Mission Statement The National Hispanic Science Network on Drug Abuse is dedicated to improving the health of Hispanics by


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Mission Statement

  • The National Hispanic Science Network on Drug Abuse is dedicated to improving the health of Hispanics by:



Major Activities

  • National Network of Hispanic scientists, students & NIH federal advisors

  • National scientific conference

  • Summer Research Training Institute for graduate students & post-doctoral fellows

  • On-line Measures Archive

  • Website (www.HispanicScience.org)



A National Strategic Plan for Hispanic Drug Abuse Research





Goal

  • To identify gaps in research and scientific opportunities – that can quicken the rate of discovery with regard to Hispanic drug abuse



Why?

  • To improve the health of Hispanics

  • To capitalize on ethnic variability to enhance our scientific understanding of universal principles



National Strategic Plan Hortensia Amaro, Ph.D. Chair

  • Epidemiology

  • Human Genome & Neurobiology

  • Prevention

  • Treatment

  • Health Services

  • Blending Research to Practice

  • HIV/AIDS

  • Training & Mentoring



Development Process

  • More than 60 researchers participated in the formulation of the Strategic Plan

  • Each chapter was externally reviewed by a minimum of 2 outside experts in the field of drug abuse research

  • NHSN Steering Committee provided a second level of review



Common Themes

  • No or low samples of Hispanics in most drug abuse research studies

  • Few studies provide analyses of data by race/ethnicity including Hispanics

  • NIH Guidelines for inclusion of racial/ethnic minorities and valid analyses



Common Themes

  • Few studies of prevention and treatment interventions with Hispanics

  • Few validated instruments in Spanish

  • Need for a better understanding of the role of culture, cultural adaptation and acculturation in drug use/abuse



Common Themes

  • Few Hispanic researchers across all areas, but particularly severe in behavioral prevention and treatment intervention research



Hispanics are 13% of the US populations

  • 4 genetic studies

  • 4 adolescent behavioral treatment trials from one lab

  • 3 pharmacotherapy trials

  • No behavioral treatment trials of Latinas



  • EPIDEMIOLOGY



  • The Latino population is growing at a rate of 4.7%, as compared to 0.3% for whites and 1.5% for African Americans

  • Rates for illicit drug abuse and dependence are highest for Hispanics (7.8%), followed by Whites (7.5%) and Blacks (6.2%) (SAMHSA, 2002).”



  • “Hispanic adolescents are more likely to abuse drugs, especially crack cocaine, heroin, and ‘ice,’ than are adolescents from other ethnic groups (Johnston, O’Malley & Bachman, 2003).

  • Inhalants- epidemic

  • Latino youth are more likely to report having been approached by someone selling drugs



  • Latinos experience more serious consequences of drug use (e.g., school drop out, prison, HIV)

  • Such consequences may be a function of lower access to drug abuse treatment services.

  • Hispanics report as much need for services as Whites, but are more likely to report not receiving services and to be less satisfied with the services they receive.



Epidemiology Nativity

  • US born Latinos in all sub-groups report higher rates of use, abuse and dependence than immigrants

  • Many studies show that higher acculturation leads to more drug use, but this does explain drug use for all Latino groups



Risk and Protective Factors for Drug Use Social Context Effects

  • Familism (family as referent, value family) is uniquely important in the Latino culture and is seen as protective against drug use; and should be studied as a protective factor

  • Factors that diminish the positive influence of the family should be investigated.



Future Research

  • Empirically validated measures for acculturation (cultural change) need further evaluation.

  • What are the mechanisms by which acculturation influence drug use?







  • Human Genome and Neurobiology



Global Recommendation: Hispanic Populations

  • Hispanics are biologically heterogeneous

    • Human studies on candidate genes as well as on neurobiology should consider biologically homogeneous subpopulations of Hispanics


Biological Differences Related to Health

  • Hispanic subpopulations show biological differences in comparison with other populations

    • genes, proteins and risk for disease


Recommendations: Genes

  • Target Hispanic populations for research on candidate genes related to addiction

  • Genetic vulnerability-environment interactions, for example, may account for the very high rates of drug use among Puerto Ricans



  • PREVENTION





  • TREATMENT



Adolescents: What we know

  • Group therapy has iatrogenic effects on delinquent and drug abusing adolescents – also true for Hispanics

  • One family therapy treatment has been found to be efficacious with Hispanic drug using adolescents



Treatment Research with Hispanic Women:

  • There are no published randomized clinical trials of a behavioral treatment with Hispanic women.



Hispanic Women: Recommendations

  • Test Motivation Enhancement Therapy, Contingency Management and Engagement Moms interventions - to improve engagement, retention and treatment outcomes.

  • Test trauma treatments because exposure to trauma is high among drug using Hispanic women



PHARMACOTHERAPY RESEARCH

  • Differences in response to pharmacotherapy for depression and schizophrenia in Hispanic populations vs. others

  • Only three published studies have explored pharmacotherapy for drug abuse in Hispanic populations

      • Methadone treatment for heroin addicts
      • Nicotine patch for smokers
      • Naltrexone for alcoholism


Recommendations: Pharmacotherapy





Training







  • BLENDING RESEARCH AND PRACTICE



.



Recommendations for Training Research:

  • Research can be most productive by focusing on:



Organizational barriers/facilitators to adoption of innovative interventions

  • Organizational variables including size of organization, functional differentiation, number of years of operation, and level of training of the administrator appear to be positively related to adoption.



Implications for Hispanic/Latino Serving Organizations

  • The potential impact on adoption rate of agency size and level of training and education of administrators may be particularly important given that many Hispanic serving agencies may be smaller size.



Recommendations for Research on Organizational factors

  • Research specifically focused on:



The Nature of Multilevel Dissemination in the Hispanic Community



Recommendations for Research on Multi-level Dissemination.



  • HIV/AIDS



Sexual Risk within the Context of Drug Abuse

  • Hispanics have more negative attitudes towards safe sex practices and a corresponding tendency towards risky sexual behaviors such as not using condoms.

  • “with those less acculturated reporting the most negative attitudes” towards safe sex practices.



Initiation of Injection Risk in Latino Youth & Young Adults.

  • Pedagogy of technical skills necessary to prepare and inject illicit drugs.

  • Prospective studies of Latino IDUs

      • Evolution of social, behavioral, & environmental processes.
      • Situate within context of key life-course changes.


Sexual Risk within the Context of Drug Abuse

  • Latinos across all sexual orientations report more negative attitudes toward safer sex practice.Correlates with level of acculturation.

  • High-risk heterosexual activities are the main predictor for HIV seroconversion among Latinas.

    • Latinas have low overall sexual assertiveness.
    • Significant proportion believe they never have the right to make decisions about condom use.


Sexual Risk within the Context of Drug Abuse

  • Enrich our understanding of personal &situational factors that will enable the development of targeted interventions.

  • Ways that normative beliefs brought from sending cultures filter through sexual decision-making contexts to increase risk behavior.

  • Ways in which drugs are imbedded in sexual partnering processes.

  • Prospective intervention studies with Latina youth that parallel developmental life-course changes and build sexual communication & negotiation capacity over time.



  • TRAINING



















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