Abstract
BackgroundTreatment for drug use disorders (DUD) can be effective, but only a small proportion of people with DUD seek or receive treatment. Research on racial and ethnic treatment differences and disparities remains unclear. Understanding racial and ethnic differences and disparities in drug treatment is necessary in order to develop a more effective referral system and to improve the accessibility of treatment. The purpose of the current study was to explore the role of race and ethnicity in service utilization.MethodsUsing data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), this study examined racial and ethnic differences in use of 14 types of treatment services for DUD and 27 different treatment barriers among persons who met lifetime criteria for a DUD. Multivariate logistic regression analyses were used to examine service utilization and barriers among the racial and ethnic groups, while adjusting for other sociodemographic and clinical variables.Results and discussionAmong Blacks, Hispanics and Whites in the overall NESARC sample, approximately 10.5% met criteria for at least one lifetime drug use disorder. Approximately 16.2% of persons with a lifetime DUD received at least one type of service. Overall, this study indicated that Whites were less likely to report receiving help for drug-related problems than Blacks, Blacks used a greater number of different types of services, and no racial and ethnic differences were observed with respect to perceived barriers to drug treatment. However, by examining types of services separately, a complex picture of racial and ethnic differences emerges. Most notably, Whites were most likely to use professional services, whereas Blacks were most likely to use 12-step and clergy. The service use pattern of Hispanics most resembled that of Whites.ConclusionWhile structural barriers to accessing treatment were observed, broad-based educational programs and interventions that are appropriately targeted to racial and ethnic groups remains an important area for prevention and treatment.
Highlights
Treatment for drug use disorders (DUD) can be effective, but only a small proportion of people with DUD seek or receive treatment
While Blacks and Hispanics have similar rates of substance use disorders compared to non-Hispanic Whites [3,4], population-based studies show they are less likely to use specialty treatment services [3,5,6,7]
Blacks were more likely to live in urban areas, have lower incomes, and be unemployed compared to Whites and Hispanics and had the lowest rates of polydrug use disorder
Summary
Treatment for drug use disorders (DUD) can be effective, but only a small proportion of people with DUD seek or receive treatment. Racial and ethnic minorities appear to have significantly higher rates of unmet needs for substance use disorders [4] and are less likely to seek or complete treatment [12]. Considering that HIV/ AIDS disproportionately affect Blacks [14] and HIV/AIDS is often associated with and complicated by drug use [15], it is critical to understand the treatment needs of Blacks with DUDs. Studies consistently find that minority populations experience more adverse health and social consequences related to substances misuse and have more treatment needs [16,17]. Studies consistently find that minority populations experience more adverse health and social consequences related to substances misuse and have more treatment needs [16,17] This finding may be due to racial or ethnic discrimination, or to issues relating to acculturation stress and community responses to substance use behaviors. Significant increases in substance use disorder treatment gaps between Hispanics and nonHispanic Whites over the period between 1993 and 2003 were observed [18], a development warranting further monitoring and investigation of services for this population
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