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Lundgren L, Padyab M, Lucero NM, Blom-Nilsson M, Nyström S, Carver-Roberts T, Sandlund M. Immigration Status and Substance Use Disorder-related Mortality in Sweden: A National Longitudinal Registry Study. J Addict Med 2020; 13:483-492. [PMID: 30889058 PMCID: PMC6844649 DOI: 10.1097/adm.0000000000000524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 02/02/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES First-generation immigrants, in many countries, are healthier than their native counterparts. This study examined the association between first- and second-generation immigrant status and alcohol- or drugs other than alcohol-related (primarily opioids) mortality for those with risky substance use. METHODS A Swedish longitudinal, 2003 to 2017, registry study combined Addiction Severity Index (ASI) assessment data with mortality data (n = 15 601). Due to missing data, the analysis sample for this study was 15 012. Multivariate models tested the relationship between immigration status and drugs other than alcohol or alcohol-related mortality, controlling for demographics and the 7 ASI composite scores (CS). RESULTS Age, a higher ASI CS for alcohol, a lower ASI CS family and social relationship, a lower ASI CS for drug use and a higher ASI CS for health significantly predicted mortality because of alcohol-related causes. Higher ASI CS for drugs other than alcohol, employment, and health, age, male sex, and immigration status predicted drugs other than alcohol, related mortality. Individuals born in Nordic countries, excluding Sweden, were 1.76 times more likely to die of drugs other than alcohol compared with their Swedish counterparts. Individuals born outside a Nordic country (most common countries: Iran, Somalia, Iraq, Chile) were 61% less likely to die of drugs other than alcohol compared with their Swedish counterparts. Those with parents born outside Nordic countries were 54% less likely to die of drugs other than alcohol. DISCUSSION Research is needed on why people with risky substance use from Nordic countries (not Sweden) residing in Sweden, have higher mortality rates because of drugs other than alcohol (primarily opioids drugs other than alcohol compared with the other population groups in our study). Findings indicate that ASI CSs are strong predictors of future health problems including mortality due to alcohol and other drug-related causes.
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Affiliation(s)
- Lena Lundgren
- Butler Institute of Families, Graduate School of Social Work, University of Denver, Denver, CO (LL, NML,TCR); Department of Social Work, Umeå University, Umeå, Sweden (LL, MBN, MP); Centre for Demography and Ageing Research (CEDAR), Umeå University, Umeå, Sweden (MP); National Board of Health and Welfare, Stockholm, Sweden (SN); Department of Psychiatry, School of Medicine, Umea University, Umeå, Sweden (MS)
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McCartney G, Bouttell J, Craig N, Craig P, Graham L, Lakha F, Lewsey J, McAdams R, MacPherson M, Minton J, Parkinson J, Robinson M, Shipton D, Taulbut M, Walsh D, Beeston C. Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change. Public Health 2016; 132:13-23. [PMID: 26917268 DOI: 10.1016/j.puhe.2015.12.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/21/2015] [Accepted: 12/25/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This paper tests the extent to which differing trends in income, demographic change and the consequences of an earlier period of social, economic and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales (E&W). STUDY DESIGN Comparative time trend analyses and arithmetic modelling. METHODS Three approaches were utilised to compare Scotland with E&W: 1. We modelled the impact of changes in income on alcohol-related deaths between 1991-2001 and 2001-2011 by applying plausible assumptions of the effect size through an arithmetic model. 2. We used contour plots, graphical exploration of age-period-cohort interactions and calculation of Intrinsic Estimator coefficients to investigate the effect of earlier exposure to social, economic and political adversity on alcohol-related mortality. 3. We recalculated the trends in alcohol-related deaths using the white population only to make a crude approximation of the maximal impact of changes in ethnic diversity. RESULTS Real incomes increased during the 1990s but declined from around 2004 in the poorest 30% of the population of Great Britain. The decline in incomes for the poorest decile, the proportion of the population in the most deprived decile, and the inequality in alcohol-related deaths, were all greater in Scotland than in E&W. The model predicted less of the observed rise in Scotland (18% of the rise in men and 29% of the rise in women) than that in E&W (where 60% and 68% of the rise in men and women respectively was explained). One-third of the decline observed in alcohol-related mortality in Scottish men between 2001 and 2011 was predicted by the model, and the model was broadly consistent with the observed trends in E&W and amongst women in Scotland. An age-period interaction in alcohol-related mortality was evident for men and women during the 1990s and 2000s who were aged 40-70 years and who experienced rapidly increasing alcohol-related mortality rates. Ethnicity is unlikely to be important in explaining the trends or differences between Scotland and E&W. CONCLUSIONS The decline in alcohol-related mortality in Scotland since the early 2000s and the differing trend to E&W were partly described by a model predicting the impact of declining incomes. Lagged effects from historical social, economic and political change remain plausible from the available data.
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Affiliation(s)
- G McCartney
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - J Bouttell
- Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - N Craig
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top Floor, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - L Graham
- Public Health and Intelligence, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, UK.
| | - F Lakha
- NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh EH1 3EG, UK.
| | - J Lewsey
- Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - R McAdams
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M MacPherson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - J Minton
- Urban Studies, School of Social and Political Sciences, University of Glasgow, 25 Bute Gardens, University of Glasgow, Glasgow, UK.
| | - J Parkinson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M Robinson
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - D Shipton
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - M Taulbut
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | - D Walsh
- Glasgow Centre for Population Health, Olympia Building, Bridgeton Cross, Glasgow, G40 2QH, UK.
| | - C Beeston
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
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Pavarin RM. Mortality Risk Among Heroin Abusers: Clients and Non-clients of Public Treatment Centers for Drug Addiction. Subst Use Misuse 2015; 50:1690-6. [PMID: 26595386 DOI: 10.3109/10826084.2015.1027932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED In Europe, the prevalence of problematic heroin consumption is declining but, in spite of the constant rise in the number of treated patients, many of them do not turn to a public treatment center (PTC) for their drug addiction. The aim of this study is to study the mortality risk separately for heroin abusers PTC clients and non-PTC clients (i.e., those never treated at a PTC). METHODS Cohort study on 959 subjects resident in the metropolitan area of Bologna who went to a health service (i.e., hospital, emergency unit) or to a PTC following problems due to heroin abuse for the first time between 01/01/2004 and 31/12/2009. Standardized mortality ratios (SMRs) were calculated, and regression analysis using the Poisson method was used. RESULTS Elevated and statistically significant SMRs were found in both genders, irrespective of the contact facility, being higher for PTC clients. Among non-PTC clients 28% of deaths overall were from AIDS or infectious diseases (6% PTC clients), 17% from opiate overdose (6% PTC clients) and 14% from violent causes (6% PTC clients). Multivariate analysis showed a higher mortality risk for patients who used both heroin and cocaine and for concomitant abuse of benzodiazepines. CONCLUSIONS The characteristics of patients never before treated for addiction prompts a reflection on the presence of a hidden group of patients who are hard to reach, who have a high mortality risk and who turn to health care treatment facilities only in the event of an emergency.
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Affiliation(s)
- Raimondo Maria Pavarin
- a Epidemiological Monitoring Center on Addiction , Mental Health and Dependences , ASL Bologna , Bologna , Italy
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Qureshi A, Garcia Campayo J, Eiroa-Orosa FJ, Sobradiel N, Collazos F, Febrel Bordejé M, Roncero C, Andrés E, Casas M. Epidemiology of substance abuse among migrants compared to native born population in primary care. Am J Addict 2013; 23:337-42. [DOI: 10.1111/j.1521-0391.2013.12103.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/12/2013] [Accepted: 07/14/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Adil Qureshi
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
| | - Javier Garcia Campayo
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | | | - Natalia Sobradiel
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Francisco Collazos
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
| | - Mercedes Febrel Bordejé
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Carlos Roncero
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
| | - Eva Andrés
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Miguel Casas
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
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Bayley M, Hurcombe R. Drinking patterns and alcohol service provision for different ethnic groups in the UK: a review of the literature. ACTA ACUST UNITED AC 2011. [DOI: 10.5042/eihsc.2011.0073] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wanigaratne S, Dar K, Abdulrahim D, Strang J. Ethnicity and Drug Use: exploring the nature of particular relationships among diverse populations in the United Kingdom. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/0968763021000022220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Shamil Wanigaratne
- South London & Maudsley NHS Trust & National Addiction Centre, Institute of Psychiatry, Kings College, University of London, 4, Windsor Walk, London SE5 8AF, UK
| | - Karim Dar
- Central North West London Mental Health NHS Trust, Gate House Alcohol Team, St Bernard's Hospital, Uxbridge Road, Middlesex, UB1 3EY, UK
| | - Dima Abdulrahim
- National Treatment Agency, 5th Floor, Hannibal House, London SE1 6TE, UK
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Kings College, University of London, 4, Windsor Walk, London SE5 8AF
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Foster J. The Irish Alcohol Misuser in England: Ill served by Research and Policy? Some suggestions for future research opportunities. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630210163675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- J.H. Foster
- Department of Health and Social Sciences, Middlesex University, Enfield Campus, Queensway, Enfield, Middlesex EN3 4SF, UK
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Tilki M. The social contexts of drinking among Irish men in London. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630600577964] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
AIM The study set out to explore the perceptions and knowledge of drug use of the Bangladeshi origin population in Leicester through local Mosques and community and resource centers for recruiting subjects. SETTING AND DESIGN A triangulated methodology was used for this research. A review of all available literature was carried out to establish if there was evidence of a drug problem among the Bangladeshis in the UK along with questionnaires and interviews. MATERIALS AND METHODS A triangulated methodology was used for this research. A review of all available literature was carried out along with questionnaires as well as semi-structured interviews using self-designed questionnaires. RESULTS AND CONCLUSIONS Only 66 questionnaires (16.5%) were returned (46 males and 20 females). These and qualitative exploratory interviews with a small number of community leaders confirmed that drug-related problems exist among the Bangladeshi community, especially in the younger age group and are recognized as such but help seeking is often problematic. An understanding of the perceptions of the Bangladeshi population is useful in developing culturally appropriate services for this group.
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Affiliation(s)
- Mohammad Shams Uddin
- The Crisis Resolution and Home Treatment Service-Counties, OSL House, East Link, Meridian Business Park, Leicester, LE19 1XU, UK
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Leavey G, Rozmovits L, Ryan L, King M. Explanations of depression among Irish migrants in Britain. Soc Sci Med 2007; 65:231-44. [PMID: 17448583 DOI: 10.1016/j.socscimed.2007.03.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Indexed: 11/28/2022]
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Selten JP, Wierdsma A, Mulder N, Burger H. Treatment seeking for alcohol and drug use disorders by immigrants to the Netherlands: retrospective, population-based, cohort study. Soc Psychiatry Psychiatr Epidemiol 2007; 42:301-6. [PMID: 17334900 PMCID: PMC1913176 DOI: 10.1007/s00127-007-0162-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2007] [Indexed: 10/25/2022]
Abstract
BACKGROUND We compared risks of first contact with services for an alcohol use disorder (AUD) or drug use disorder (DUD) between the largest immigrant groups to the Netherlands and Dutch nationals. We tested the hypothesis that the ethnic pattern for DUD is similar to the previously demonstrated pattern for schizophrenia. METHODS Retrospective, population-based cohort study of First Admissions to Dutch psychiatric hospitals during the period 1990-1996 (national data) and First Contacts with inpatient or outpatient centres in Rotterdam for treatment of AUD or DUD during the period 1992-2001 (Rotterdam data). RESULTS In both datasets the risk of service contact for AUD was significantly lower in immigrants from Surinam, Turkey and Morocco than in Dutch nationals. The risk was lower or moderately higher in immigrants from western countries. Analysis of the national data showed that, compared with Dutch males, the risk of first hospital admission for DUD was higher for male immigrants from the Dutch Antilles (RR = 4.6; 95% CI: 4.0-5.3), Surinam (RR = 4.3; 3.9-4.7) and Morocco (RR = 2.3; 2.0-2.6), but not for male immigrants from Turkey (RR = 0.9; 0.7-1.1). A similar pattern was found with the Rotterdam data. Female immigrants from Surinam and the Dutch Antilles had a higher risk for DUD according to the national data, but a lower risk according to the Rotterdam data. Female immigrants from Turkey and Morocco had a lower risk (both datasets). Immigrants from western countries had a higher risk for DUD, but many had developed the disorder before emigrating. CONCLUSION Those immigrant groups in the Netherlands that are at increased risk of schizophrenia appear also at increased risk of developing DUD, but not AUD.
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Affiliation(s)
- Jean-Paul Selten
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Centre Utrecht, P.O.Box 85500, Reference Nr A00.241, 3508, GA, Utrecht, The Netherlands.
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Helmus TC, Tancer M, Johanson CE. Reinforcing effects of diazepam under anxiogenic conditions in individuals with social anxiety. Exp Clin Psychopharmacol 2005; 13:348-356. [PMID: 16366765 DOI: 10.1037/1064-1297.13.4.348] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Diazepam (DZ) reinforcement was tested under anxiogenic (public speaking) and neutral (computer task) conditions. Individuals with social anxiety disorder (n = 11) and healthy controls (n = 11) participated in two 5-session phases. Each phase used a standard choice procedure (2 sample, 3 choice sessions) comparing 10-mg DZ and placebo. During the public speaking condition, DZ preference was greater among the participants with social anxiety compared with controls (81.8% vs. 36.4%; p < .05). Participants with social anxiety also gave DZ significantly higher crossover values on the multiple choice procedure under the speech condition compared with the computer condition. Subjective effects indicated that DZ reduced anxiety when levels were elevated during the speech in socially anxious participants. These results suggest that DZ reinforcement may occur under conditions of heightened anxiety by bestowing therapeutic efficacy.
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Affiliation(s)
- Todd C Helmus
- Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University
| | - Manuel Tancer
- Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University
| | - Chris-Ellyn Johanson
- Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University
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Abstract
Substance misuse among the older population is largely overlooked and underreported. Many factors contribute to this, not least the fact that presentation may be atypical and hence easily missed by the medical practitioner. There may be many clues to its existence, provided the physician remains alert to these. Despite this it is quite comforting to know that once identified, the evidence to date suggests that older people may respond at least as well as younger people to treatment.
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Affiliation(s)
- A McGrath
- Springfield Unit, City General Hospital, Stoke on Trent ST4 6QG, UK.
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Chien LY, George MA, Armstrong RW. Country of birth and language spoken at home in relation to illicit substance use. Canadian Journal of Public Health 2002. [PMID: 12050985 DOI: 10.1007/bf03404998] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examines the association between country of birth, language spoken at home, and lifetime illicit substance use in a Canadian national sample. METHOD Secondary analysis of data was conducted using a sample of 8,656 persons who were between 15 and 54 years of age in 1994 and who participated in Canada's Alcohol and Other Drugs Survey. RESULTS Rates of substance use differed among the four groups (42.6% for Canadian-born who spoke official languages, 33.8% for Canadian-born who spoke non-official languages, 35.2% for foreign-born who spoke official languages, and 11.1% for foreign-born who spoke non-official languages). The rate differences persisted after adjustment for sociodemographic factors, religiousness, friends' use of substances, and participation in social activities. INTERPRETATION More in-depth studies that include culture-specific information are required to explain the rate differences. In addition, alternative preventive strategies may be required to reduce substance use among foreign-born persons.
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Affiliation(s)
- Li-Yin Chien
- School of Nursing, National Yang Ming University, Taipei, Taiwan
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Johnson TP, VanGeest JB, Cho YI. Migration and substance use: evidence from the U.S. National Health Interview Survey. Subst Use Misuse 2002; 37:941-72. [PMID: 12180572 DOI: 10.1081/ja-120004160] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Representative data from the U.S. National Health Interview Survey are used to investigate the substance use patterns of immigrants and compare them to those of the native born populations. The information examined is from the 1991 supplementary Drug and Alcohol Use Data File, which examined the self-reported substance use behaviors of approximately 21,000 adults aged 18-44. Findings indicate that immigrants to the U.S. in the late twentieth century are less likely to use alcohol and other drugs than are native born citizens. Additional findings suggest assimilation processes by which exposure to mainstream American society leads to patterns of alcohol and illicit drug use among long term immigrants that approximates that of the native born population. The patterns of substance use observed among immigrants, however, are not consistent with acculturative stress mechanisms. These findings provide an important and representative profile of the substance use patterns of one of the largest international migration streams of the past one hundred years.
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Affiliation(s)
- Timothy P Johnson
- Survey Research Laboratory, College of Urban Planning and Public Affairs, University of Illinois at Chicago, 60607, USA.
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