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Latinos and African Americans do not have higher overall prevalence rates of substance abuse compared to white Americans. However, they are disproportionately impacted by the consequences of substance abuse, and they have less access to health care and programs that can help to prevent and to treat substance abuse. 

A consistent and interesting research finding is the strong relationship between high levels of acculturation and the development of serious health, mental health and substance use problems. This pattern, referred to as the “Immigrant Paradox”, includes higher rates of symptoms among immigrants that have been in the U.S. longer when compared to those who have been in the U.S. less time, and also greater among U.S. born Hispanics as compared to immigrant Hispanics.  The finding is paradoxical because one would expect that recent immigrants might show greater levels of symptoms due to stressors, losses, and disruptions in support networks that result from immigration and acculturation processes. 

Social factors such as poverty, poor educational opportunities and inadequate housing disproportionately affect minorities. These factors may be related to substance abuse and relapse, and may hinder access to effective treatment. 

Poverty in particular is a significant factor that impacts the ability of racial and ethnic minorities to access and use mental health services. 

One of the major obstacles to improving minority access to and retention in substance abuse and aftercare treatment programs is that these programs often lack cultural sensitivity. 

The family plays a central role in the lives of African Americans and Hispanics. The family not only provides important emotional and practical supports, but also strongly influences the behaviors and decisions made by its members.  For this reason, substance abuse treatments for minorities that only work with the individual are not as effective as treatments that address the family as well as the cultural context in which the person is embedded (for example: poverty, racial discrimination and immigration issues).