Cultural and Psychosocial Correlates of co-use among Black-White Biracial Adults

J Subst Use Addict Treat. 2023 Oct:153:209006. doi: 10.1016/j.josat.2023.209006. Epub 2023 Mar 15.


Introduction: Biracial individuals, a subset of the fastest growing population segment in the United States, frequently experience conflict with ethnic identity, according to marginality theory. Ethnic identity is associated with perceived discrimination and self-esteem, and each of these factors is associated with alcohol and marijuana use. Some research suggests that Black-White biracial individuals have specific challenges with ethnic identity, discrimination, and self-esteem, as well as have disproportionate rates of alcohol and marijuana use separately. Co-use of these substances is linked to more risk behaviors and greater quantity/frequency of use compared to singular use of alcohol or marijuana. However, research examining these cultural and psychosocial factors as correlates of recent co-use among Black-White biracial individuals is limited.

Method: The current study examined past-year cultural (i.e., ethnic identity, perceived discrimination) and psychosocial (i.e., age, gender, self-esteem) factors associated with past 30-day co-use (i.e., alcohol, marijuana) among a sample of 195 biracial (Black-White) adults recruited and surveyed via MTurk. We analyzed data using a hierarchical logistic regression.

Results: Results of the final step of logistic regression indicate increases in perceived discrimination were significantly associated with a 1.06 times greater likelihood in 30-day co-use (95% CI [1.002, 1.10]; p = .002). Further, co-use is more common among women than men (OR = 0.50, 95% CI [0.25, 0.98]; p = .04).

Conclusions: Findings indicate discrimination experienced among Black-White biracial adults is the most culturally relevant correlate of recent co-use in this study, of the factors measured given the framework. As such, substance use treatment with this population may focus on experiences of and coping with discrimination. Since women were also at greater risk for co-use, gender-specific treatments may be beneficial for this population. The article also discussed other culturally relevant treatment considerations.

Keywords: Biracial; Co-use; Discrimination; Ethnic identity; Self-esteem.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • Humans
  • Logistic Models
  • Male
  • Marijuana Smoking*
  • Self Concept
  • Substance-Related Disorders* / epidemiology
  • Surveys and Questionnaires
  • United States / epidemiology