Of people who identify themselves as Hispanic in the U.S. Census, 35% are under the age of 18. (31) According to the National Center for Education Statistics, 26% of current public school students are Hispanic, a number expected to rise to 29% by 2027.(18)
As the number of Hispanic/Latino youth continues to grow in the U.S., understanding the historical and cultural factors that impact cannabis use among these youth is important for educators, policymakers, and service professionals. When planning prevention and treatment efforts, care should be taken to understand the diverse backgrounds and experiences of Latino/Hispanic individuals in order to prevent stereotyping.
Even the terms used to identify people as Latino or Hispanic can be problematic, as Latinos/Hispanics are from diverse ethnic, linguistic, and geographical backgrounds – they are from Mexico, Puerto Rico, Cuba, South America, Spain, Dominican Republic, and Central America. For simplicity, we use the terms Latino or Hispanic here.
Historical context of cannabis and Latino/Hispanic youth
Many Latinos/Hispanics are acutely aware of the historical context of the term “marijuana” and how it was used to vilify the cannabis plant by relating it closely to Mexican people and Spanish speakers. Prejudices against Mexicans, particularly Mexican laborers, and other minorities, were employed to garner support for criminalization of cannabis. The racialized origins of U.S. cannabis policy continues to impact enforcement, and communities of color remain disproportionally represented within the prison system.(4)
- While making up less than 20% of the U.S. population, Hispanics received 77% of federal cannabis sentences in 2016 (U.S. Sentencing Commission, 2017).
- Hispanic youth are also overrepresented in the juvenile justice system. (28)
- Many Latino/Hispanic youth in the U.S. have close relationships with people who have been disproportionally incarcerated or sentenced for cannabis-related offenses.
How does culture impact cannabis use by Latino/Hispanic youth?
“Hispanic adolescents who identify primarily with the U.S. culture but not with their heritage cultures may be at increased risk for substance use.” (Unger et.al, 2014)
There is little research specifically on cannabis use disorder among Latino/Hispanic youth, but studies of overall substance use prevention and treatment find that Latino/Hispanic heritage may be either a protective factor or a risk factor for substance use. For example, some studies suggest the strong social relationships and families commonly experienced by Hispanics are a protective factor against substance use.(8, 20, 24)
On the other hand, some Latino adolescents are exposed to discrimination and racism on a daily basis, (6) which may increase their risk of substance use. For example, Hispanic 9th graders who reported more discrimination indicated higher levels of substance use compared to their peers who reported experiencing less discrimination. (30)
Many Hispanic/Latino youth have strong relationships with their families. This familism is described as including a) a sense of obligation to help family members, b) confidence in the support from family members, and c) looking to family members to determine appropriate behavior and attitudes.(14) For youth with strong family relationships, understanding the relationships may provide awareness of potential underlying causes of substance use and knowledge about how to help the family function in a healthier way.(23)
Not all Latino/Hispanic youth are immigrants or from immigrant families. In fact, some families, particularly in the American southwest, have ancestors who lived in that geographic area since before the region became part of the U.S. in 1848. However, for youth and families who are undocumented or do not have permission to live in the U.S. permanently, there are unique circumstances that may impact prevention and treatment of cannabis use:
- Fear of deportation. Parents may be reluctant to report their children’s criminal or delinquent behavior or may terminate treatment early to avoid deportation. (23)
- Length of time since immigrating to the U,S.
- Latinas who are born outside the U.S are more likely to abstain from substance use than U.S.- born Latinas.(2, 33)
- Hispanics who immigrated to the U.S. before age six or those who have lived in the U.S. for 13 years or more had a similar risk of SUD to U.S.-born Hispanics of the same age.(1)
Acculturation refers to the changes that occur as a result of the direct and continuous contact of individuals to a culture different from their own.(21) Latino/Hispanic youth and their families may identify with U.S. culture, with their home country/ culture, with both cultures, or with neither culture. Notably, biculturalism may be a protective factor against substance use.(5,19)
- Youth often acculturate faster than their parents, which can widen the generation gap.(23)
- An adolescent’s quicker assimilation into a culture that values individualism may create additional parent/child tension when the adolescent is seeking independence. This developmental stage may have happened more slowly in the country of origin.(23)
- A mismatch between an adolescent’s and parent’s level of acculturation has been linked to youth intentions to use substances, less effective parenting, and increased family stress for middle school age children and their parents.(15)
Cannabis use by Latino/Hispanic youth in the U.S. and Washington State
- According to the 2018 Monitoring the Future national survey of secondary school students, by 12th grade, 43.7% of Hispanic youth report they have ever used cannabis – about the same as white and African American youth in that grade.(11)
- Also in 12th grade, 34.2% of Hispanic youth report they have used cannabis in the past year; 20.5% have used in the past 30 days; and 4.3% are daily users. These rates are lower than for white and African American youth.(11)
- According to the national Youth Risk Behavior Surveillance System (YRBSS), 42.1% of Hispanic youth have used cannabis at least once, and 24.4% reported using cannabis within the month before completing the survey.(13)
- According to the 2014 and 2016 Washington Healthy Youth Survey, 23.4% of Hispanic students in 10th grade reported using cannabis in the past 30 days.(26, 33)
Trends in treatment admissions for cannabis use by Latino youth
Research on nationwide Hispanic treatment samples is scarce.(16) Guerrero et al (2013) found that Latinos experience disparities in seeking and receiving treatment — i.e. they have less access to treatment, fewer service offered, and less satisfaction with treatment provided.
For Hispanic youth, the rate of cannabis-related admissions increased from 13% in 1995 to 27.33% in 2012, indicating more likelihood of seeking treatment.(16) Marzell et al (2016) also found:
- Hispanic youth are more likely to seek treatment between the ages of 15-17; are attending high school; not living independently; and report no income.
- High schools are increasingly a referring source, suggesting that school personnel may be more committed to their students’ recovery.
- Hispanic youth entering treatment reported low frequency of use of cannabis and not having problems with other substances.
Culturally informed treatment interventions for Latino youth
There is a lack of research about how culturally relevant factors such as discrimination and language differences impact healthy development in Latino families.(3,6) Additionally, there are few studies on service use, and treatment outcomes for Hispanic youth, and the findings of the studies that exist are inconsistent.(10) In 2007, a study located only four randomized substance abuse prevention intervention models targeting Latino youth (ages 12-17) and only 70% of the participants identified as Latino.(28)
For prevention and treatment approaches to be effective, it’s important to understand the risk and protective factors for substance use among this vulnerable population, especially those factors that are unique to immigrant and/or minority groups.(28) Research has demonstrated that culturally informed behavioral health inteventions are more effective for Latino youth.(22)
Treatment and prevention models for Latino/Hispanic youth
Culturally Informed and Flexible Family-Based treatment for Adolescents (CIFFTA)
CIFFTA is an outpatient treatment program (for youth 11-18 years old) that combines family treatment, individual treatment, and psycho-educational modules to address adolescent conduct problems, depression, school failure, family conflict, delinquency/violent behavior, drug use and/or risky sexual behavior. CIFFTA also identifies and strengthens protective/resiliency factors as part of the program. The program was designed to address unique issues faced by diverse populations which may impact treatment and outcomes. For example, discrimination, acculturation, and immigration. http://sites.education.miami.edu/ciffta/
Familia Adelante: Multi-risk Reduction Behavioral Health Prevention for Latino Youth and Families
Familia Adelante is a family development model to be used with youth with early signs of emotional or behavior problems. It is used with the youth and the parents (but in a separate group format). This 12 session curriculum designed to help Latino families (with youth age 10-14) manage the stress of acculturation and the associated negative behaviors. The curriculum provides education in peer communication, substance abuse prevention, HIV knowledge and harm from high-risk behaviors, and positive school bonding and behavior. http://www.familiaadelante.com/
Helpful resources for parents
- Cómo prevenir el consumo de marihuana entre los jóvenes: una guía para padres de familia. (Parents’ Guide to Preventing Underage Marijuana Use, brochure by Childrens’ Hospital and UW School of Social Work)
- Marihuana: Lo que los padres deben saber. (Marijuana: Know the Facts, card by Washington State Liquor & Cannabis Board)
- Alegria M, Sribney W, Woo M, et al. Looking beyond nativity: the relation of age of immigration, length of residence, and birth cohorts to the risk of onset of psychiatric disorders for Latinos. Res Human Development 2007;4(1):19–47.
- Alvarez J, Jason LA, Olson BD et al. Substance abuse prevalence and treatment among Latinos and Latinas. J Ethn Subst Abuse 2007; 6:115–141.
- Avison WR, Gotlib IH. Future prospects for stress research. In: Avison, WR, Gotlib IH (eds.) Stress and Mental Health: Contemporary Issues and Prospects for the Future. Plenum Pres; New York, 1994, p.317-332.
- Bender S. Joint Reform? The Interplay of State, Federal, and Hemispheric Regulation of Recreational Marijuana and the Failed War on Drugs. Albany Government Law Review, 2013;6: 359–663.
- Carvajal SC, Hanson CE, Romero AJ et al. Behavioural risk factors and protective factors in adolescents: a comparison of Latinos and non-Latino whites. Ethn Health 2002;7:181–193.
- Córdova D, Cervantes R. Intergroup and within-group ethnic and racial perceived discrimination among U.S. born and Foreign-born Latino youth. Hispanic J Behav Sci 2010;32:259–274.
- De La Rosa M. Acculturation and Latino adolescents’ substance use: a research agenda for the future. Subst Use Misuse 2002; 37: 429–456.
- Gloria AM, Peregoy JJ. Counseling Latino alcohol and other substance users/abusers. Cultural considerations for counselors. J Subst Abuse Treat1996;13(2):119–26.
- Gfroerer JC, Tan LL. Substance use among foreign-born youths in the United States: does the length of residence matter? Am J Public Health 2003;93(11):1892–5.
- Guerrero EG, Marsh JC, Khachikian T et al. Disparities in Latino substance use, service use, and treatment: Implications for culturally and evidence- based interventions under health care reform. Drug Alcohol Depend 2013;133(3):805– 813.
- Johnston LD et al. Demographic subgroup trends among adolescents in the use of various licit and illicit drugs, 1975–2018 (Monitoring the Future Occasional Paper No. 92 ). Ann Arbor, MI: Institute for Social Research, University of Michigan, 2019.
- Kann L, Kinchen S, Shanklin SL et alYouth risk behavior surveillance – United States, 2013. MMWR Morb Mortal Wkly Rep 2014; 63(Supplement 4):1–168.
- King KA, Vidourek RA, Merianos AL et al. Predictors of recent marijuana use and past year marijuana use among a national sample of Hispanic youth. Subst Use Misuse 2015;50(11), 1395–1405.
- Marin G, Marin BV. Research with Hispanic populations. Newbury Park, CA: Sage, 1991.
- Martinez CR. Effects of differential family acculturation on Latino adolescent substance use. Family Relations 2006;55:306–317.
- Marzell M, Sahker E, Pro G, Arndt S. A brief report on Hispanic youth marijuana use: Trends in substance abuse treatment admissions in the United States. J Ethn Subst Abuse 2017;16(2):155-164.
- McQueen A, Getz JG, Bray JH. Acculturation, substance use, and deviant behavior: examining separation and family conflict as mediators. Child Develop 2003;74:1737–1750.
- National Center for Education Statistics. Status and Trends in the Education of Racial and Ethnic Groups. https://nces.ed.gov/programs/raceindicators/indicator_rbb.asp
- Nguyen AMD, Benet-Martínez V. Biculturalism and adjustment: A meta-analysis. J Cross-Cultural Psychol 2013;44: 122–159.
- Ojeda VD, Patterson TL, Strathdee SA. The influence of perceived risk to health and immigration related characteristics on substance use among Latino and other immigrants. Am J Public Health 2008; 98(5): 862–8.
- Redfield R, Linton R, Herskovits MJ. Memorandum for the study of acculturation. Am Anthropologist 1936; 38(1):149–152.
- Santisteban DA, Mena MP. Culturally informed and flexible family-based treatment for adolescents: A tailored and integrative treatment for Hispanic youth. Family Process 2009;48: 253–268.
- Santisteban, DA, Mena MP, Abalo C . Bridging diversity and family systems: Culturally informed and flexible family-based treatment for Hispanic adolescents. Couple Family Psychol Res Practice 2013; 2(4): 246–263.
- Schinke S, Schwinn T, Hopkins J et al. Drug abuse risk and protective factors among Hispanic adolescents. Prev Med Rep 2016;3():185-188
- Schwartz SJ, Weisskirch RS, Zamboanga BL et al. Dimensions of acculturation: associations with health risk behaviors among college students from immigrant families. J Counseling Psychol 2011: 58:27–41.
- Shah A, Stahre M. Marijuana use among 10th grade students — Washington, 2014. MMWR Morb Mortal Wkly Rep 2016;65:1421–1424.
- Snyder HN. Juvenile Offenders and Victims: 2006 National Report. Office of Juvenile Justice and Delinquency Prevention; Washington, DC, 2006.
- Szapocznik J, Prado G, Burlew A et al. Drug abuse in African American and Hispanic adolescents: Culture, development, and behavior. Ann Rev Clinical Psychol 2007;3:77–105.
- Unger JB, Schwartz SJ, Huh J et al. Acculturation and perceived discrimination: Predictors of substance use trajectories from adolescence to emerging adulthood among Hispanics. Addict Behav 2014;39(9):1293–1296.
- U.S. Department of Health and Human Services. Mental Health: Culture, Race and Ethnicity – A supplement to mental health: A report to the Surgeon General. Rockville, MD, 2001.
- U.S. Census Bureau, 2010. The US Census Bureau. The Hispanic Population: 2010. https://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf
- Vega WA, Sribney WM. Seeking care for alcohol problems: patterns of need and treatment among Mexican-origin adults in central California. Alcohol Treat Q 2005;23:29–51.
- WA State Department of Health. Marijuana Use. In: Washington Health Assessment 2018. (DOH pub 78945) http://www.doh.wa.gov/healthassessment
Citation: Harwick RM. Latino/Hispanic Youth and Cannabis. Seattle: Addictions, Drug & Alcohol Institute (ADAI), University of Washington, June 2018.
This report was produced with support from the Washington State Dedicated Marijuana Fund.