Blacks, NH/PI and AI/AN had the highest rates of transition from use to dependence. Acculturative stress and racial/ethnic discrimination may help explain the increased risk of transition from use to dependence among these minority groups (Caraballo et al., 2008; Chae et al., 2008; Kim et al., 2007). Experiencing a stressful event, like discrimination, may promote the utilization of maladaptive coping mechanisms, such as substance use (Gibbons et al., 2004; Whitbeck et al., 2001), or produce enduring neurochemical changes leading to develop a SUD (Koob, 2009). Low social capital, common among AI/AN and Blacks may further increase the risk of transition (Beauvais et al., 2004; Fothergill et al., 2009; U.S. Department of Health and Human Services, 1998). Furthermore, several biological mechanisms and genetic factors may also contribute to explain racial-ethnic variations in the risk of transition to SUD. Genetic influences have accounted for a significant amount of the variance in the development of SUD among AI/AN (Ehlers et al., 2009; Wilhelmsen and Ehlers, 2005). Genetic factors involved in nicotine and cotinine metabolism may contribute to variations in the amount of daily
