Discrimination may be linked to substance use

By Joene Hendry

NEW YORK (Reuters Health) - Does discrimination lead to substance use? Study findings suggest one's perception of unfair treatment may be linked to smoking, alcohol and substance use.

"Perceived unfair treatment because of one's race/ethnicity affects everyone and may lead to different coping mechanisms including substance use," Dr. Luisa N. Borrell told Reuters Health.

Borrell at Columbia University, New York, and colleagues collected self-reported data on racial discrimination and substance use from 1,507 African Americans and 1,813 white adults over 15 years.

During this time 89 percent of the African American and 38 percent of white study participants reported they experienced discrimination, the researchers note.

The study group, aged 40 years, on average, at the last follow-up, were original participants the long-term Coronary Artery Risk Development in Young Adults (CARDIA) study, the researchers report in the American Journal of Epidemiology.

Overall, discrimination was associated with higher education and income levels in African American participants, but lower education and income levels among white participants.

The researchers also found that, regardless of race, study participants reporting any discrimination were more likely to also report less emotional support and control of their life, and more negative interactions and anger.

More African Americans and whites who reported racial discrimination were current smokers than their non-discriminated against counterparts, while an association between current alcohol use and racial discrimination was evident only in African American participants, Borrell notes.

After adjusting for factors such as demographics (age, gender, marital status, income and education); coping mechanisms; and social support, the researchers found that African Americans who reported the most racial discrimination were more than three-times as likely to use marijuana 100 times or more, compared with those who reported no discrimination.

Likewise, African Americans who reported more racial discrimination over time were seven-times more likely to use cocaine 11 to 99 times over their lifetime, compared with their counterparts who reported no discrimination.

Similar patterns of lifetime marijuana and cocaine use were observed for the white participants, but because levels of discrimination were lower, these associations did not reach statistical significance.

"Substance use may be an unhealthy coping response to perceived unfair treatment for some individuals, regardless of their race/ethnicity," the researchers conclude.

SOURCE: American Journal of Epidemiology, November 1, 2007.