Differences in service utilization and barriers among Blacks, Hispanics, and Whites with drug use disorders

University of Michigan, School of Social Work, 1080 S, University Avenue, Ann Arbor, MI 48109, USA.
Substance Abuse Treatment Prevention and Policy (Impact Factor: 1.16). 02/2009; 4(1):3. DOI: 10.1186/1747-597X-4-3
Source: PubMed


Treatment 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.
Using 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.
Among 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.
While 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.

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    • "Other patient factors include clients' knowledge, expectations, and preferences about specialty SUD care. Common barriers to patients accessing such care are lack of knowledge about the harmful effects of continued substance use, the belief that patients can cope with substance misuse on their own or the problem will improve by itself, and embarrassment (Perron et al., 2009; Mowbray et al., A conceptual model to facilitate transitions from primary care to SUD care 5 2010). Stigma is a significant barrier to accessing SUD treatment services; individuals may choose to conceal their substance misuse to avoid stigma (Livingston et al., 2012). "
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    • "However, after accounting for socio-demographic characteristics, significantly more Hispanics enrolled in long-term treatment compared to Whites. Studies suggest that drug treatment enrollment patterns between Hispanics and Whites are similar (Perron et al., 2009). More research is needed to confirm the findings in this study accounting for discrimination and neighborhood factors among a representative sample of current and former drug users who may have successfully completed treatment and would therefore not be eligible for this study. "
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