SUD Treatment and Recovery for the Latinx Community: The Importance of Culture and Language

Health disparities in the Latinx^[i] population in America are well documented.^[ii] In addition to social and economic marginality factors and other Social Determinants of Health, deeply rooted structural and systemic considerations – including both logistical and cultural barriers – often make it difficult for members of the Latinx community to receive treatment for Substance Use Disorder.

Barriers of Culture and Language in SUD Treatment and Recovery

Only 3.7^[1] percent of Latinx individuals with substance use disorder ever get treatment despite need for it. This is a troublesome statistic because regardless of race or ethnicity, specialty substance use treatment services (such as inpatient and intensive outpatient programs) are known to be the most effective^[2] to achieve recovery.

Cultural barriers play a large role, but it is important to note that logistical barriers^[3] play a major part too. The logistical barriers^[4] to receiving care that impact Latinx individuals mirror the barriers that impact other communities: lack of health insurance coverage, no time, no access to childcare, and not knowing where to find or go for help.

Importantly, many Latinx individuals also face additional barriers stemming from cultural norms^[4], which may include:

• Providers’ lack of familiarity with Latinx culture
• Issues surrounding immigration or discrimination
• Treatment that is not tailored to address cultural perspectives
• Treatment for SUD being stigmatized in the Latinx culture

These cultural barriers are complex and intertwined.  The confluence of perceived ineffectiveness of treatment and lack of lived experience among counselors and therapists causes some individuals within the Latinx community to give up on treatment.  Because treatment isn’t typically culturally accepted^[4]—many Latinx believe that one shouldn’t talk about their problems with substances. There’s a fear of stigma, of being “found out” by members of their culture and community. Some believe that seeking treatment would only confirm to their family that they had a substance use problem, which could be viewed as a personal failure.

What We Can Do to be More Effective with Latinx Clients

It’s essential that we recognize that Latinx communities are extremely diverse and unique. By focusing on individual and community strengths, we can often support individuals with care that is more deeply impactful to long-term recovery from SUD.

Research suggests that we need to incorporate important Latin cultural values^[5] into treatment and recovery programs. By adopting values and discussion topics within our treatment approach, such as familismo (family over the individual), personalismo (preference for personalized attention and interpersonal relations), and respeto (respect for an individual’s age and position in society), clinicians may be better able to connect with their patients.

About 95 percent of Latinx reported that when they had a counselor that understood their culture and were comfortable discussing cultural life, upbringing, and norms, it helped them open up about their issues with substance^[6].  It could be beneficial to this population to include harm reduction strategies and highlight other recovery-oriented outcomes^[7], which can be as effective as abstinence-based treatment.

Due to the stigma some Latinx individuals feel from family and community members, it is especially important to emphasize anonymity in treatment. Integrating substance use disorder treatment with primary care services might increase utilization of such services. And with this strategy, comes another: web-based services^[8] like phone apps may decrease fear associated with treatment and recovery support services.  

Technology Can Lead the Way to be Bilingual and Bicultural in SUD Recovery

A promising strategy for technology-enabled recovery programs is through providing self-help interventions and connecting individuals with others of the same cultural background and experiences. Research^[9] has shown that online self-help interventions are most likely to reach those who are first-time help seekers.  Members of the Latinx community take up web-based interventions and technology-enabled support on a wider scale than face-to-face interventions. Web-based support programs can also offer the privacy and anonymity that many in the Latinx community desire.

We at CHESS understand the importance of cultivating cultural understanding when an individual from the Latinx community seeks treatment and enters recovery. We are committed to supporting the unique needs of individuals, and continuing to advocate for strategies that address Social Determinants of Health, including cultural and language barriers to receiving treatment for SUD. We’ve recently launched Conexiones—a new version of our Connections app that is available in Spanish and has culturally relevant information, as well as peer support services available in-language.

REFERENCES

1. https://pubmed.ncbi.nlm.nih.gov/23953657/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488852/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329903/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660316/
5. https://journals.sagepub.com/doi/abs/10.1177/002204260203200304
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315590/
7. https://pubmed.ncbi.nlm.nih.gov/12369473/
8. https://pubmed.ncbi.nlm.nih.gov/18332300/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713880/

[i] We are using “Latinx” throughout this blog and in our materials to be representative of the diverse Hispanic, Latin(a/o), and Latinx communities, and support the use of culturally sensitive terms wherever possible. 

[ii] Vega WA, Rodriguez MA, Gruskin E. Health disparities in the Latino population. Epidemiol Rev. 2009;31:99-112. doi: 10.1093/epirev/mxp008. Epub 2009 Aug 27. PMID: 19713270; PMCID: PMC5044865.