Racial/ethnic groups trends with substance use: which has the highest prevalence?

• A. American Indians or Alaska Natives
• B. African Americans
• C. Whites
• D. Hispanics

Answer: (A)

The main idea is understanding how substance use prevalence varies by racial/ethnic group and identifying which group shows the highest burden in the population. American Indians and Alaska Natives consistently show the highest prevalence of substance use across multiple substances in national data. This pattern includes higher rates of tobacco use and alcohol use (often with higher rates of binge drinking) compared with other groups, though exact figures vary by substance and study.

Several factors help explain this pattern: longstanding socioeconomic disparities, barriers to accessing prevention and treatment services, and the lingering effects of historical trauma and marginalization. These contexts can increase exposure to stressors and influence patterns of use. It’s important to remember that these are population trends and don’t apply to every individual; within any group there’s wide variation. But when you look at large-scale data, this group tends to have the highest overall prevalence of substance use.