Racial and Ethnic Diversity Among a Heroin and Cocaine Using Population

Abstract

Knowledge about the meanings and consequences of behaviors associated with drug use among diverse populations is essential for developing effective public health and clinical strategies. In this study we identify racial/ethnic variations in patterns of drug use, Addiction Severity Index (ASI) scores, response to intervention, concordance between self-report of drug use and biochemical confirmation, and treatment system contacts in a sample of 1175 out-of-treatment cocaine and heroin users drawn from a trial of brief motivation in the outpatient clinics of an inner-city academic hospital. Key differences were identified in drug of choice, in all of the ASI domains except medical, in validity of self-report of use, and in rate of treatment contact. Differences related to race and ethnicity should be evaluated to determine needs for a variety of substance abuse treatment modalities, assure timely access to culturally competent care, and develop policies that are tailored to real conditions.

Parenting under the influence: The effects of opioids, alcohol and cocaine on mother–child interaction

“…Similar to national reports, opioid addiction was primarily observed among White mothers (80.9%) while alcohol and cocaine/alcohol addiction was primarily observed among African American mothers (70.2%) (Bernstein et al, 2005; SAMHSA, 2012). African American mothers were observed to show less negative parenting than Whites, in terms of lower undermining autonomy behaviors.…”

“…However, race appears to influence substance use related consequences (Bernstein et al, 2005; Patkar et al 1999; Zapolski, Pedersen, McCarthy, & Smith, 2013) parental discipline (Deater-Deckard, Bates, Dodge, & Pettit, 1996), monitoring (Slesnick et al, 2012), and communication patterns (Baldwin, Baldwin, & Cole, 1990; Steinberg, Dornbusch, & Brown, 1992). …”

Adapting Screening, Brief Intervention, and Referral to Treatment for Alcohol and Drugs to Culturally Diverse Clinical Populations

“…Bernstein et al (2005) studied brief interventions for cocaine and heroin users screened in a routine medical visit in a public hospital, in a large sample (N=1175) that was 14% white, 62% African American and 23% Latino. Cocaine levels in the intervention group, as measured by assay of hair, were reduced by 29% for cocaine and 25% for heroin.…”

“…Currently, the AUDIT has the most extensive evidence base, but research could continue to examine the need to adapt substance use screening tools. Studies reviewed indicate that brief interventions are efficacious with diverse populations (Bernstein et al, 2005; Field et al, 2010) and that cultural adaptations such as ethnic-concordance -matching (Field & Caetano, 2010) and culturally tailored interventions (Lee et al, 2013) lead to greater reductions in substance use post-treatment. Research findings also indicate that minority patients may be more likely to experience treatment admission delays compared to White patients (Lo & Cheng, 2011; Gryczynski et al, 2011).…”

Organizational- and individual-level correlates of posttreatment substance use: A multilevel analysis

“…Client demographics-Some studies indicated that, as compared with Whites, African Americans entering treatment have lower retention rates (Agosti, Nunes, & Ocepeck-Welikson, 1996;McCaul, Svikis, & Moore, 2001;Milligan, Nich, & Carroll, 2004), have more severe levels of addiction (Bernstein et al, 2005), and are more likely to use after treatment (Schildhaus et al, 2000). Hispanics, on the other hand, have been found to be more likely to stay abstinent from any drug use after treatment (Bernstein et al, 2005). Researchers have also found that women are more likely to be involved in treatment (Hser, Huang, Teruya, & Anglin, 2004) and less likely to use after treatment (Hser et al, 2004;Hubbard et al, 1989).…”