A comparison of substance use patterns among lifetime heroin-injecting individuals by racial groups

Abstract

Background: Studies have identified differential substance use patterns by racial groups. One of the most commonly reported differences is a higher rate of injection drug use (IDU) among Non-Hispanic Whites compared to African Americans, but this is complicated by factors related to IDU (e.g. earlier drug-use initiation) that overlap with being White.

Objective: We explored differential substance use-patterns by racial groups within a sample of injection heroin users.

Methods: Substance-use data were collected from 373 not-in-treatment heroin users who endorsed any lifetime injection use (69.4% male). We examined differences in substance-use patterns (e.g. age of initiation, gateway adherence) by racial groups. Multiple t-tests with Bonferroni correction were conducted to understand which demographic and substance-use characteristics varied by racial groups.

Results: Relative to Non-Hispanic Whites, African Americans (45.8% of sample) were more likely to start using heroin earlier in their life, but also more likely to experience a longer delay between starting and regularly using heroin. We also identified differences in the degree of (injection) heroin-use consequences by racial groups. After correcting for multiple comparisons and controlling for age and gender, we observed differences for six substance-use and demographic characteristics by racial group. White participants were younger, started cocaine use earlier, and experienced more heroin-use consequences across two separate domains.

Conclusions: After controlling for injection use, we observed differential substance-use characteristics by racial groups. The findings could be used to develop targeted prevention and harm-reduction strategies.

Keywords:

• Heroin
• injection
• consequences
• race

Acknowledgments

The authors thank Ken Bates for recruiting participants and Debra Kish, Joi Moore, Melissa Williams, Elorie Eggleston, Hayley Harrison, and Lisa Sulkowski for data collection and management.

Disclosure of interest

All authors declare no conflict of interest with respect to the conduct or content of this work.

Additional information

Funding

NIH 2 R01 DA015462 from the National Institute on Drug Abuse (to MKG), a grant (Joe Young Sr./Helene Lycaki Funds) from the State of Michigan, and funds from the Detroit Wayne Mental Health Authority supported this research. Funding sources had no role in the design, conduct, or analysis of these data, nor the decision to submit this manuscript. Data for this analysis were obtained under registered NIH clinical trials NCT00218309, NCT00218361, NCT00429767, NCT00608504, NCT00684840, NCT00698737, and NCT01536925.