Examining Risk for Frequent Cocaine Use: Focus on an African American Treatment Population

ABSTRACT

Background: Cocaine use and its consequences are disproportionately higher and more severe among African Americans compared to other ethnic/racial groups. Objectives: The aims of this study were to examine a risk model specific for African American users and assess whether risk varies as a function of sex. Methods: 270 African American adults in a residential drug treatment facility completed measurements assessing first and past year crack/cocaine use frequency, childhood trauma, and stress reactivity. Multiple linear regression analysis was used to examine the unique effect of each predictor variable on past year crack/cocaine frequency. Sex was included as a moderator variable in the regression analysis. Results: All predictor variables were positively correlated with past year crack/cocaine use. However, sex differences were also observed: females reported higher rates of childhood emotional abuse, childhood sexual abuse, and stress reactivity—as well as past year crack use and cocaine use—than males. Regression analyses were performed with sex, first year use, and stress reactivity emerging as the only significant predictors for frequency of crack and cocaine use among all study participants. Moreover, sex differences were observed in the influence of first year crack use frequency on past year crack use frequency, such that the effect was stronger for males than for females. Conclusion/Importance: This study offers a clearer understanding of the risk factors for crack and cocaine abuse specific to African Americans, as well as sex specific pathways to risk, providing useful implications for future prevention and treatment efforts.

KEYWORDS:

• African American
• race
• cocaine use
• risk
• treatment

Additional information

Notes on contributors

Tamika Chere Barkley Zapolski

Tamika Chere Barkley Zapolski is a clinical psychologist, receiving her doctoral degree from the University of Kentucky in 2013 in clinical psychology. She is currently an assistant professor in the Clinical Psychology Program at Indiana University Purdue University—Indianapolis. Dr. Zapolski's research program examines the influence of cultural and psychosocial factors on behavioral health outcomes among ethnic/racial minority youth and young adults.

Patrick Baldwin

Patrick Baldwin, MA, is a mental health specialist at McLean Hospital in Belmont, Massachusetts. His research interests include substance abuse treatment in underserved populations, the pathophysiology of antisocial personality disorder, and the role of impulsivity in borderline personality disorder.

Carl W. Lejuez

Carl W. Lejuez received his graduate training at West Virginia University, earning his PhD in 2000 after completing a Clinical Internship at the Brown University Clinical Psychology Training Consortium. He is currently a Professor and the Director of Clinical Training in the Clinical Psychology Program, as well as the Founding Director of the Center for Addictions, Personality, and Emotion Research (CAPER). Starting in February 2016 he will begin his term as Dean of Liberal Arts and Sciences at the University of Kansas.