Over 60 million Latinx people now live in the United States, with a nearly 20 percent increase over the past decade. Obviously this indicates a growing migration trend of Latinx people. And with it come important considerations: for migrants' mental health and for culturally informed treatment that understands a patient's potential migration-based trauma and other co-occurring disorders. In this article, we'll briefly explain the most relevant terms and cover the most important considerations related to migration-induced trauma and its relevance to treatment for substance use disorders. To what culture and origin do Latinx people belong? Latinx is a gender-neutral reference to people of Latin American origin who now live in the United States. The term has quickly gained widespread popularity online, and has been used by activists to raise awareness for this migratory group. The term was influenced by certain indigenous communities in Mexico—Juchitán de Zaragoza and Oaxaca—who have a third gender role. It was later added to the Merriam-Webster Dictionary in 2018 and Oxford English Dictionary the following year. Although the term is contested by some members of the Latin American diaspora—who often prefer the gendered versions, Latino or Latina—it has become widely accepted for its gender inclusivity. What is migration-induced trauma? Among the tens of millions of immigrants that now live in the United States, over half are of Hispanic, Latin American or Caribbean origin.1 Similar to refugees who flee from persecution, war or natural disaster, many immigrants have deeply affecting personal experiences that result from the migratory process and the trauma it induces. This is especially true of those immigrants who migrate without authorization or who come from low socioeconomic backgrounds. How does migration produce trauma? Migration consists of three distinct stages: Premigration Relocation Adjustment Premigration is characterized by physically moving. The motivations that initiate premigration vary, and often include one or more of the following reasons: Poverty or unemployment Lack of educational opportunities Environmental reasons, like natural disasters Conflict, like war or revolution Recently, a mass exodus of migrants from the Northern Triangle—Honduras, Guatemala and El Salvador—was prompted by increased regional violence that was compounded by the COVID-19 pandemic. Relocation, the second stage of migration, is often defined by pervasive uncertainty and worsening health disparities. And the third stage, adjustment, is perhaps the most relevant to the rising rate of co-occurring disorders. Migrants fleeing from the Northern Triangle, and those in similar situations, report being victims of physical violence while in transit through Mexico, and also report psychological violence deriving from threats to themselves or their families. What's the most common mental health disorder associated with migration? Twenty-seven percent of Latinx people with mental illnesses have a serious mental illness (SMI). SMIs are any mental, behavioral or socioemotional disorder that severely impairs a person's functioning and seriously interferes with life activities. The most prevalent SMI among Latinx youth and adults is major depressive disorder (MDD), often referred to simply as depression. Symptoms may include low self-esteem, loss of interest in previously enjoyable activities, difficulty concentrating and suicidal ideation. What are the most frequently misused substances? The most frequently misused substances following migration are prescription drugs, marijuana and hallucinogens. For people with MDD, the rate of substance use nearly doubles. Latinx migrants often use substances like marijuana to cope with migration-induced trauma and violence that they either were victim to or witnessed personally. This substance use creates a self-reinforcing cycle where people with MDD use to self-medicate, thereby increasing the symptoms associated with MDD. This exposes Latinx migrants to an increased risk of severe psychiatric disorders, especially in the presence of genetic predispositions. What are the barriers to entry for Latinx migrants? There are several barriers to entry for Latinx people seeking treatment for substance use and co-occurring disorders, including both individual and systemic barriers. Individual barriers include: Limited English proficiency Need to retain employment Internalized cultural stigmas surrounding addiction and co-occurring disorders Limited access to health insurance Feared revelation of legal status or lack thereof Systemic barriers may include: Shortage of Spanish-language programs Lacking benefits related to work absences and time off Long wait lists High cost of treatment High cost of child care What types of treatment are recommended for migration-induced trauma? The most-promising clinical results for migration-induced trauma are among those Latinx participants who are assigned to the Twelve Step condition of the Matching Alcoholism Treatment to Client Heterogeneity project. Participants experienced decreased severity of cravings for substances and increased rates of sobriety. Of particular note is the cultural affinity among Latinx people to favor a Higher Power, and the relevance of a spiritual connection to the Twelve Step program. The most promising results are among those Latinx participants who are assigned to Twelve Step programming. Virtual programming greatly expands accessibility to treatment and removes some of the Latinx-specific barriers to entry.