Factors including language and cultural barriers, as well as fear of deportation, may be contributing to the rising drug overdose rate among Latinos in the United States, NPR reports.

According to the Centers for Disease Control and Prevention, drug overdose deaths among Latinos increased 52.5 percent between 2014 and 2016, compared with 45.8 percent for whites.

NPR interviewed people who currently and formerly used drugs, their family members, addiction treatment providers and physicians about why the drug overdose death rate is spiking among Latinos.

Some said the language barrier keeps anyone who can’t read English out of treatment, because they have trouble reading websites or brochures that explain options. If they call a number advertised for a treatment center, often the person answering the phone doesn’t speak Spanish. Group counseling sessions and clinics often do not have a translator. Few Spanish-speaking doctors prescribe buprenorphine.

Some people are afraid to call for help in the case of an overdose because of fear of deportation, people told NPR.