1. Drug Use Patterns and Problems on the Texas-Mexico Border Lynn Wallisch and Richard Spence University of Texas at Austin, School of Social Work, Addiction Research Institute Introduction The Texas-Mexico border is a distinctive and complex region, in which melding populations, cultures, and economies contribute to a constantly changing environment. Border residents are more predominantly Hispanic, younger, and of lower income than residents of the state as a whole. The Border is one of the fastest growing regions in the country, with many health challenges and sometimes inadequate delivery of services. The potential for drug and alcohol use and abuse on the Border has been of concern, because of the presence of factors believed to increase risk, including neighborhood poverty, low educational levels, significant drug trafficking and drug availability, a young age structure, easy access to alcohol and prescription pharmaceuticals on the Mexican side, excess tobacco and alcohol advertising, high population growth and mobility, and acculturative stresses. On the other hand, the region enjoys factors that may be protective against substance misuse as well, including cultural influences from Mexico that discourage substance use among women, strong family support systems, and the influence of the Catholic Church. Little is known about the drug and alcohol use patterns on the Border. With the projected continuing growth of this population, it is important to anticipate needs for and barriers to prevention and treatment services there. Design/Sample The study is based on a survey conducted in 2002-2003 of a representative sample of 1200 adults living in three sites on the Texas-Mexico border: the city of El Paso, the urban Rio Grande Valley, and colonias – unregulated communities lacking in basic public services – in Hidalgo and Cameron counties. Together, these three areas comprise about 80 percent of the total Border population. In the urban areas, the sampling utilized a multistage cluster design (block groups, blocks, households). One adult within each household was randomly selected to be interviewed. In the colonias, respondents were randomly sampled from communities stratified by size and density. In face-to-face interviews conducted in Spanish or English, respondents were asked extensive questions about their use of tobacco, alcohol, inhalants and nine categories of illicit drugs; drug and alcohol abuse; drug-related attitudes and perceptions; treatment utilization and barriers; gambling; mental health; family; neighborhood; and demographic characteristics. In statistical analysis, respondents were weighted to account for selection probability and to conform to county census distributions by age, gender and ethnicity. Significance tests were performed using SUDAAN to control for the design effects. Discussion & Recommendations Results Methods The Border area represents a learning opportunity for other areas of the country that are experiencing a merging of Hispanic and other cultures as well as undergoing rapid economic and social change. Overall prevalence of substance use appears similar to statewide levels (as estimated from the NSDUH). However, there is considerable variation within the Border region. Residents of colonias showed higher prevalence of binge drinking and alcohol dependence than urban residents, and lifetime cocaine use was twice as high in colonias as in neighboring urban areas. Past-year drug use almost doubled in colonias since a similar survey was done in 1996. In terms of substance abuse treatment, El Paso residents were twice as likely as colonia residents and four times as likely as Valley residents who had ever used alcohol or drugs to have received professional addiction treatment. However, participation in self-help groups was as high in colonias as in El Paso. Health concerns were the most important reason given for abstaining from drug use, and the acceptability of using professional help for substance-related problems was high, especially in colonias. The low rates of professional treatment actually received in the urban Valley and colonias are plausibly due to the lack of accessible and affordable services. 1996 data are from a similar study conducted by the Texas Commission on Alcohol and Drug Abuse. This poster was presented at the College on Problems of Drug Dependence in San Juan Puerto Rico: June, 2004. This study was supported by NIDA grant R01DA14794. The 1996 published survey results are available at http://www.tcada.state.tx.us/research/adult/1298border.pdf.