Yale University School of Medicine, New Haven, CT, USA.
U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, USA.
J Addict Dis. 2022 Jul-Sep;40(3):345-356. doi: 10.1080/10550887.2021.1997038. Epub 2021 Nov 8.
Racial disparities in access to psychiatric treatment are well documented, but less is known about disparities in use of substance use disorder (SUD) treatment.
To compare Black and White individuals with SUDs on overall differences and correlates of SUD treatment receipt.
Using nationally representative survey data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we compared Black (n = 1,312 unweighted) and White (n = 3,076 unweighted) adults with past-year SUDs on proportions who received SUD treatment and on sociodemographic and clinical correlates of receiving treatment. Due to large samples, effect sizes, rather than -values, were used to identify substantial differences between racial groups. Multivariate analyses were used to identify independent differentiating factors.
Black individuals with past-year SUDs were no less likely to receive treatment than White individuals (10.1% versus 11.3%; = 0.24). Bivariate analyses demonstrated similar correlates of treatment receipt between racial groups, including sociodemographic disadvantage, racial discrimination, criminal justice involvement, low social support, multimorbidity of SUDs and psychiatric disorders, and prior SUD treatment. Multivariate analyses demonstrated that low income, unemployment, and criminal justice involvement had a significantly stronger association with receiving treatment for Whites, while parental problems with alcohol was more strongly associated with treatment among Black individuals ( < 0.05).
Recognizing methodological limitations, our findings are encouraging suggesting that Black individuals with SUDs are not less likely than White individuals to receive treatment and have few differences in correlates of receiving treatment. However, treatment receipt was low for both groups and remains a major unmet challenge.
精神治疗获取方面的种族差异已得到充分记录，但关于物质使用障碍（SUD）治疗获取方面的差异知之甚少。
比较 SUD 患者中的黑人和白人在总体差异及 SUD 治疗获取相关因素方面的差异。
使用全国代表性调查数据，即《国家酒精与相关状况流行病学调查-III》（NESARC-III），我们比较了过去一年有 SUD 的黑人和白人成年人在接受 SUD 治疗的比例，以及接受治疗的社会人口统计学和临床相关因素。由于样本量较大，使用效应大小（而不是 p 值）来确定种族群体之间的显著差异。多变量分析用于确定独立的区分因素。
过去一年有 SUD 的黑人患者接受治疗的可能性并不低于白人患者（10.1%对 11.3%；p=0.24）。 单变量分析表明，种族群体之间存在相似的治疗获取相关因素，包括社会人口统计学劣势、种族歧视、刑事司法涉入、低社会支持、SUD 和精神障碍的多病共存，以及之前的 SUD 治疗。多变量分析表明，对于白人来说，低收入、失业和刑事司法涉入与接受治疗的关联更强，而父母酗酒问题与黑人接受治疗的关联更强（p<0.05）。
考虑到方法学的局限性，我们的研究结果令人鼓舞，表明 SUD 黑人患者与白人患者相比，接受治疗的可能性并不低，且在接受治疗的相关因素方面差异不大。然而，两组的治疗率都很低，这仍然是一个未满足的主要挑战。
