Racial/Ethnic Disparities in Mutual Help Group Participation for Substance Use Problems

Abstract

Mutual help groups are a ubiquitous component of the substance abuse treatment system in the United States, showing demonstrated effectiveness as a treatment adjunct; so, it is paramount to understand whether they are as appealing to, and as effective for, racial or ethnic minority groups as they are for Whites. Nonetheless, no known comprehensive reviews have examined whether there are racial/ethnic disparities in mutual help group participation. Accordingly, this study comprehensively reviewed the U.S. literature on racial/ethnic disparities in mutual help participation among adults and adolescents with substance use disorder treatment need. The study identified 19 articles comparing mutual help participation across specific racial/ethnic minority groups and Whites, including eight national epidemiological studies and 11 treatment/community studies. Most compared Latinx and/or Black adults to White adults, and all but two analyzed 12-step participation, with others examining “self-help” attendance. Across studies, racial/ethnic comparisons yielded mostly null ( N = 17) and mixed ( N = 9) effects, though some findings were consistent with a racial/ethnic disparity ( N = 6) or minority advantage ( N = 3). Findings were weakly suggestive of disparities for Latinx populations (especially immigrants, women, and adolescents) as well as for Black women and adolescents. Overall, data were sparse, inconsistent, and dated, highlighting the need for additional studies in this area.

Recovery Capital among Migrants and Ethnic Minorities in Recovery from Problem Substance Use: An Analysis of Lived Experiences

“…Accepting what one can and cannot change as a meaningful form of recovery capital is in line with Anthony’s original view on mental health recovery [ 54 ] and the 12-step philosophy [ 55 ], though none of the respondents participated in 12-step programs. The lack of 12-step involvement among study participants is consistent with literature reporting unique barriers toward mutual aid groups for MEM, often related to cultural differences [ 56 ]. Several authors have pointed out the importance of cultural sensitivity in mutual aid groups to overcome these barriers [ 7 , 57 ].…”

Alcohol or Drug Self-Help Use Among Adults in the United States: Age, Period, and Cohort Effects Between 2002 and 2018

“…Larger cohort effects among younger Black Americans indicate that they are less likely to use peer support services than their non-Hispanic white counterparts. Our findings help clarify mixed results reported in a recent review of racial and ethnic disparities in mutual help participation (Zemore et al, 2021 ), specifically identifying racialized patterns of self-help use in the youngest cohorts. Because self-help engagement could have potential benefits (Kelly et al, 2020 ), cohort differences in self-help use among Black Americans could then translate to differences in SUD-related outcomes and worsening disparities in the USA.…”

“…Consistent with low SUD treatment use, we hypothesized that self-help use would be low throughout the study period, but anticipated higher uptake in recent years due to increases in overdose events contributing to period effects, particularly drug self-help use, as attention to the overdose epidemic increased in the USA. Our study also responds to calls to improve the evidence base examining racial and ethnic disparities in self-help (Zemore et al, 2021). We assessed whether observed relationships varied by sociodemographic characteristics, including race and ethnicity, sex, education, and income.…”

“…In the context of these mixed findings, national trends over time in self-help group participation across subgroups are poorly understood. A recent review of racial and ethnic disparities in mutual help group participation found inconsistent findings signaling potential disparities in use among Hispanic and Black people, and called for updated and methodologically rigorous studies examining self-help use (Zemore et al, 2021 ).…”

From the Editors

“…9 Several articles describe the therapeutic and dynamic mobilizers of recovery-related change across various clinical, nonclinical, and selfmanagement pathways, including articles about the recovery journey (Davidson, Rowe, DiLeo, et al, 2021; Stout, 2021) 11,12 among individuals and their families (McCrady and Flanagan, 2021). 10 This section includes articles on long-term clinical in-person care (McKay, 2021), 13 pharmacology (Mason and Heyser, 2021), 14 and the growing array of community-based recovery support services, such as mutual help organizations (Zemore, Gilbert, Pinedo, et al, 2021), 15 as well as recovery housing, recovery coaching, recovery supports in education, and recovery community centers (Jason, Salomon-Amend, Guerrero, et al, 2021). 16 Demographic and clinical factors that have been shown to affect initiation and trajectories of recovery and related change are featured in depth with specific focus on sex (Holzhauer, Cucciare, and Epstein, 2020), 17 age (Finch, Jurinsky, and Anderson, 2020), 18 and race and ethnicity (Wagner and Baldwin, 2020).…”