How long does it take to complete outpatient substance use disorder treatment? Disparities among Blacks, Hispanics, and Whites in the US

Mennis, Jeremy; Stahler, Gerald J.; Magd, Samir A; Baron, David

doi:10.1016/j.addbeh.2019.01.041

Cited by 59 publications

(33 citation statements)

References 44 publications

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“…But, we recognize that our administrative data measures on treatment initiation and engagement may have some issues of fidelity in reporting and in their recording. These measures are consistently used in addiction health services research ( Mennis et al., 2019 ; SAMSA, 2009 ); furthermore, our initiation and engagement rates are consistent with other studies ( Arnd, 2010 ; Kraemer et al., 2019 ; SAMHSA, 2009 ; Stahler et al., 2016 ). Our data is also limited in identifying programs under a parent organization.…”

Section: Limitationssupporting

confidence: 89%

“…These indicators have been explored as access and retention outcomes associated with client characteristics (e.g., race, alcohol and drug use severity) and facility types (e.g., served by non-specialty and integrated primary and addiction care) ( Campbell et al., 2019 ; Yarborough et al., 2018 ). In particular, racial disparities in initiation ( Acevedo et al., 2012 ) and completion ( Mennis, Stahler, Abou El Magd & Baron, 2019 ) have supported the use of these measures to establish performance-based contracting in diverse treatment systems funded by Medicaid.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…Considering program initiation and engagement is critical because these process outcomes are predictors of treatment success and increasingly used for system performance evaluation ( Appel et al., 2004 ; Guerrero et al., 2016 ; Teruya, 2012 ). For instance, successful completion of SUD treatment is associated with long-term client outcomes, such as reduced substance use, future criminal involvement, future employment, and fewer readmissions ( Evans, Li & Hser, 2009 ; Ghose, 2008 ; Mennis et al., 2019 ; TOPPS-II Interstate Cooperative Study Group, 2003 ). State-level completion rates are monitored by health administrators and reported annually by the Agency for Healthcare Quality and Research (2014).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

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Stability in a large drug treatment system: Examining the role of program size and performance on service discontinuation

Guerrero¹,

Al-Ibrahim

Howard

et al. 2020

International Journal of Drug Policy

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Background Little is known about the stability of public drug treatment in the United States to deliver services in an era of expansion of public insurance. Guided by organizational theories, we examined the role of program size, and performance (i.e., rates of treatment initiation and engagement) on discontinuing services in one of the largest treatment systems in the United States. Methods This study relied on multi-year (2006–2014) administrative data of 249,029 treatment admission episodes from 482 treatment programs in Los Angeles County, CA. We relied on survival regression analysis to identify associations between program size, treatment initiation (wait time) and engagement (retention and completion rates) and discontinuing services in any given year. We examined program differences between discontinued versus sustained services in pre- and post-expansion periods. Results Sixty-two percent of programs discontinued services at some point between 2006 and 2014. Program size and rates of treatment retention were negatively associated with risk of discontinuing services. Proportion of female clients was also negatively associated with risk of discontinuing services. Compared to residential programs, methadone programs were associated with reduced likelihood of discontinuing services. Two interactions were significant; program size and retention rates, as well as program size and completion rates were negatively associated with risk of discontinuing services. Conclusions Program size (large), type (methadone), performance (retention) and client population (women) were associated with stability in this drug treatment system. Because more than 70% of programs in this system are small, it is critical to support their capacity to sustain services to reduce existing disparities in access to care. We discuss the implications of these findings for system evaluation and for responding to public health crises .

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Section: Limitationssupporting

confidence: 89%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

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Stability in a large drug treatment system: Examining the role of program size and performance on service discontinuation

Guerrero¹,

Al-Ibrahim

Howard

et al. 2020

International Journal of Drug Policy

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“…34 Differential treatment retention is also evident among Black people receiving treatment for opioid, alcohol, stimulant, and cannabis use disorders. 35,36 Reasons for lower engagement and retention of Black individuals in SUD treatment are poorly studied, but likely due to less social, financial, and environmental supports, a lack of culturally-informed and responsive treatment, mistrust in the healthcare system, and unequal enforcement of treatment rules and requirements. 7,35,36 We would be remiss if we did not also address racial disparities in harm reduction and other services for persons who use drugs.…”

Section: Substance Use Treatment and Harm Reduction Services: Racial mentioning

confidence: 99%

Article Commentary: Dismantling Racism Against Black, Indigenous, and People of Color across the Substance use Continuum: A Position Statement of the Association for Multidisciplinary Education and Research in Substance use and Addiction

et al. 2021

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The Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) acknowledges that racism profoundly affects persons who use alcohol and other drugs. Racism's deadly effects compounded with other social determinants of health result in a cascade of negative impacts. The AMERSA Board of Directors (BOD) proposes an initial set of strategies to promote diversity, equity, and inclusion using a framework that speaks to four key AMERSA experiences: engagement, education, mentorship, and leadership. Through these strategies, AMERSA commits to promoting equity and inclusion to dismantle the individual, institutional, and structural racism that has permeated the United States for centuries.

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“…Yet health research in this rapid increasing population remains at a standstill (Alvarez, 2001;Price & Khubchandani, 2016). Furthermore, a recent study found that among individuals in the United States, Hispanics are less likely to complete substance abuse treatment (Mennis et al, 2019). The overdose rates are increasing for opioids and other drugs (e.g., cocaine) are increasing faster for Latino and Hispanic populations (Bebinger, 2018) than for White individuals; thus, further research is warranted into the correlates for cocaine use among Hispanic individuals.…”

Section: Introductionmentioning

confidence: 99%

The Epidemiology of Cocaine Use Among Hispanic Individuals: Findings From the 2015–2018 National Survey of Drug Use and Health

Yockey

Stryker

2020

Hisp Health Care Int

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Cocaine use disproportionately affects several social groups, including ethnic and sexual minorities. The present study sought to identify the epidemiology of cocaine use among a national sample of Hispanic young adults using pooled data from the 2015–2018 National Survey of Drug Use and Health. Weighted analyses were used to identify correlates to past-year cocaine use. Results revealed that 4.11% ( n = 729) of individuals used cocaine in the past year. Individuals who identified as gay/lesbian or bisexual, who drove under the influence of alcohol in the past year, and who reported prior drug use were at risk of cocaine use. Of concern, nearly 10% of gay/lesbian Hispanic individuals report having used cocaine in the past year. Furthermore, cocaine use was associated with other risky behaviors; 41.1% of LSD (Lysergic acid diethylamide) users also reported cocaine use, and 18.2% of cocaine users reported having driven under the influence of alcohol within the past year. Findings from the present study may inform harm reduction efforts and health prevention messages.

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How long does it take to complete outpatient substance use disorder treatment? Disparities among Blacks, Hispanics, and Whites in the US

Cited by 59 publications

References 44 publications

Stability in a large drug treatment system: Examining the role of program size and performance on service discontinuation

Stability in a large drug treatment system: Examining the role of program size and performance on service discontinuation

Article Commentary: Dismantling Racism Against Black, Indigenous, and People of Color across the Substance use Continuum: A Position Statement of the Association for Multidisciplinary Education and Research in Substance use and Addiction

The Epidemiology of Cocaine Use Among Hispanic Individuals: Findings From the 2015–2018 National Survey of Drug Use and Health

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