Racial and Ethnic Differences in Substance Abuse Treatment Initiation and Engagement

Abstract

This study examined variations by race and ethnicity in initiation and engagement, two performance measures of treatment for substance use disorders that focus on the timely receipt of services during the early stage of substance abuse treatment. Administrative data from the Oklahoma Department of Mental Health and Substance Abuse Services were linked with facility-level information from the National Survey of Substance Abuse Treatment Services. We found that Black clients were least likely to initiate treatment, but no race or ethnic differences in treatment engagement were found when compared by race or ethnicity. Most client and facility characteristics' association with initiation or engagement did not differ across racial or ethnic groups. Increased attention is needed to understand what may contribute to the differences and how to address them. This study also offers an approach that state agencies may implement for monitoring treatment quality and examining racial and ethnic disparities in substance abuse treatment services.

KEYWORDS:

• performance measures
• race/ethnicity
• substance abuse treatment
• treatment engagement
• treatment initiation

Acknowledgments

This study was supported by The National Institute on Alcohol Abuse and Alcoholism (NIAAA) (grant R21 AA14229) and The National Institute on Drug Abuse (NIDA) (grant R21 DA15704), with additional support from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, through a supplement to the Brandeis/Harvard NIDA Center to Improve the Quality of Drug Abuse Treatment (grant 3 P50 DA010233). The first author received support from the Brandeis University NIAAA Doctoral Teaching Grant on Health Services Research on Alcohol Related Problems (grant T32-AA007567).

Notes

***p < .001.

Abbreviations: s.e. = standard error; N/A = not applicable; SA = substance abuse; MH = mental health.

*p < .05.

Abbreviation: s.e. = standard error; N/A = not applicable.

*p < 0.05; **p < 0.01; ***p < 0.001.

Note: The following variables were not significant in either model and are not shown: high school graduate, the various substance use variables, and prior year DUI, arrest/incarceration, or employment.

Abbreviations: SA = substance abuse; MH = mental health.