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The Study and Prevention of Alcohol and Other Drug Misuse Among Migrants: Toward a Transnational Theory of Cultural Stress

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Abstract

Prior research suggests that international migrants, taken together, experience alcohol and other drug (AOD)-related problems at lower rates than do non-migrants. However, many migrants do, in fact, misuse AOD, with elevated levels of risk observed among those who migrate during childhood and those who experience adverse/stressful events. In our prior work, we have advanced cultural stress theory, which is concerned with the ways in which adverse migration-related experiences can create disruptions in family functioning and, in turn, increase risk for adverse behavioral and mental health outcomes, including AOD misuse. In this article, we provide an overview of prior research on AOD misuse among immigrants and highlight critical gaps in research and theory. In turn, we present a framework for AOD misuse research and prevention that (1) considers the importance of pre-migration, transit-related, and post-migration stressors; (2) prioritizes cross-national and multisite comparative designs; and (3) highlights transnational dynamics in migration.

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Notes

  1. Our focus in this article is on individuals who relocate from one country to another. To be sure, manifold terms can be used to describe such individuals, depending upon the characteristics of those who migrate and the context in which migration is discussed (see Berry 1997; Schwartz et al. 2010). Such terms include “migrant” (those who move from one country to another), “immigrant” (foreign-born individuals who have migrated and live in a new destination country), “asylum seeker” and “refugee” (those who have migrated specifically to escape danger or disaster), and “sojourner” (those who migrate only for a period of time, such as international students and guest workers). Without any doubt, there are many other terms and categories that could be included as well. In this manuscript, we primarily refer to migrants (and international migration) when discussing persons who move from one nation to another and immigrants (and immigration) when discussing the experiences of foreign-born people in their new destination countries.

  2. Although the majority of studies in North America and Europe suggest that rates of AOD misuse are lower among first-generation immigrants (i.e., foreign-born) than among native-born populations, there certainly are exceptions. For instance, a recent study conducted in France—using data from a large, multisite survey—found no difference in the prevalence of alcohol use disorder between first-generation immigrants and French-born individuals (Rolland et al. 2017). Moreover, some studies have found that, although applicable to immigrants from most global regions, the healthy migrant phenomenon does not invariably extend to immigrants from particular regions of Europe (Hjern and Allebeck 2004). Other studies have found that effects tend to be strongest among non-European immigrants (Ali et al. 2004; Salas-Wright et al. 2014a).

  3. Family functioning is an important mechanism through which cultural stressors influence adolescent AOD misuse, but it is likely not the only such mechanism. Other mechanisms may include school bonding and performance, peer affiliations, one’s sense of personal and cultural identity, and other psychosocial factors (e.g., Grigsby et al. 2018; Oshri et al. 2014; Salas-Wright et al. 2014c).

  4. One challenge in the integration of pre-migration data is identifying individuals with concrete plans to emigrate. Some prior work has been done in this area (see Tartakovsky and Schwartz 2001), and we are currently working to develop and test measures that can identify those who are most likely to migrate within a span of 2–3 months.

  5. Since 2016, Venezuela has been the leading source of asylum seekers in the US. In 2017, Venezuelan nationals filed nearly 30,000 asylum applications—more than those of China and Mexico (the other leading countries) combined and more than a 150% increase from the number of applications submitted by Venezuelans in 2016 (United States Citizenship and Immigration Services 2018).

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Authors and Affiliations

  1. School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA

    Christopher P. Salas-Wright

  2. Department of Public Health Sciences, Division of Prevention Science & Community Health University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA

    Seth J. Schwartz

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  1. Christopher P. Salas-Wright
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This research was supported in part by grant number R25 DA030310 from the National Institute on Drug Abuse at the National Institutes of Health and by the National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI Grant Number 1KL2TR001411. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The authors are grateful to Maryann Amodeo, Professor Emerita at Boston University, for her thoughtful feedback.

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Salas-Wright, C.P., Schwartz, S.J. The Study and Prevention of Alcohol and Other Drug Misuse Among Migrants: Toward a Transnational Theory of Cultural Stress. Int J Ment Health Addiction 17, 346–369 (2019). https://doi.org/10.1007/s11469-018-0023-5

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