Women’s Barriers to Specialty Substance Abuse Treatment: A Qualitative Exploration of Racial/Ethnic Differences

Pinedo, Miguel; Zemore, Sarah E.; Beltrán-Girón, J; Gilbert, Paul A.; Castro, Yessenia

doi:10.1007/s10903-019-00933-2

Cited by 32 publications

(41 citation statements)

References 47 publications

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“…Fourth, there is limited representation in the COGA sample of Asian, Native American/Alaska Native, Pacific Islander, and those who identify by another race(s). Multiple studies have found racial/ethnic differences in service use (e.g., Chartier and Caetano, 2011) as well as gender and race/ethnicity integrations (e.g., Pinedo et al, 2019;Zemore et al, 2014) that we were not powered to examine in the current study. Fifth and relatedly, Hispanic ethnicity was not asked separately in SSAGA-I and SSAGA-II; therefore, we are unable to examine likely sociodemographic and cultural differences between Hispanics and non-Hispanics.…”

Section: Limitationsmentioning

confidence: 96%

“…Accordingly, being male has been found to predict receiving any treatment as well as seeking help with alcohol or drug problems (Chartier and Caetano, ; Gilbert et al, ; Ilgen et al, ) and inpatient care (Raimo et al, ). Women have reported barriers to receiving services for substance use to be stigma, lack of support from family, difficulty finding services, and cost (Pinedo et al, ). These barriers are amplified due to their enhanced family role as mothers and the fact that such disorders are often seen as “male” problems (i.e., in Latino cultures; Pinedo et al, ).…”

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

“…Women have reported barriers to receiving services for substance use to be stigma, lack of support from family, difficulty finding services, and cost (Pinedo et al, ). These barriers are amplified due to their enhanced family role as mothers and the fact that such disorders are often seen as “male” problems (i.e., in Latino cultures; Pinedo et al, ). One study has also noted a mediational model among white males and females whereby social pressure, legal consequences, and work‐related consequences reduced females’ likelihood of receiving services for alcohol problems (Zemore et al, ).…”

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

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Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Bourdon

Tillman

Francis

et al. 2020

Alcoholism Clin & Exp Res

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Background There are gaps in the literature on service use (help‐seeking and treatment utilization) for alcohol problems among those with alcohol use disorder (AUD). First, policy changes and cultural shifts (e.g., insurance) related to AUD have occurred over the last few decades, making it important to study generational differences. Second, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations can inform public health and research endeavors. The current study examined service use for alcohol problems among individuals with AUD. The aims were as follows: (i) to describe service use for alcohol problems; (ii) to assess generational differences (silent [b. 1928 to 1945], boomer [b. 1946 to 1964], generation X [b. 1965 to 1980], millennial [b. 1981 to 1996]) in help‐seeking and treatment utilization; and (iii) to examine sex differences across generations. Methods Data were from affected family members of probands who participated in the Collaborative Study on the Genetics of Alcoholism (N = 4,405). First, frequencies for service use variables were calculated across generations. Pearson chi‐square and ANOVA were used to test for differences in rates and types of service use across generations, taking familial clustering into account. Next, Cox survival modeling was used to assess associations of generation and sex with time to first help‐seeking and first treatment for AUD, and time from first onset of AUD to first help‐seeking and first treatment. Interactions between generation and sex were tested within each Cox regression. Results Significant hazards were found in all 4 transitions. Overall, younger generations used services earlier than older generations, which translated into higher likelihoods of these behaviors. Regardless of generation, younger females were less likely to use services than males. Conclusions There are generational and sex differences in service use for alcohol problems among individuals with AUD. Policy and clinical implications are discussed.

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Section: Limitationsmentioning

confidence: 96%

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

See 1 more Smart Citation

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Bourdon

Tillman

Francis

et al. 2020

Alcoholism Clin & Exp Res

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“…39 Both before and during recovery from AUD, the life contexts of minority populations are likely to include more pervasive and enduring hardships, stresses, and disadvantages compared to the life contexts of majority populations. [40][41][42][43][44][45][46][47] Among marginalized minority groups, disadvantaged life contexts are (1) socially determined, (2) a function of social injustices, and (3) the primary causes of health inequities and disparities. 41,42 This means that the long-term elimination of health disparities, including those associated with recovery from AUD, is dependent on social change.…”

Section: Challenges To Recovery Among Minority Populationsmentioning

confidence: 99%

“…Research has identified a range of socially determined disadvantaged life contexts that significantly impact the course of AUD among minority populations; [40][41][42][43][44][45][46][47] it is very likely that these same social determinants significantly impact recovery from AUD. Key social determinants that may influence recovery among minority populations include: Such inequity in exposure to economically disadvantaged and health-compromising life contexts is a pressing environmental justice issue.…”

Section: Challenges To Recovery Among Minority Populationsmentioning

confidence: 99%

Recovery in Special Emphasis Populations

Wagner¹,

Baldwin

2020

ARCR

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Special emphasis populations in the current context can be defined as groups experiencing health disparities resulting in elevated risk to health, safety, and well-being from drinking alcohol. Individuals from marginalized minority populations often encounter barriers to accessing and receiving effective alcohol treatment due to social inequities and disadvantaged life contexts, which also may adversely affect recovery from alcohol use disorder (AUD). Recovery from AUD often involves the adoption of a stable non-drinking lifestyle (sobriety), increased health and well-being, and increased social connection. Although there has been considerable work on AUD epidemiology among special emphasis populations, little research exists directly examining recovery among racial/ethnic minority populations and/or sexual and gender minority populations. The current narrative review hopes to spark scholarly interest in this critically neglected area. This article opens with a review of special emphasis populations and their alcohol-related risks. Next, definitions of recovery, Alcoholics Anonymous, and culturally adapted recovery models for racial/ethnic minority populations are explored. This is followed by a discussion of factors that may particularly influence recovery among marginalized minority populations. This narrative review concludes with a discussion of research priorities for promoting health equity through studies focused on understanding and supporting recovery from AUD among marginalized minority populations.

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Assessment of Racial and Ethnic Disparities in the Use of Medication to Treat Opioid Use Disorder Among Pregnant Women in Massachusetts

et al. 2020

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IMPORTANCE Racial and ethnic disparities persist across key health and substance use treatment outcomes for mothers and infants. The use of medications, such as methadone or buprenorphine, for the treatment of opioid use disorder (OUD) has been associated with improvements in the outcomes of mothers and infants; however, only half of all pregnant women with OUD receive these medications. The extent to which maternal race or ethnicity is associated with the use of medication to treat OUD, the duration of the use of medication to treat OUD, and the type of medication used to treat OUD during pregnancy are unknown.OBJECTIVE To examine the extent to which maternal race and ethnicity is associated with the use of medications for the treatment of OUD in the year before delivery among pregnant women with OUD. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study used a linked populationlevel statewide data set of pregnant women with OUD who delivered a live infant in Massachusetts between October 1, 2011, and December 31, 2015. Of 274 234 total deliveries identified, 5247 deliveries among women with indicators of having OUD were included in the analysis. Maternal race and ethnicity were defined as white non-Hispanic, black non-Hispanic, or Hispanic based on selfreported data on birth certificates. MAIN OUTCOMES AND MEASURESMain outcomes were the receipt of any medication for OUD, the consistency of the use of medication (at least 6 continuous months of use before delivery, inconsistent use, or no use) for the treatment of OUD, and the type of medication (methadone or buprenorphine) used to treat OUD. Multivariable models were adjusted for maternal sociodemographic characteristics, comorbidities, and any significant interactions between the covariates and race and ethnicity. RESULTSThe sample included 5247 pregnant women with OUD who delivered a live infant in Massachusetts during the study period. The mean (SD) maternal age at delivery was 28.7 (5.0) years; 4551 women (86.7%) were white non-Hispanic, 462 women (8.8%) were Hispanic, and 234 women (4.5%) were black non-Hispanic. A total of 3181 white non-Hispanic women (69.9%) received any type of medication for the treatment of OUD in the year before delivery compared with 228 Hispanic women (49.4%) and 108 black non-Hispanic women (46.2%). Compared with white non-Hispanic women, black non-Hispanic and Hispanic women had a substantially lower likelihood (adjusted odds ratio [aOR], 0.37; 95% CI, 0.28-0.49 and aOR, 0.42; 95% CI, 0.35-0.52, respectively) of receiving any medication for the treatment of OUD. Stratification by maternal age identified greater disparities among younger women. Black non-Hispanic and Hispanic women also had a lower likelihood (aOR, 0.24; 95% CI, 0.17-0.35 and aOR, 0.34; 95% CI, 0.27-0.44, respectively) of consistent use of medication for the treatment of OUD compared with white non-Hispanic women. With respect to (continued) Key Points Question Do differences by maternal race and ethnicity exist in the use of methadone or buprenorphine...

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Women’s Barriers to Specialty Substance Abuse Treatment: A Qualitative Exploration of Racial/Ethnic Differences

Cited by 32 publications

References 47 publications

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Recovery in Special Emphasis Populations

Assessment of Racial and Ethnic Disparities in the Use of Medication to Treat Opioid Use Disorder Among Pregnant Women in Massachusetts

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