Perron Brian E, Mowbray Orion P, Glass Joseph E, Delva Jorge, Vaughn Michael G, Howard Mathew Owen
University of Michigan, School of Social Work, 1080 S, University Avenue, Ann Arbor, MI 48109, USA.
Subst Abuse Treat Prev Policy. 2009 Mar 13;4:3. doi: 10.1186/1747-597X-4-3.
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.
药物使用障碍(DUD)的治疗可能是有效的,但只有一小部分患有药物使用障碍的人寻求或接受治疗。关于种族和族裔在治疗方面的差异和差距的研究仍不明确。了解药物治疗中的种族和族裔差异及差距对于建立更有效的转诊系统和提高治疗的可及性是必要的。本研究的目的是探讨种族和族裔在服务利用中的作用。
利用全国酒精及相关疾病流行病学调查(NESARC)的数据,本研究调查了符合药物使用障碍终身标准的人群在14种药物使用障碍治疗服务的使用情况以及27种不同治疗障碍方面的种族和族裔差异。多变量逻辑回归分析用于检验种族和族裔群体之间的服务利用情况和障碍,同时对其他社会人口统计学和临床变量进行调整。
在NESARC总体样本中的黑人、西班牙裔和白人中,约10.5%符合至少一种终身药物使用障碍的标准。约16.2%的患有终身药物使用障碍的人接受了至少一种类型的服务。总体而言,本研究表明,白人比黑人更不太可能报告因药物相关问题获得帮助,黑人使用的不同类型服务更多,并且在药物治疗的感知障碍方面未观察到种族和族裔差异。然而,通过分别检查服务类型,种族和族裔差异呈现出复杂的情况。最值得注意的是,白人最有可能使用专业服务,而黑人最有可能使用12步戒酒法和神职人员服务。西班牙裔的服务使用模式最类似于白人。
虽然观察到了获得治疗的结构性障碍,但针对种族和族裔群体的广泛教育计划和干预措施仍然是预防和治疗的一个重要领域。