UCSF

Title. Older African Americans and Illicit Drug Use: A Qualitative Study

Aim. To explore the underlying social factors associated with illicit drug use in older African Americans as an underpinning to the development of approaches to nursing care and treatment.

Background. By 2020 there will be approximately five million older Americans with substance use disorders. A disproportionate number, almost half a million, will be of African descent. Drug use along with age related changes predisposes these older adults to a myriad of undesirable social, psychological, and health outcomes such as homelessness, mental illness, HIV, and hepatitis C.

Method. Grounded Theory methodology was used to explore the social processes involved in the use of illicit drugs by older African-Americans. Interviews were conducted with 20 older African American substance users who were currently in drug treatment programs. Responses to the questions were recorded, transcribed, and analyzed using constant comparative methods. The data were collected in 2008.

Findings. Three core themes emerged: (1) Family, (2) Media Images, and (3) Environment. Further analysis established that the family and media images themes were components of a larger core category entitled "emulation." Emulation of an admired person or lifestyle was associated with initiation into a drug lifestyle. Environment remained a core category that supported continued and long term substance abuse.

Conclusion. Emulation of admired behavior of humans by other humans, unlike the emulation reproduced in the laboratory model by lab rats, occurs in no predictable temporal pattern making the point of intervention for prevention of observed unwanted social behaviors most difficult. However, nurses are in a unique position to assess for and thus intervene against substance abuse initiation and will play a key role in leading the way to healthier communities.