driving among Whites and Hispanics on and off the US/Mexico border in California. TRAFFIC INJURY PREVENTION 2023; 24:536-542. [PMID: 37358330 PMCID: PMC10528719 DOI: 10.1080/15389588.2023.2217460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/05/2023] [Accepted: 05/20/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE To examine self-reported rates of driving under the influence (DUI) with and without arrest among border and non-border residents in California. METHODS Data were obtained from 1,209 adults 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample. Data were collected on the phone or online and analyzed with a heteroskedastic ordinal generalized linear model. RESULTS Driving after drinking (11.1% vs. 6.5%; q = 0.04) and the lifetime DUI arrest rates were higher for men than women (10.7% vs. 4%; q = 0.001). In multivariable analysis driving after drinking and DUI arrests were not higher on the border, not higher among Hispanics than Whites, and among Hispanics, the rates were not higher among those located on the border. Income was positively associated with drinking and driving. Impulsivity was positively and significantly associated with both drinking and driving and lifetime DUI arrest. CONCLUSION The null results suggest that DUI related risk behaviors may not be higher on the border than in other areas of California. There may be health related risk behaviors of higher prevalence in the border population than in other areas, but DUI related behavior may not be one of them.
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Affiliation(s)
| | | | | | | | - Zoe Kaplan
- Prevention Research Center, Berkeley, CA, USA
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Karriker-Jaffe KJ, Li L, Cherpitel CJ, Bensley KMK, Zemore SE. Neighborhood Contexts and Alcohol Use Disorder Among Mexican Americans Living in the US-Mexico Border Region. Alcohol Alcohol 2022; 57:678-686. [PMID: 35596957 DOI: 10.1093/alcalc/agac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/25/2022] [Accepted: 04/05/2022] [Indexed: 11/14/2022] Open
Abstract
AIMS This study assessed contributions of exposure to neighborhood stressors (violent victimization, witnessing crime, greater alcohol and drug availability) to variation in alcohol use disorder (AUD) symptoms among drinkers in three cities in Texas, USA. METHODS We used data from interviews conducted from 2011 to 2013 with Mexican-origin adults (ages 16-65) in the US-Mexico Study of Alcohol and Related Conditions who were past-year drinkers (N = 1960; 55% male) living in two cities in the Texas-Mexico border region (Laredo, n = 751 and Brownsville/McAllen, n = 814) and one interior comparison site (San Antonio, n = 771). Analyses (conducted in 2018 and 2019) examined overall and gender-stratified multilevel mediated effects of each border site (versus San Antonio) on AUD symptoms through the neighborhood-level factors, adjusting for individual- and neighborhood-level covariates. RESULTS Overall, drinkers in Laredo reported more AUD symptoms than drinkers in the other cities, and their neighborhoods had more witnessing of crime and greater perceived drug availability, as well as higher levels of disadvantage and a lower proportion non-Hispanic White residents, than neighborhoods in San Antonio. Witnessing neighborhood crime was associated with increased AUD symptoms, while neighborhood disadvantage and proportion non-Hispanic White residents each were negatively associated with AUD symptoms. Perceived neighborhood insecurity, crime victimization, perceived neighborhood drug availability and neighborhood alcohol availability (off- and on-premise) were not significantly associated with AUD symptoms. Stratified models suggested possible gender differences in indirect effects through witnessing neighborhood crime. CONCLUSION Reducing witnessing of neighborhood crime may help reduce AUD symptoms among adults living in the US border region.
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Affiliation(s)
- Katherine J Karriker-Jaffe
- Community Health Research Division, RTI International, Berkeley, CA, USA.,Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | | | - Kara M K Bensley
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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Zemore SE, Li L, Bensley K, Karriker-Jaffe KJ, Cherpitel C. Alcohol- and Drug-Related Mortality Among Adults Within and Outside the U.S.-Mexico Border Region. J Stud Alcohol Drugs 2022; 83:175-184. [PMID: 35254240 PMCID: PMC8909922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Although researchers and policy makers have often considered the U.S.-Mexico border region to be at high risk for substance use problems, epidemiological studies of this region have been hard to interpret because of their modest geographic coverage, reliance on self-report, and mixed results. The current study addresses limitations of existing studies and extends the knowledge base by comparing alcohol- and drug-related mortality in counties on versus off the border across all four U.S. border states. METHOD Data were from the 2008-2017 Centers for Disease Control and Prevention WONDER Multiple Causes of Death data set, American Community Survey, and Rural Urban Continuum Codes, including all four border states. Spatial lag models tested differences across on- and off-border counties in total alcohol- and drug-related mortality ("total mortality"), alcohol-related mortality, and drug-related mortality. RESULTS In multivariate models, mortality rates were significantly higher in off- versus on-border counties for all three outcomes (ps < .05). Rates for total mortality, alcohol-related mortality, and drug-related mortality were 28%, 82%, and 30% higher, respectively, off versus on the border. Border effects were similar, excluding California; robust over time; and stronger for Latinx versus White decedents. CONCLUSIONS Results suggest a revised understanding of the border, revealing that residents of interior counties of border states are at highest risk of severe substance use consequences. Results are consistent with other research finding that border counties were protected against drug overdose deaths, particularly for Latinx residents.
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Affiliation(s)
- Sarah E. Zemore
- Alcohol Research Group, Emeryville, California,Correspondence may be sent to Sarah E. Zemore at theAlcohol Research Group, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, or via email at:
| | - Libo Li
- Alcohol Research Group, Emeryville, California
| | - Kara Bensley
- Department of Public Health, Bastyr University, Kenmore, Washington
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Zemore SE, Li L, Bensley K, Karriker-Jaffe KJ, Cherpitel C. Alcohol- and Drug-Related Mortality Among Adults Within and Outside the U.S.-Mexico Border Region. J Stud Alcohol Drugs 2022; 83:175-184. [PMID: 35254240 PMCID: PMC8909922 DOI: 10.15288/jsad.2022.83.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 06/14/2021] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Although researchers and policy makers have often considered the U.S.-Mexico border region to be at high risk for substance use problems, epidemiological studies of this region have been hard to interpret because of their modest geographic coverage, reliance on self-report, and mixed results. The current study addresses limitations of existing studies and extends the knowledge base by comparing alcohol- and drug-related mortality in counties on versus off the border across all four U.S. border states. METHOD Data were from the 2008-2017 Centers for Disease Control and Prevention WONDER Multiple Causes of Death data set, American Community Survey, and Rural Urban Continuum Codes, including all four border states. Spatial lag models tested differences across on- and off-border counties in total alcohol- and drug-related mortality ("total mortality"), alcohol-related mortality, and drug-related mortality. RESULTS In multivariate models, mortality rates were significantly higher in off- versus on-border counties for all three outcomes (ps < .05). Rates for total mortality, alcohol-related mortality, and drug-related mortality were 28%, 82%, and 30% higher, respectively, off versus on the border. Border effects were similar, excluding California; robust over time; and stronger for Latinx versus White decedents. CONCLUSIONS Results suggest a revised understanding of the border, revealing that residents of interior counties of border states are at highest risk of severe substance use consequences. Results are consistent with other research finding that border counties were protected against drug overdose deaths, particularly for Latinx residents.
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Affiliation(s)
| | - Libo Li
- Alcohol Research Group, Emeryville, California
| | - Kara Bensley
- Department of Public Health, Bastyr University, Kenmore, Washington
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Caetano R, Vaeth PA, Gruenewald PJ, Ponicki WR, Kaplan Z. Drinking in Mexico by Whites and Hispanics on and off the US/Mexico border in California. J Ethn Subst Abuse 2021; 22:701-719. [PMID: 34878365 PMCID: PMC9200137 DOI: 10.1080/15332640.2021.2011815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This paper compares drinking patterns of Whites and Hispanics who after crossing the U.S./Mexico border drink and do not drink in Mexico. Data came from a household survey of 1,209 adults 18 to 39 years of age in California. Residence near the US/Mexico border increases the likelihood of drinking in Mexico (AOR = 4.57; 95%CI = 2.45-8.52; p < .001). Hispanics (AOR = 1.91; 95%CI = 1.26-2.90; p < .01), those who drink more frequently (AOR = 1.05; 95%CI = 1.02-1.09; p < .01) and those who drink six or more drinks in day (AOR = 1.91; 95%CI = 1.26-2.29; p < .01) are more likely than Whites and lighter drinkers to report this behavior. Crossing the U.S./Mexico border to drink is influenced by living close to the border, Hispanic ethnicity, and drinking many drinks in a day.
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Affiliation(s)
| | | | | | | | - Zoe Kaplan
- Prevention Research Center, Berkeley, CA, USA
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10
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Martinez P, Zemore SE, Pinedo M, Borges G, Orozco R, Cherpitel C. Understanding differences in prescription drug misuse between two Texas border communities. ETHNICITY & HEALTH 2021; 26:1028-1044. [PMID: 31116033 PMCID: PMC6872923 DOI: 10.1080/13557858.2019.1620175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
Objectives: The misuse of prescription drugs in the U.S. is an alarming public health crisis. Prior research at the U.S.-Mexico border has found high rates of prescription drug misuse, but with rates varying significantly across border communities. We aimed to examine a model of permissive climate measures and stress exposures as potential mediators of community differences in prescription drug misuse at the U.S.-Mexico border.Design: We analyzed data from the U.S.-Mexico Study of Alcohol and Related Conditions (UMSARC). Household, in-person interviews were conducted with Mexican-origin residents of the Texas border cities Laredo (n = 751) and Brownsville/McAllen (n = 814). Interviews assessed past-year misuse of any and pain-reliever prescription drugs. Drug availability, neighborhood safety, exposure to violence/crime, and social support were examined as potential mediators. Analyses were stratified by gender and employed regressions and mediation analysis with Mplus.Results: The past-year prevalence of any prescription drug misuse in Laredo was 26.3% among women and 24.4% among men, and in Brownsville/McAllen was 12.4% among men, and 6.7% among women. Mediation analysis revealed site effects via some of the hypothesized risk factors for men, but not for women. Specifically, for men, site effects on any and pain reliever prescription drug misuse were partially mediated via high drug availability and low family support.Conclusions: Past-year prescription drug misuse was over 3 times the 2015 national prevalence among both men and women in Laredo and calls for immediate attention. Findings regarding the model suggest drug availability and social support may be relevant to understanding community differences in prescription drug misuse among men living at the border, and that additional factors should be investigated to understand misuse among women living at the border.
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Affiliation(s)
| | - Sarah E. Zemore
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | | | - Guilherme Borges
- Instituto Nacional de Psiquiatria Ramon de la Fuente, Mexico City, Mexico
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatria Ramon de la Fuente, Mexico City, Mexico
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Lui PP, Zamboanga BL, Ertl MM, Rodriguez LM, Martin JL, Gonzales R. Drinking motives, cultural orientations, and alcohol use among Hispanic college students at the U.S.-Mexico border. J Ethn Subst Abuse 2020; 21:1-19. [PMID: 33208047 DOI: 10.1080/15332640.2020.1845901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hispanic college students at the U.S.-Mexico border are at higher risk for alcohol use and negative drinking consequences relative to their counterparts in non-border areas. Hispanic students at the U.S.-Mexico border (N = 219, Mage = 20.14; 71.2% women) completed an online survey. U.S. orientation was negatively associated with alcohol consumption. Enhancement motives predicted alcohol consumption, whereas coping and conformity motives predicted negative drinking-related consequences. Cultural orientations did not moderate the relations between social motives and alcohol use outcomes. Results highlight the need to consider alcohol-related cognition and to better contextualize U.S. and heritage cultural orientations among Hispanics in the U.S.-Mexico areas.
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Affiliation(s)
| | | | - Melissa M Ertl
- University of Albany State University of New York, Albany, New York, USA
| | | | - Jessica L Martin
- University of Albany State University of New York, Albany, New York, USA
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Bensley KMK, Karriker-Jaffe KJ, Cherpitel C, Li L, Wallisch LS, Zemore SE. Limited treatment accessibility: Implications for alcohol treatment disparities among Mexican Americans living in the U.S.-Mexico border region. J Subst Abuse Treat 2020; 121:108162. [PMID: 33172725 DOI: 10.1016/j.jsat.2020.108162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 09/12/2020] [Accepted: 10/05/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Receipt of alcohol-related care for alcohol use is particularly low among those residing in the U.S.-Mexico border region. One reason for this disparity may be limited treatment accessibility, making it difficult for those who need it to access needed treatment. The current study assesses whether differences in treatment utilization are mediated by differences in treatment accessibility in cities within and outside of the border region. METHODS We used data from the U.S.-Mexico Study of Alcohol and Related Conditions involving a probability sample of Mexican-origin adults surveyed in three cities in Texas (2011-2013). We included only participants with a lifetime history of alcohol use disorder (AUD) (n = 792). We examined two lifetime measures of self-reported alcohol treatment utilization: considering getting help for an alcohol problem and receipt of treatment. We geocoded locations of facilities listed in the SAMHSA National Directory of Drug and Alcohol Abuse Treatment Facilities. We considered three types of facilities: any outpatient treatment, programs offering fee assistance, and programs offering Spanish-language services. We measured treatment accessibility by density of treatment (i.e., number of facilities within a 20-mile radius of participant's residence) and proximity to treatment (i.e., travel time to nearest facility). We assessed direct and indirect effects of two cities in the border region (versus one nonborder city) on the outcomes through treatment accessibility using generalized structural equation models that accounted for clustering of respondents in cities and in neighborhoods, weighted for sampling and nonresponse and adjusted for covariates. RESULTS Of 792 respondents with lifetime AUD, 22% had considered getting help and 11% had received treatment, with consideration of getting help being less likely in cities in the border region. We observed no significant differences in treatment receipt across cities. Reduced densities of all three types of treatment programs were significant mediators for the effect of residing in a border region on considering getting help. Time to nearest Spanish-language program also mediated the effect of residing in a border region on considering getting help for one city. CONCLUSIONS Border cities had lower density of treatment and because treatment density was positively associated with considering getting help, residence in a city in the border region was associated with lower odds of considering getting help, regardless of type of treatment. These findings suggest increasing the number of treatment locations available within cities along the U.S.-Mexico border may encourage those with AUD to consider getting help.
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Affiliation(s)
- Kara M K Bensley
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St #450, Emeryville, CA 94062, USA; University of California, Berkeley School of Public Health, 6001 Shellmound St #450, Emeryville, CA 94062, USA.
| | | | - Cheryl Cherpitel
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St #450, Emeryville, CA 94062, USA.
| | - Libo Li
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St #450, Emeryville, CA 94062, USA.
| | - Lynn S Wallisch
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd., Austin, TX 78712, USA.
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St #450, Emeryville, CA 94062, USA; University of California, Berkeley School of Public Health, 6001 Shellmound St #450, Emeryville, CA 94062, USA.
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Cherpitel CJ, Karriker-Jaffe KJ, Li L, Zemore SE. Neighborhood Context and Drug Use Among Mexican Americans on and off the U.S.-Mexico Border. J Stud Alcohol Drugs 2020; 81:770-779. [PMID: 33308407 PMCID: PMC7754854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 07/21/2020] [Indexed: 03/31/2024] Open
Abstract
OBJECTIVE Prior research has suggested that drug use rates may be high at the U.S.-Mexico border, but in more recent research rates varied significantly between border communities. This study reports findings on the mediating influence of neighborhood-level variables on the observed difference in past-year drug use rates between two border sites and an interior site, focusing on Mexican Americans. METHOD Data were analyzed from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) on 1,345 Mexican-origin respondents ages 18-40 from the border sites of Laredo and Brownsville/McAllen compared with the nonborder site of San Antonio, separately for men and women. Neighborhood-level variables (based on census tracts and block groups) included drug availability, neighborhood insecurity, crime victimization, crime witnessing, off-premise alcohol outlet density, on-premise alcohol outlet density, percentage crossing the border more than 100 times, neighborhood disadvantage, residential stability, and percentage of White/non-Hispanic. RESULTS When individual sociodemographic characteristics were controlled for, lower drug use among men in Brownsville/McAllen (vs. San Antonio) was partially mediated by lower drug availability and lower perceived neighborhood insecurity whereas increased drug use among women in both Laredo and Brownsville/McAllen was partially mediated by the lower proportion of White/non-Hispanic residents compared with San Antonio. CONCLUSIONS Neighborhood-level variables partially explain the heterogeneity in drug use across sites at the U.S.-Mexico border, but different factors appear to be operating for men compared with women. These findings suggest the potential importance of addressing neighborhood factors in reducing drug-related harm at the U.S.-Mexico border.
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Affiliation(s)
| | | | - Libo Li
- Alcohol Research Group, Emeryville,
California
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14
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Cherpitel CJ, Karriker-Jaffe KJ, Li L, Zemore SE. Neighborhood Context and Drug Use Among Mexican Americans on and off the U.S.-Mexico Border. J Stud Alcohol Drugs 2020; 81:770-779. [PMID: 33308407 PMCID: PMC7754854 DOI: 10.15288/jsad.2020.81.770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Prior research has suggested that drug use rates may be high at the U.S.-Mexico border, but in more recent research rates varied significantly between border communities. This study reports findings on the mediating influence of neighborhood-level variables on the observed difference in past-year drug use rates between two border sites and an interior site, focusing on Mexican Americans. METHOD Data were analyzed from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) on 1,345 Mexican-origin respondents ages 18-40 from the border sites of Laredo and Brownsville/McAllen compared with the nonborder site of San Antonio, separately for men and women. Neighborhood-level variables (based on census tracts and block groups) included drug availability, neighborhood insecurity, crime victimization, crime witnessing, off-premise alcohol outlet density, on-premise alcohol outlet density, percentage crossing the border more than 100 times, neighborhood disadvantage, residential stability, and percentage of White/non-Hispanic. RESULTS When individual sociodemographic characteristics were controlled for, lower drug use among men in Brownsville/McAllen (vs. San Antonio) was partially mediated by lower drug availability and lower perceived neighborhood insecurity whereas increased drug use among women in both Laredo and Brownsville/McAllen was partially mediated by the lower proportion of White/non-Hispanic residents compared with San Antonio. CONCLUSIONS Neighborhood-level variables partially explain the heterogeneity in drug use across sites at the U.S.-Mexico border, but different factors appear to be operating for men compared with women. These findings suggest the potential importance of addressing neighborhood factors in reducing drug-related harm at the U.S.-Mexico border.
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Affiliation(s)
| | | | - Libo Li
- Alcohol Research Group, Emeryville, California
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Borges G, Lown EA, Orozco R, Cherpitel CJ. The relationship between social inequalities, substance use and violence in border and non-border cities of northern Mexico. Drug Alcohol Depend 2019; 200:1-5. [PMID: 31063887 DOI: 10.1016/j.drugalcdep.2019.02.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/28/2022]
Abstract
UNLABELLED We know little about determinants of violence and drug use in Mexican northern cities, places considered to be at high risk for alcohol, drug use, and violence, including crimes and homicides. METHODS Data are from the US-Mexico Study on Alcohol and Related Conditions (2011-2013), a survey of respondents living in the border metropolitan areas of Nuevo Laredo (n = 828) and Reynosa and Matamoros (n = 821) and in the non-border metropolitan area of Monterrey (n = 811). Associations between violence (interpersonal, direct community [such as physical attack] and indirect community violence [such as heard gunshots]), drug related activities and neighborhood insecurity with alcohol use disorders (AUD), drug misuse (illicit and out of prescription) and area-level disadvantage (ALD) were estimated with multilevel logistic models, controlling for covariates. RESULTS Substance use was generally related to violence regardless of ALD in these northern cities in Mexico (statistically significant odds ratios range: 0.68-4.24). AUD was associated with 3 forms of violence and also with drug-related activities, but not with neighborhood insecurity. Both illicit drug use and misuse prescription medicines seem to act in unison and were related only to indirect community violence and drug related activities. ALD in these cities was associated with physical violence and neighborhood insecurity. An inverse relationship between illicit drug use and neighborhood insecurity was an unexpected finding. CONCLUSIONS AUD and drug use were associated with violence and drug involvement regardless of ALD. Neighborhood insecurity depended mainly on ALD and to an inverse relationship with illicit drug use that needs further study.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría, Calzada México Xochimilco No 101, Col. San Lorenzo Huipulco, 14370, CDMX, Mexico.
| | - E Anne Lown
- Department of Social and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatría, Calzada México Xochimilco No 101, Col. San Lorenzo Huipulco, 14370, CDMX, Mexico
| | - Cheryl J Cherpitel
- Alcohol Research Group, Public Health Institute Emeryville, California, USA
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Borges G, Zemore SE, Orozco R, Cherpitel CJ, Martínez P, Wallisch L. Drug use on both sides of the US-Mexico border. SALUD PUBLICA DE MEXICO 2019; 60:451-461. [PMID: 30137947 DOI: 10.21149/8603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 10/02/2017] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To compare drug use for cities along the USMexico border. MATERIALS AND METHODS Data are from the US-Mexico Study on Alcohol and Related Conditions (UMSARC, 2011-2013), a survey of 4 796 randomly selected BMexican and of Mexican origin individuals on both sides of the border. RESULTS Higher rates of any past-year drug use and symptoms of drug use disorders were found only in the border city of Laredo, when compared to the non-border city of San Antonio. Nuevo Laredo and Reynosa/Matamoros showed higher rates of drug use than the non-border city of Monterrey. Much higher rates (OR's in the range of 4-11) were found in the US cities when compared to their acrossthe-border Mexican counterparts. CONCLUSIONS Drug use is high on the border for the selected Mexican cities. Misuse of prescription drugs is nevertheless a concern in the south Texas border cities in our study.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría Ramón de la Fuente. Mexico City, Mexico
| | | | - Ricardo Orozco
- Instituto Nacional de Psiquiatría Ramón de la Fuente. Mexico City, Mexico
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Zemore SE, Karriker-Jaffe KJ, Mulia N, Kerr WC, Ehlers CL, Cook WK, Martinez P, Lui C, Greenfield TK. The Future of Research on Alcohol-Related Disparities Across U.S. Racial/Ethnic Groups: A Plan of Attack. J Stud Alcohol Drugs 2018; 79:7-21. [PMID: 29227222 DOI: 10.15288/jsad.2018.79.7] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Research suggests striking disparities in alcohol use, problems, and treatment across racial/ethnic groups in the United States. However, research on alcohol-related disparities affecting racial/ethnic minorities remains in its developmental stages. The current article aims to support future research in this growing field by highlighting some of the most important findings, questions, and approaches, focusing on psychosocial research. METHOD This article advances seven research needs (i.e., questions and topics meriting attention) that we believe are of crucial importance to the field. We draw on the existing literature to illuminate under-explored areas that are highly relevant to health intervention and that complement the field's existing focus. RESULTS Identified research needs include research that (a) better describes disparities in alcohol-related health conditions and their drivers, (b) identifies appropriate screening and brief intervention methods for racial/ethnic minorities, (c) investigates disparities in access to and use of alcohol treatment and support services, (d) examines the comparative efficacy of existing alcohol interventions and develops tailored interventions, (e) explores the impacts of specific alcohol policies across and within racial/ethnic groups, and (f) describes the full spectrum of alcohol-related harms and how and why these may vary across racial/ethnic groups. We also call for (g) continuing research to monitor disparities over time. CONCLUSIONS This article points to specific strategies for describing, explaining, intervening on, and monitoring some of the most substantial alcohol-related disparities. Conclusions outline methods and processes that may be advantageous in addressing these priorities, including the use of longitudinal designs; consideration of life course changes; attention to nontraditional intervention settings; and inclusion of disadvantaged populations in all aspects of research.
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Affiliation(s)
| | | | - Nina Mulia
- Alcohol Research Group, Emeryville, California
| | | | - Cindy L Ehlers
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
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Cherpitel CJ, Li L, Borges G, Zemore S. Age at Immigration and Substance Use and Problems Among Males and Females at the U.S.-Mexico Border. J Stud Alcohol Drugs 2018; 78:827-834. [PMID: 29087816 DOI: 10.15288/jsad.2017.78.827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Although substance use and problems among Mexican Americans are associated with both immigration to the United States and living at the U.S.-Mexico border, little is known about relationships between age at immigration and substance use by gender within the border context. The purpose of this study was to analyze the association of age at immigration with heavy alcohol use, alcohol use disorders (AUD), and drug use among Mexicans Americans living both on and off the U.S.-Mexico border. METHOD Household surveys were conducted, using area probability sampling of 2,336 Mexican Americans (1,185 female), ages 18-65, living at the Texas-Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville, and in the nonborder location of San Antonio. RESULTS Females immigrating before age 12 were less likely to report heavy alcohol use (odds ratio [OR] = 0.309), and those immigrating before age 21 were less likely to report any drug use during the last year compared with their U.S.-born counterparts (OR = 0.473; OR = 0.386, respectively). Males immigrating after age 20 were less likely to report heavy alcohol use (OR = 0.478), and those immigrating between ages 12 and 20 were less likely to report AUD (OR = 0.479) and drug use (OR = 0.255) compared with their U.S.-born counterparts. Early age at immigration (before age 12) was significantly associated with drug use for males living on the border compared with those living off the border. CONCLUSIONS Findings suggest that among females, immigrating before age 12 (vs. being born in the United States) is protective against heavy alcohol and drug use, but among males, immigrating before age 12 results in similarly heavy patterns of use as their U.S.-born counterparts, partially supporting previous findings that early immigration is particularly risky in relation to substance use and AUD.
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Affiliation(s)
| | - Libo Li
- Alcohol Research Group, Emeryville, California
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Lown EA, Cherpitel CJ, Zemore SE, Borges G, Greenfield TK. Hazardous drinking and exposure to interpersonal and community violence on both sides of the U.S. -Mexico border. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2017; 39:528-545. [PMID: 29276337 DOI: 10.1177/0739986317720911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Different patterns of heavy drinking occur by country and proximity to the U.S. Mexico border. Few studies describe the impact of violence on drinking between countries and along the border. Methods Survey data is from U.S. Mexican origin adults living in Texas and Mexican border and non-border cities, N=4,796. Participants were asked about alcohol consumption, interpersonal physical violence (IPV) and exposure to community violence. Monthly hazardous drinking (5+/4+ for men/women) was the primary outcome. Multivariate logistic regression model comparisons identified best predictors. Results In the U.S. hazardous drinking was associated with past year IPV (ORadj=2.5; 1.8-3.5) and community violence (ORadj=1.4; 1.1-1.8). In Mexico, IPV (ORadj=3.9; 2.0-7.4) and border proximity (ORadj=0.5; 0.4-0.8) were associated with hazardous drinking but not community violence. Conclusion Hazardous drinking is associated with IPV in both countries, but violence did not explain border hazardous drinking differences where they existed in Mexico.
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Affiliation(s)
- E A Lown
- Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, 3333 California Ave, San Francisco, CA 94118, United States
| | - C J Cherpitel
- Alcohol Research Group, Public Health Institute, 6001 Shellmound, Suite 450, Emeryville, CA 94608, United States
| | - S E Zemore
- Alcohol Research Group, Public Health Institute, 6001 Shellmound, Suite 450, Emeryville, CA 94608, United States
| | - G Borges
- National Institute of Psychiatry & Autonomous Metropolitan University of Mexico, Mexico City, Mexico
| | - T K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound, Suite 450, Emeryville, CA 94608, United States
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Wallisch L, Zemore SE, Cherpitel CJ, Borges G. Wanting and Getting Help for Substance Problems on Both Sides of the US-Mexico Border. J Immigr Minor Health 2017; 19:1174-1185. [PMID: 27286883 PMCID: PMC5149114 DOI: 10.1007/s10903-016-0442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The US-Mexico border presents potential cultural and logistic barriers to obtaining substance abuse treatment. We compare the prevalence and correlates of wanting and getting help between border and non-border residents in both the US and Mexico. Data come from the 2011 to 2012 US-Mexico Study on Alcohol and Related Conditions which surveyed 3214 border and 1582 non-border residents in the US and Mexico. Multivariate logistic regressions estimate the effect of border residence on desire for and receipt of help. In both countries, border substance users were about half as likely as nonborder substance users to have wanted or obtained any kind of help, independent of predisposing, need and enabling factors, including migration status. Among those desiring help, however, about half had obtained it, both on and off the border in both countries. While substantial proportions of those who need help do not get it either on or off the border, lower motivation for treatment may be more important than access in explaining border/non-border differences. Future research should investigate whether there are border-specific barriers to wanting help, and how to minimize them.
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Affiliation(s)
- Lynn Wallisch
- Addiction Research Institute, The University of Texas at Austin, 1717 W. 6th Street, Suite 335, Austin, TX, 78703, USA.
| | - Sarah E Zemore
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA, 94608, USA
| | - Cheryl J Cherpitel
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA, 94608, USA
| | - Guilherme Borges
- Instituto Nacional de Psiquiatría, Universidad Autónoma Metropolitana, Calzada México Xochimilco, No. 101, Col. San Lorenzo Huipulco, C.P. 14370, Mexico, DF, Mexico
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Orozco R, Benjet C, Velasco-Acosta SR, Altamirano LM, Karriker-Jaffe KJ, Zemore S, Cherpitel C, Borges G. Area-level disadvantage and alcohol use disorder in northern Mexico. Drug Alcohol Depend 2017; 175:219-226. [PMID: 28456100 PMCID: PMC5497703 DOI: 10.1016/j.drugalcdep.2017.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND In Mexico, the Northern States are highly impacted by alcohol consumption and associated problems. Little is known about the association between contextual social disadvantage and alcohol use disorder in this region. METHODS Information from 1265 current drinkers surveyed in the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) was combined with official data on neighborhood disadvantage (index of urban marginalization, a composite of ten indicators of area-level social disadvantage) for 302 neighborhoods. Using statistical marginal models, we estimated the association of neighborhood disadvantage with alcohol use disorder (AUD; based on DSM-5 criteria), alone and with adjustment for individual and contextual covariates. We also tested for moderation of neighborhood disadvantage effects by sex, education, internal migration and border area. RESULTS There was a statistically significant increase in the odds of AUD of 59% (AOR=1.59; 95%CI=1.03, 2.46) for every one-point increase on the neighborhood disadvantage scale, after adjustment for covariates. A significant interaction between sex and neighborhood disadvantage was indicated by two measures of additive interaction (AP=0.55; p<0.001 and S=2.55; p<0.001), with higher neighborhood disadvantage related to higher prevalence of AUD for men but not for women. No moderation effects were observed for education, internal migration or border area. CONCLUSIONS Neighborhood disadvantage is a risk factor for AUD independent of other variables, specifically in men. Studies of contextual variables offer the possibility for understanding the role of collective circumstances on individuals in society. Future studies of alcohol use in this geographic area should consider effects of contextual determinants such as disadvantage.
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Affiliation(s)
- Ricardo Orozco
- Department of Epidemiologic and Psychosocial Research, Ramón de la Fuente National Institute of Psychiatry, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, Mexico City, CP 14370, Mexico.
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, Ramón de la Fuente National Institute of Psychiatry, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, Mexico City, CP 14370, Mexico.
| | - Silvia Ruiz Velasco-Acosta
- Department of Probability and Statistics, IIMAS, Universidad Nacional Autónoma de México, Circuito Escolar, Ciudad Universitaria, Mexico City, C.P. 04510, México
| | - Laura Moreno Altamirano
- Department of Public Health, Facultad de Medicina, Universidad Nacional Autónoma de México. Circuito Interior, Ciudad Universitaria, Mexico City, C.P. 04510, México
| | | | - Sarah Zemore
- Alcohol Research Group, Public Health Institute,6001 Shellmound St., Suite 450, Emeryville, CA 94608-1010, United States.
| | - Cheryl Cherpitel
- Alcohol Research Group, Public Health Institute,6001 Shellmound St., Suite 450, Emeryville, CA 94608-1010, United States.
| | - Guilherme Borges
- Department of Epidemiologic and Psychosocial Research, Ramón de la Fuente National Institute of Psychiatry, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, Mexico City, CP 14370, Mexico.
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Wallisch L, Zemore SE, Borges G, Cherpitel CJ, Maxwell JC. Prevalence and correlates of arrests or stops for drunk driving on both sides of the U.S.-Mexico border. J Ethn Subst Abuse 2017; 17:478-500. [PMID: 28281916 DOI: 10.1080/15332640.2017.1288190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Risk for driving under the influence of alcohol (DUI) may be higher in U.S. and Mexico border cities as compared to nonborder cities in each country. We examine rates and correlates of self-reported DUI arrests or stops on both sides of the border, drawing on a large-scale survey of 4,796 Mexicans and Mexican Americans in border and nonborder cities of Texas and two states in Mexico. Findings varied by site and country and did not consistently show higher rates on the border. DUI prevention efforts should consider the heterogeneity of local conditions and needs.
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Affiliation(s)
- Lynn Wallisch
- a Addiction Research Institute, The University of Texas at Austin , Austin , Texas
| | | | - Guilherme Borges
- c Instituto Nacional de Psiquiatría, Universidad Autónoma Metropolitana, San Lorenzo Huipulco , México D.F. , México
| | | | - Jane C Maxwell
- a Addiction Research Institute, The University of Texas at Austin , Austin , Texas
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Gelberg L, Natera G, Andersen RM, Arroyo M, Bojorquez I, Rico MW, Vahidi M, Yacenda-Murphy J, Arangua L, Serota M. Prevalence of Substance Use Among Patients of Community Health Centers in East Los Angeles and Tijuana. Subst Use Misuse 2017; 52:359-372. [PMID: 28001094 PMCID: PMC6003777 DOI: 10.1080/10826084.2016.1227848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Given the increased use of psychoactive substances on the United States-Mexico border, a binational study (Tijuana, Mexico-Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings. OBJECTIVES To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use. METHODS This was an observational, cross-sectional, analytical study, comparing substance use screening results from patients in Tijuana and LA. The settings were 2 community clinics in LA and 6 in Tijuana. Participants were 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March-October 2013. Patients anonymously self-administered the WHO ASSIST on a tablet PC in the clinic waiting rooms. RESULTS Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the United States had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico. CONCLUSIONS Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities.
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Affiliation(s)
- Lillian Gelberg
- University of California, Los Angeles Department of Family Medicine
- University of California, Los Angeles School of Public Health
| | | | | | - Miriam Arroyo
- National Institute of Psychiatry Ramón de la Fuente Muñiz
| | - Ietza Bojorquez
- El Colegio de la Frontera Norte Department of Population Studies
| | - Melvin W. Rico
- University of California, Los Angeles Department of Family Medicine
| | - Mani Vahidi
- University of California, Los Angeles Department of Family Medicine
| | | | - Lisa Arangua
- University of California, Los Angeles Department of Family Medicine
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Greenfield TK, Ye Y, Lown EA, Cherpitel CJ, Zemore S, Borges G. Alcohol Use Patterns and DSM-5 Alcohol Use Disorder on Both Sides of the U.S.-Mexico Border. Alcohol Clin Exp Res 2017; 41:769-778. [PMID: 28207949 DOI: 10.1111/acer.13356] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/09/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders (AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states. METHODS Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country. RESULTS A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident. CONCLUSIONS Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities.
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Affiliation(s)
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - E Anne Lown
- Alcohol Research Group, Public Health Institute, Emeryville, California.,Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California
| | | | - Sarah Zemore
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Guilherme Borges
- Instituto Nacional de Psiquiatria, Autonomous Metropolitan University of Mexico, Mexico City, Mexico
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Zemore SE, Cherpitel CJ, Ye Y, Borges G, Li L, Wallisch LS. Factors Explaining Variation in Alcohol Use Disorder Prevalence Across Border and Nonborder Communities in Texas. Alcohol Clin Exp Res 2016; 40:1707-16. [PMID: 27381753 PMCID: PMC4961595 DOI: 10.1111/acer.13124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/09/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND U.S. border populations have been found to be at high risk for alcohol problems. However, results from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) revealed surprisingly large variation in alcohol outcomes even among Texas border sites, with alcohol use disorder (AUD) prevalence ~1.5 to 1.6 times greater in the border city of Laredo compared to both San Antonio and the border site of McAllen/Brownsville. Because a better understanding of this variation is important to identifying environmental influences on AUD, we developed and tested a conceptual model addressing variation in AUD prevalence across Texas UMSARC sites. METHODS Surveys involved in-person, household interviews with Mexican-origin residents of the Texas border cities Laredo (n = 751) and McAllen/Brownsville (n = 814), with San Antonio as an off-border comparison (n = 771). Interviews assessed past-year DSM-5 AUD; past-year heavy drinking; coping and enhancement motives; and 7 indicators of substance use climate and stress exposure hypothesized to mediate site effects. Analyses, conducted separately by gender, included regressions and structural equation modeling with Mplus. RESULTS Preliminary analyses revealed that site effects on AUD prevalence were, unexpectedly, exclusive to men, and that Laredan men were similar to McAllen/Brownsville men on demographics, acculturation, and cross-border mobility. However, sites differed dramatically on most of the hypothesized risk factors. Structural equation models confirmed that site effects on AUD were partially mediated via effects of site on indicators of a permissive climate (i.e., permissive drinking norms, high drug availability) and stress exposures (i.e., high exposure to violence/crime, low family support), and via downstream effects on drinking motives and heavy drinking. CONCLUSIONS Findings of very high rates of past-12-month AUD among Laredan men (35%) suggest the possibility of significant heterogeneity even within demographically similar border areas and underline the need for additional study of the border region. Findings regarding our conceptual model suggest that this model may constitute a useful initial framework for future research on alcohol problems at the border. However, additional research using representative samples is needed to confirm and expand this model to comprehensively address relevant individual and community factors.
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Affiliation(s)
- Sarah E Zemore
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | | | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales and Universidad Autónoma Metropolitana, Instituto Nacional de Psiquiatría Ramón de la Fuente, Mexico City, Mexico
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Lynn S Wallisch
- Addiction Research Institute, University of Texas, Austin, Texas
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Cherpitel CJ. ALCOHOL AND DRUG USE AT THE U.S.-MEXICO BORDER - DOES CROSS-BORDER MOBILITY MAKE A DIFFERENCE? JOURNAL OF DRUG ABUSE 2016; 2. [PMID: 27092338 DOI: 10.21767/2471-853x.100013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Cheryl J Cherpitel
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, 510 898-5843, Fax 510 985-6459,
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Borges G, Cherpitel CJ, Orozco R, Zemore SE, Wallisch L, Medina-Mora ME, Breslau J. Substance Use and Cumulative Exposure to American Society: Findings From Both Sides of the US-Mexico Border Region. Am J Public Health 2015; 106:119-27. [PMID: 26562124 DOI: 10.2105/ajph.2015.302871] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated whether Mexican immigration to the United States exerts transnational effects on substance use in Mexico and the United States. METHODS We performed a cross-sectional survey of 2336 Mexican Americans and 2460 Mexicans in 3 Texas border metropolitan areas and their sister cities in Mexico (the US-Mexico Study on Alcohol and Related Conditions, 2011-2013). We collected prevalence and risk factors for alcohol and drug use; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol-use disorders; and 2 symptoms (hazardous use and quit or control) of drug use disorder across a continuum of migration experiences in the Mexican and Mexican American populations. RESULTS Compared with Mexicans with no migrant experience, the adjusted odds ratios for this continuum of migration experiences ranged from 1.10 to 8.85 for 12-month drug use, 1.09 to 5.07 for 12-month alcohol use disorder, and 1.13 to 9.95 for 12-month drug-use disorder. Odds ratios increased with longer exposure to US society. These findings are consistent with those of 3 previous studies. CONCLUSIONS People of Mexican origin have increased prevalence of substance use and disorders with cumulative exposure to US society.
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Affiliation(s)
- Guilherme Borges
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Cheryl J Cherpitel
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Ricardo Orozco
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Sarah E Zemore
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Lynn Wallisch
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Maria-Elena Medina-Mora
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
| | - Joshua Breslau
- Guilherme Borges, Ricardo Orozco, and Maria Elena Medina-Mora are with Instituto Nacional de Psiquiatría, México DF, México. Guilherme Borges is also with the Universidad Autónoma Metropolitana, México DF. Cheryl J. Cherpitel and Sarah E. Zemore are with the National Alcohol Research Center, Public Health Institute, Emeryville, CA. Lynn Wallisch is with the University of Texas, Center for Social Work Research, Austin, TX. Joshua Breslau is with RAND Corporation, Pittsburgh, PA
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Cherpitel CJ, Ye Y, Zemore SE, Bond J, Borges G. The effect of cross-border mobility on alcohol and drug use among Mexican-American residents living at the U.S.-Mexico border. Addict Behav 2015; 50:28-33. [PMID: 26103423 DOI: 10.1016/j.addbeh.2015.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/06/2015] [Accepted: 06/04/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Little epidemiological evidence exists on alcohol or other substance use and related problems along the U.S.-Mexico border, although the border has been the focus of recent media attention related to the escalating drug/violence "epidemic". The purpose of this study was to analyze the association of variables related to crossing the border (cross-border mobility) with three substance use outcomes reported for the last year: 1) heavy drinking (5+ drinks per day for men or 4+ for women), 2) alcohol use disorder (AUD), and 3) co-occurring heavy drinking and drug use (any use of illicit and/or non-medically prescribed drugs). METHODS Household surveys were conducted, using area probability sampling of 1565 Mexican-American residents, aged 18-65, living at the Texas-Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville. RESULTS Among those 18-29, more frequent crossing of the border was significantly predictive of AUD (OR = 1.61, p < 0.01) and co-occurring heavy drinking and drug use (OR = 1.70, p < 0.01). Staying more than one full day was predictive of AUD (OR = 3.07, p < 0.001) and crossing to obtain over-the-counter or prescription drugs ("drug tourism") or for nightlife/drinking were predictive of heavy drinking (ORs = 4.14, p < 0.001; 3.92, p < 0.01, respectively), AUD (ORs = 7.56, p < 0.001; 7.68, p < 0.01, respectively) and co-occurring heavy drinking and drug use (ORs = 8.53, p < 0.01; 4.96, p < 0.01, respectively). Among those 30-65, staying more than a full day and crossing for pharmaceutical reasons were predictive of heavy drinking (OR = 2.54, p < 0.001; 2.61, p < 0.05, respectively) and co-occurring heavy drinking and drug use (OR = 3.31, p < 0.001; 4.86, p < 0.01, respectively), while none of the mobility variables were predictive of AUD in this age group. CONCLUSIONS Cross-border mobility may play an important role in substance use and problems, especially among those 18-29. Findings also highlight the importance of "drug tourism" in substance use across the age spectrum.
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Affiliation(s)
| | - Yu Ye
- Alcohol Research Group, Emeryville, CA 94608, United States
| | - Sarah E Zemore
- Alcohol Research Group, Emeryville, CA 94608, United States
| | - Jason Bond
- Alcohol Research Group, Emeryville, CA 94608, United States
| | - Guilherme Borges
- National Institute of Psychiatry, Autonomous Metropolitan University of Mexico, Mexico City, Mexico
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