Understanding BIPOC Addiction and Mental Health

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Alcohol, substance use disorder and other mental health diagnoses impact people of all races. However individuals in the BIPOC community are disproportionately affected by these conditions.

Defining BIPOC

Merriam Webster defines the term BIPOC as any individual who identifies as Black, Indigenous or as a Person of Color. The use of this term also includes Asian and Latino/a individuals but the term acknowledges that Black and Indigenous people face racism that is unique to their own experiences and is more descriptive than just saying people of color.

This racism is especially evident in terms of unequal access to healthcare including mental health and substance use disorder treatment.

Healthcare providers must acknowledge that the BIPOC community faces obstacles to care deriving from their unique experiences of racial violence, discrimination and cultural disregard. When they consider this awareness by providing culturally competent, evidence based practices then the outcomes for their BIPOC clients will be closer to that of their white counterparts.

People of Color

“People of Color” refers to people who do not identify as “White.” This term covers a wide range of individuals from different backgrounds and identities. This includes Black or African American, Native American or Indigenous People, Latino/a, Asian American and Pacific Islanders (AAPI).

There are many differences among people within this group but most individuals have experienced discrimination that most white people have not faced.

In 2023, the United States Census Bureau reported that 44.3% of the U.S. population aged 12 and older identified as the following:

According to a recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) 48.5 million people aged 12 or older have a substance use disorder in the United States. Of these, nearly 30 million have alcohol use disorder, 27.2 million have substance use disorder and 7.5 million have both alcohol and substance use disorder.

In the BIPOC community, American Indian or Alaska Native and Multiracial individuals were more likely than most other racial or ethnic groups to have used substances or to have been diagnosed with a substance use disorder.

A serious risk of alcohol and substance use disorder is death due to overdose. Among all races, overdose deaths increased exponentially between 2002 and 2022 according to a Center for Disease Control (CDC) study on provisional drug overdose death counts. However the rates of overdose death did not change significantly between 2021 and 2022.

Members of the BIPOC community face higher numbers in terms of drug overdose deaths with American Indian, Alaska Native, and Black people accounting for a majority of all drug overdose deaths in the U.S. The rate of overdose deaths increased 15% during this period for American Indians and Alaska Native people.

Impacts on the Black Community

It is important to remember that within the BIPOC Community the term “Black” has a very diverse definition. For many years, people who identified as Black were referred to as “African Americans.” The use of this term is incorrect in some cases because many Black individuals are of Caribbean descent.

Understanding and acknowledging which term an individual identifies with recognizes their humanity and is also a step toward providing culturally sensitive healthcare and treatment.

Data included in the  2023 SAMHSA National Survey on Drug Use and Health found that among Black individuals aged 12 or older the following occurred:

Within one month in 2023:

In 2023: 

• 27.7% used illicit drugs
• 24.5% used marijuana
• 1.4% used cocaine
• 0.7% used crack
• 2.7% used hallucinogenic drugs 
• 0.8% used inhalants 
• 0.4% used methamphetamines
• 3.7% misused prescription pain relievers
• 0.8% misused prescription stimulants
• 0.9% misused prescription tranquilizers
• 0.3% misused prescription sedatives
• 0.7% misused prescription benzodiazepines 
• 3.8% Misused opioids 
• 2.3% used any central nervous system stimulants 
• 0.8% used or misused fentanyl or illegally made fentanyl 
• 6.5% had a major depressive episode (MDE) with severe impairment.
• 19.4% were described as having any mental illness (AMI) 
• 7.8% had both a mental health diagnosis and substance use disorder at the same time

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Impacts on Native American and Indigenous Peoples

Native Americans or Indigenous People are the original inhabitants of North America. They are sometimes referred to as First Nations, American Indian, Native Alaskans or Alaska Native people.  Alcohol and substance use disorder impacts people of this background at disproportionately higher rates than any other racial categories in America. 

Alcohol use disorder (AUD) is a significant concern among Native American and Alaska Native populations Studies have shown that Indigenous communities are at an elevated risk of alcohol-related morbidity and mortality. Researchers attribute this to unique risk factors that contribute to this problem including generational trauma, current trauma, environment and lower levels of education when compared to the general population.  

The same SAMHSA report shows that over the past decade the rate of substance use disorder among this group has increased by 50%. According to the study, it is estimated that 10.1% of Indigenous people are living with this condition. 

Within one month in 2023:

In 2023:

• 36.7% used illicit drugs
• 30.2% used marijuana
• 1.8% used cocaine
• 0.8% used crack
• 4.0% used hallucinogenic drugs 
• 0.5% used inhalants 
• 4.3% used methamphetamines
• 5.7% misused prescription pain relievers
• 1.2% misused prescription stimulants
• 0.7% misused prescription tranquilizers
• 0.2% misused prescription sedatives
• 0.6% misused prescription benzodiazepines
• 5.9% misused opioids 
• 6.4% used any central nervous system stimulants 
• 1.7% used or misused fentanyl or illegally made fentanyl 
• 4.2% had a major depressive episode (MDE) with severe impairment.
• 23.5% were described as having any mental illness (AMI) 
• 1.3% had both a mental health diagnosis and substance use disorder at the same time

A host of culturally-informed treatment models is available for Native populations. Substance abuse and mental health resources can be accessed across the United States to support holistic healing for Native American and Alaska Native individuals, couples, and families.

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Impacts on the Hispanic and Latino/Latina Community

The term Hispanic or Latino/Latina refers to individuals who are native Spanish speakers from more than 20 different countries around the world now residing in America. In 2023 the U.S. Census Bureau found that 19.5% of the population in the United States identifies as Hispanic or Latino/Latina or one fifth of the overall number.

Hispanic and Latino/Latina persons in need of mental health or substance use treatment may fear stigmatization or they may experience difficulty in accessing care that is aligned with their needs. And these are key reasons why alcohol and substance use disorders may go untreated within the community.  

According to a 2024 report from SAMHSA, Hispanics/Latino adults were 17% less likely than multiracial or white adults to have received mental health care within the previous year.  Additionally, members of this community often have less access to culturally-appropriate care. They may also experience barriers to care relating to health insurance coverage, language, or healthcare provider availability.    

Within one month in 2023:

In 2023:

• 21.6% used illicit drugs
• 18.2% used marijuana
• 2.0% used cocaine
• 0.2% used crack
• 2.9% used hallucinogenic drugs 
• 0.5% used inhalants 
• 0.9% used methamphetamines
• 0.9% misused prescription pain relievers
• 0.9% misused prescription stimulants
• 1.5% misused prescription tranquilizers
• 0.3% misused prescription sedatives
• 1.3% misused prescription benzodiazepines.
• 3.1% misused opioids 
• 3.2% used any central nervous system stimulants 
• 0.9% used or misused fentanyl or illegally made fentanyl 
• 8.3% had a major depressive episode (MDE) with severe impairment
• 20.6% were described as having any mental illness (AMI) 
• 7.1% had both a mental health diagnosis and substance use disorder at the same time

Despite the prevalence of substance use disorders and mental health concerns within the Hispanic and Latino/Latina communities, help is available. Mental health and addiction recovery resources are available for clients in every state and region who are seeking culturally-responsive care in multiple languages.

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Impacts on the QTBIPOC Community

QTBIPOC stands for Queer and Trans Black, Indigenous and People of Color and is used to describe a combination of one’s gender identity, sexuality, class, race and mobility. It is imperative that people within this community not only find evidence based alcohol and substance use treatment but that they find it with a culturally sensitive approach.

Recent data suggest that about ⅓ of LGBTQIA people had experienced some form of substance use disorder between 2022 and 2023. Members of this community face increased stressors including rejection and shame from family or friends, discrimination, physical and emotional abuse, hate crimes, humiliation and ridicule.

In addition, members of this community may turn to self-medication to treat the psychological toll these stressors have on their daily lives.  The study showed that members of the LGBTQIA community were significantly more likely than the general population to experience serious mental illness (SMI), such as major depressive disorder, generalized anxiety disorder, and suicidal ideation.     

Treatment programs designed for members of the LGBTQIA community support long-term and whole-person healing. They recognize the unique experiences that many individuals within this community face and acknowledge how trauma and discrimination have shaped the lives of LGBTQIA persons.

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Impacts on the Asian American and Pacific Islander (AAPI) Community

AAPI is a term used to describe people of Asian American and Pacific Islander heritage. This includes those of Chinese, Indian, Cambodian, Indonesian, Taiwanese, Thai,  Filipino, Vietnamese, Korean and Japanese heritage. 

Studies indicate that members of these communities have lower rates of alcohol and substance use disorder when compared with the general population. This does not mean, however, that substance use disorders are not a concern among members of the AAPI community. 

For example, Korean-Americans, Filipino-Americans, and Japanese-Americans have higher rates of problematic drinking when compared to other AAPI groups. In the Pacific Islander community, men drink more heavily and more frequently than their female counterparts.  

When compared with other members of the BIPOC community, individuals within the AAPI community are relatively less likely to seek treatment for alcohol and substance use disorders. Cultural stigmas surrounding mental health care appear to be a significant barrier to care. Other obstacles to getting treatment include spiritual and cultural beliefs, language barriers, financial issues, and mistrust of Western medicine.

Culturally-responsive mental health and addiction recovery resources are available for members of the AAPI community in towns and cities across the US. This includes online and in-person support in a wide variety of languages.

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