Moderating effects of race in clinical trial participation and outcomes among marijuana-dependent young adults

Abstract

BackgroundFew studies have examined clinical trial participation rates and treatment outcomes among underserved young adults who are dependent on marijuana, the most commonly abused illicit drug. MethodThe present study was a secondary analysis of a trial of court-referred marijuana-dependent young adults (ages 18–25) randomized to one of four treatment conditions: Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), MET/CBT+Contingency Management (CM), Drug Counseling (DC) or DC+CM. African American (N=81) participants were compared to White (N=31) participants with respect to rates of participation in phases of treatment and substance use outcomes. In addition, the interaction of race and treatment condition was examined to ascertain if the interventions yielded different effects based on race. ResultsAmong those who started treatment, African American young adults were significantly less likely to complete the treatment and posttreatment phases of the clinical trial than their White counterparts. Irrespective of treatment type, substance use outcomes (i.e., percentage of marijuana-negative specimens and longest duration of continuous abstinence) did not vary by race. However, there was a significant interaction effect between treatment type and race; African American young adults did not benefit differentially from any specific type of treatment, but CM was effective in reducing proportion of marijuana positive samples among White young adults. ConclusionsFindings suggest that clinical trial treatment and posttreatment completion rates vary by race in this population, as does response to specific treatment types. More treatment research focusing specifically on African American marijuana-dependent young adults is warranted.