The Relationship Between Acculturation and Risky Opioid Use Among Young Adult Immigrants from the Former Soviet Union

Introduction

Evidence suggests high rates of opioid use, injection drug use and injection-related HIV/HCV risk behavior among young immigrants from the former Soviet Union (FSU), yet no research has examined the influence of acculturation on FSU youths’ drug use patterns. This study aimed to explore the relationships between immigration- and acculturation-related factors with opioid use severity and injection risk among a sample of young adults from the FSU living in New York City.

Methods

Eighty young adults (ages 18-29) from the FSU (including 40 reporting past-month use of heroin and/or prescription opioids [POs] and 40 currently in treatment for opioid use) completed structured assessments of immigration and drug use histories, current opioid use and injection risk behavior, acculturation orientation (to Russian and American cultures), and acculturation stress. Exploratory statistical analyses, including Pearson’s correlations and multivariate regression models, were conducted in SPSS to examine the relationships between acculturation- and immigration-related characteristics with opioid use and injection risk variables.

Results

Participants were 74% male (mean age=23.4 years). Most immigrated to the U.S. as young children from Ukraine (48%) or Russia (19%), with a minority (10%) born in the U.S. to FSU-born parents. Although the majority (85%) reported initiating opioid use with POs in their mid-teens, most (64% of current users) transitioned to heroin. Bivariate analyses indicated that leaving one’s country of origin at an older age (in pre- or early adolescence) was significantly correlated with having overdosed, and acculturation stress was significantly related to using heroin (vs. POs) as a primary drug. Strong orientation to American culture was associated with the use of heroin as a primary drug and with a greater likelihood of sharing secondary injection equipment, behavior that can transmit blood-borne disease. Greater participation in American cultural activities (e.g., consuming American music, movies and TV) was also associated with primary use of heroin. Being born in Russia (vs. the U.S. or another FSU country) was significantly associated with younger age of initiating a range of drug-use behaviors (e.g., any drug use, opioid use and injection drug use) and with primary heroin use. Regression analyses indicated that leaving one’s country of origin at an older age was significantly associated with having overdosed (p<.05) and of sharing syringes in the past 12 months (p<.01). Being born in Russia was significantly associated with primary heroin use (p<.01) and with initiating heroin use at a younger age (p<.05).

Conclusions

Results suggest that leaving one’s country of origin in pre- or early adolescence may increase vulnerability to risky drug use. Some findings support existing research on immigrant youths’ substance use which has found that greater acculturation to American culture is associated with riskier drug use. Other results suggest that being born in Russia, vs. the U.S. or other FSU countries, is associated with higher-severity drug use. Overall, these findings suggest a need for culturally-tailored prevention and harm reduction interventions for immigrant youth.