Non-opiate and cannabis drug use in minority ethnic groups
Prepared for the NIHR Public Health Policy Research Unit and the Department of Health and Social Care.
About the study
The second volume of the Government commissioned independent review of drugs (published in 2021) highlighted a need for research into what works to diminish problems related to substance use across supply, prevention, treatment, and recovery. Particular evidence gaps were highlighted around drug use in minority ethnic communities, including barriers and facilitators to treatment and prevention. More recently, the House of Commons Home Affairs Committee released a report which identified that people from minority ethnic communities face additional barriers in accessing treatment and support for drug use, while also being adversely impacted by drug-related legislation (e.g., stop and search policies). This study – the first of its kind in the last decade – explored these areas further, going some way to fill these evidence gaps. In particular, this research explored: variations in the frequency and type of drug use across different ethnic groups; the drivers of drug use among minority ethnic communities; and barriers and facilitators to support and treatment. The report draws on findings from a review of pre-existing research – including academic papers and research published by organisations and groups working in the field – analysis of data from the Adult Psychiatric Morbidity Survey (APMS) and the Crime Survey for England and Wales (CSEW), and in-depth interviews with professional stakeholders and people from minority ethnic communities with experience of problematic drug use.
Survey data showed variation in the numbers of people from minority ethnic groups who have used drugs or have experienced drug dependence when compared to the White British population. However, some differences were also explained by factors other than ethnicity such as age and deprivation. Interviews with professional stakeholders and people with experience of problematic drug use from minority ethnic communities highlighted that experiences of drug use are driven by a range of intersecting factors, including culture, gender, mental health, and migration experiences. In particular, people with experience of problematic drug use felt that their drug use was influenced by: normalisation of drug use within their social group; availability or lack of resources; the convenience of accessing substances; and the management of mental health issues. Our analysis also identified several barriers to accessing and engaging with treatment and support services, some specific to and others worsened by being from a minority ethnic community. These barriers included stigma, shame, and fear of judgement; lack of awareness of available services; language barriers; lack of trust in services; lack of culturally competent services; limitations in knowledge around drugs and their impacts; and financial barriers. Our recommendations involved improving knowledge about, and trust in, services; implementing culturally appropriate service delivery; ensuring person-centred, personalised approaches; and ensuring that services are accessible and responsive.
Scoping review of existing literature, secondary data analysis of the Adult Psychiatric Morbidity Survey (APMS) and the Crime Survey for England and Wales (CSEW), qualitative interviews (with stakeholders and people with experience of problematic drug use), qualitative analysis, thematic analysis, Theoretical Domains Framework (TDF).