Black youth are arrested for drug crimes at a rate ten times higher than that of whites. But new research shows that young African Americans are actually less likely to use drugs and less likely to develop substance use disorders, compared to whites, Native Americans, Hispanics and people of mixed race.
“Our goal is to alert people to the burden of drug problems and also to how some of our concern about who has these problems may not be true,” says Dr. Dan Blazer, senior author of the study and a professor of psychiatry at Duke University. “There’s a perception among many individuals that African Americans as a group — regardless of socioeconomic status — tend to abuse or use drugs at higher rate and this [does not support] that.”
Using data from 72,561 youth interviewed for the National Survey on Drug Use and Health, researchers found that 37% of those aged between 12 and 17 had used alcohol or other drugs at least once in the past year. Nearly 8% met criteria for a substance use disorder — either the less severe “substance abuse” diagnosis or the more problematic “substance dependence,” which is more commonly known as addiction.
The study, which was published Monday in the Archives of General Psychiatry, controlled for variables like socioeconomic status because rates of severe drug problems tend to be greater amongst the poor. Despite this, Native American youth fared worst, with 15% having a substance use disorder, compared to 9.2% for people of mixed racial heritage, 9.0% for whites, 7.7% for Hispanics, 5% for African Americans and 3.5% for Asians and Pacific Islanders.
It is not known why rates for Native Americans were so elevated, but the category of substance use disorders does include alcoholism, a disorder for which this group is known to be at high risk. Marijuana and prescription opioid problems also occurred at higher rates in Native Americans.
The authors considered abuse and dependence together rather than separating them because the next edition of psychiatry’s diagnostic manual, the DSM-V, will combine them into one diagnosis, with different levels of severity.
“It’s really difficult when you look at the data to actually separate out abuse and dependence,” says Blazer, while acknowledging that merging the categories could pose different problems.
For example, a large proportion of youth with drug problems recover without treatment. While rates of substance use disorders tend to be around 8% in the teen years, these rates dip to less than 2% for those over 26; the number of people who’ve gotten better far exceeds that which could have possibly attended treatment or even self-help groups.
That poses a problem: addiction treatment centers tend to focus on getting youth to acknowledge that they have a chronic, relapsing disease, but this — in combination with surrounding youth with peers who are also in trouble — could create a self-fulfilling prophecy.
“Labeling can be problematic,” says Blazer, “but also, treating these individuals is not easy. Most programs have modest success at best and with ongoing use over time the ability to actually reverse [the disorder] declines. Therefore, by identifying these individuals early and intervening early, they have a much better chance.”
That is, of course, if the treatment is effective and doesn’t use tactics that can backfire. “I would hope we get a little more enlightened in the way we treat adolescents,” Blazer says, explaining that treatment must be culturally sensitive if it is to help all types of youth resolve drug problems.