Racial Disparities in Substance Use Treatment Completion Among Older Adults

Abstract

Background and Objectives Racial disparities in substance use among young adults has been well-documented in the substance use literature, but little attention has been paid to older adults. While being an older adult is positively associated with substance use treatment completion, racial disparities in treatment completion have yet to be examined. The purpose of this study was to determine to what extent racial disparities exist in substance use treatment completion among older adults (65 and older). Research Design and Methods This cross-sectional study utilized data from the most recent Treatment Episode Data (TEDS-D) from SAMSHA, which documents discharges from a publicly funded substance use treatment program in the United States. A total of 17, 942 older adults reported to a substance use treatment program in 2017 and 6,653 met the criteria for the study. Chi square tests were used to analyze group differences and a binary logistic regression was used to predict substance use treatment completion. Results Results show that Black older adults were 37% less likely to complete a substance use treatment program than Whites (OR=.630) while Hispanic older adults were 26% more likely to complete a substance use treatment program than Whites (OR=1.26). Discussion and Implications These results support the findings from similar studies with younger adults and support the theory that racial disparities are prevalent across the lifespan. Although Hispanics had a higher treatment completion rate than Whites, this is likely a reflection of familismo, where decisions about health treatments is a group process and a steady network of family members are available to provide advice and encouragement. The significant disparity observed between Black and White older adults suggest a need to consider cultural, historical, and systemic factors that affect voluntary termination of substance use treatment among Black older adults.

Substance Use Disorders in the Geriatric Population: a Review and Synthesis of the Literature of a Growing Problem in a Growing Population

“…There also exist disparities in completion of substance use treatment programs. Suntai et al found that, among older adults, Black older adults were 37% less likely to complete a substance use treatment program than Whites, while Hispanic older adults were 26% more likely to complete a substance use treatment than Whites [ 84 ]. These results are similar to the results shown in studies of younger adults, suggesting that racial disparities must be addressed in substance use treatment across ages.…”

Racial and Ethnic Disparities and Prevalence in Prescription Drug Misuse, Illicit Drug Use, and Combination of Both Behaviors in the United States

“…The authors (Whitehead et al, 2014 ) observed that older Black participants were two times more likely to use crack in the past 6 months as compared to their younger counterparts. In another study by Suntai et al ( 2020 ), older Black adults were less likely to complete a substance use treatment program than their White counterparts. Lack of substance use treatment may be a factor associated with higher illicit drug use and the combination of both prescription drug misuse and illicit drug use, as observed in this research.…”

“…Racial and ethnic disparities continue to be a factor associated with different health outcomes or health behaviors in the United States among various age groups (Chen et al, 2016 ; Churchwell et al, 2020 ; Fiscella & Sanders, 2016 ; Gandhi et al, 2020 ; Gollust et al, 2018 ; Hammonds & Reverby, 2019 ; Lebrun & LaVeist, 2011 ; Manuel, 2018 ; Norton et al, 2016 ; Suntai et al, 2020 ). Racial and ethnic disparities also exist in other public health challenges like illicit drug use and prescription drug misuse.…”

Five-Year Cardiovascular Outcomes after Infective Endocarditis in Patients with versus without Drug Use History

“…Among Black patients, ischemic stroke was significantly higher among PWUD. Previous work has acknowledged the systemic and institutional disadvantages faced by women and racial/ethnic minorities when receiving care for IE and for substance use disorders in general [ 15 , 38 ]. The recommendations of previous authors and the American Association for Thoracic Surgery, including the need to connect PWUD to addiction medicine services, with special attention to vulnerable demographic populations, are especially relevant [ 18 , 39 , 40 ].…”