Substance Use Treatment and Overdose Prevention Among Latine Communities: A Scoping Review on the Role of Immigration Status and Family Context

Background

Overdose mortality among Latine populations has risen at a faster rate than among non-Hispanic White individuals since 2015, with recent projections suggesting Latine overdose deaths could surpass those of white Americans within a decade if current trends continue. Despite this urgent public health crisis, Latine communities remain underrepresented in substance use treatment and overdose prevention research, yet existing literature rarely examines how immigration status and family systems shape access to harm reduction services. At the same time, familismo, a core Latino cultural value emphasizing loyalty, interdependence, and collective obligation, has been identified as a protective factor against substance misuse, yet is rarely incorporated into overdose prevention interventions. Guided by a family systems perspective and LatCrit theory, which centers immigration status as a structural determinant of health, this scoping review examines how the literature addresses the intersecting roles of immigration status and family context in substance use treatment and overdose prevention among Latine populations.

Methods

A scoping review methodology was employed following Arksey and O'Malley's framework and PRISMA-ScR reporting guidelines. Systematic searches were conducted across PubMed, PsycINFO, Social Work Abstracts, CINAHL, and Web of Science using keyword combinations including: Latino/a/e, Hispanic, Latine, substance use, overdose, harm reduction, addiction, treatment, prevention, immigration status, undocumented, legal status, family dynamics, familismo, and caregiver. Peer-reviewed studies and government reports published between 2000 and 2025 were included if they addressed substance use treatment or overdose prevention in Latine populations in the U.S. Thematic analysis was used to synthesize findings across four domains: (1) immigration status as barrier to treatment and harm reduction access; (2) family context as a facilitator or barrier to service engagement; (3) culturally adapted interventions and their inclusion of family and immigration considerations; and (4) gaps in research and programmatic reach.

Discussion/Results

Preliminary findings reveal that the majority of overdose prevention and substance use treatment studies targeting Latine populations focus on individual-level behavior change without integrating family dynamics, multigenerational household context, or immigration-related stressors. Immigration status is rarely considered or reported in harm reduction studies, and databases often leave undocumented individuals out of intervention research studies. Even in culturally adapted interventions, few explicitly address mixed-status family contexts or the role of deportation fear in service avoidance. Familismo is identified in the literature as a protective factor against harmful substance use, yet it remains underutilized as a lever in intervention design. Mutual aid and community-generated support highlight the gap between population need and institutional response.

Implications for SW

Most overdose prevention strategies targeting Latine communities are designed without considering the immigration experiences and family dynamics that influence risk, resilience, and recovery. For social work practice, findings support the development of family-centered, culturally grounded harm reduction interventions that explicitly incorporate immigration status, caregiving roles, and familismo. Future research should prioritize the development and testing of interventions specifically designed for mixed-status families and undocumented individuals, as existing evidence supports the feasibility and effectiveness of culturally grounded adaptations of substance use prevention programs for Latine subpopulations.