Abt Associates, Cambridge, MA 02138, United States. Norah
Drug Alcohol Depend. 2012 Sep;125 Suppl 1(Suppl 1):S44-50. doi: 10.1016/j.drugalcdep.2012.05.005. Epub 2012 Jun 2.
The objective was to analyze disparities in unmet need for substance use treatment and to observe variation across different definitions of need for treatment.
Data were analyzed from the 2002 to 2005 National Survey of Drug Use and Health and the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regressions estimated the likelihood of specialty substance use treatment across the two data sets. Parallel variables for specialty, informal and any substance abuse treatment were created. Perceived need and normative need for substance use treatment were defined, with normative need stratified across lifetime disorder, past twelve month disorder, and heavy alcohol/any illicit drug use. Treatment rates were analyzed, comparing Blacks, Asians and Latinos to non-Latino whites across need definitions, and adjusting for age, sex, household income, marital status, education and insurance.
Asians with past year substance use disorder had a higher likelihood of unmet need for specialty treatment than whites. Blacks with past year disorder and with heavy drinking/illicit drug use had significantly lower likelihood of unmet need. Latinos with past year disorder had a higher likelihood of unmet need for specialty substance abuse treatment. Asians with heavy drinking/illicit drug use had lower likelihood of unmet need.
The findings suggest that pathways to substance abuse treatment differ across groups. Given high rates of unmet need, a broad approach to defining need for treatment is warranted. Future research to disentangle social and systemic factors from factors based on diagnostic criteria is necessary in the identification of need for treatment.
本研究旨在分析物质使用治疗需求未满足的差异，并观察不同治疗需求定义下的变化。
对 2002 至 2005 年全国药物使用和健康调查和全国酒精相关情况及流行病学调查的数据进行分析。运用逻辑回归对两个数据集中的专科物质使用治疗可能性进行估计。创建专科、非正式和任何物质滥用治疗的平行变量。定义了物质使用治疗的感知需求和规范需求，规范需求按照终生障碍、过去 12 个月障碍和大量饮酒/任何非法药物使用进行分层。在不同的需求定义下，分析了治疗率，比较了黑人、亚洲人和拉丁裔与非拉丁裔白人之间的差异，并调整了年龄、性别、家庭收入、婚姻状况、教育和保险因素。
过去一年有物质使用障碍的亚洲人比白人更有可能有未满足的专科治疗需求。过去一年有障碍且大量饮酒/使用非法药物的黑人未满足治疗需求的可能性显著降低。过去一年有障碍的拉丁裔更有可能需要专科物质滥用治疗。大量饮酒/使用非法药物的亚洲人未满足治疗需求的可能性较低。
研究结果表明，物质滥用治疗途径在不同群体之间存在差异。鉴于未满足的治疗需求率较高，有必要采用广泛的治疗需求定义方法。为了在治疗需求的识别中，从基于诊断标准的因素中分离出社会和系统因素，需要进行未来的研究。
