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

• Published in: Addictive behaviors Vol. 93; pp. 158 - 165
• Main Authors: Mennis, Jeremy, Stahler, Gerald J., El Magd, Samir Abou, Baron, David A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2019; Elsevier Science Ltd
• Subjects: Addictions; Cultural differences; Disparity; Drug addiction; Drug use; Hispanic people; Length of stay; Minority & ethnic groups; Outpatient; Race; Regression analysis; Sex offenders; Substance abuse treatment; Substance use; Substance use disorder; Treatment completion; Treatment duration; United States > US; Outpatient; Disparity; Treatment duration; Treatment completion; Race; Length of stay
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2019.01.041

This research investigates racial and ethnic disparities in outpatient substance use disorder treatment completion and duration in treatment, for different substances, across the US, using the national 2014 Treatment Episode Dataset-Discharge (TEDS-D) data set. Moderated fixed effects logistic regression models assessed effects of race/ethnicity on length of stay in treatment and treatment completion for different substances of use. Moderated models also assessed the differential effect of length of stay on treatment completion among Blacks, Hispanics, and Whites. While Blacks and Hispanics both have significantly lower treatment completion rates than Whites, treatment duration is substantially similar across the three groups. Blacks and Hispanics generally take longer to complete treatment than Whites, though this varies by substance for Hispanics. Disparities in treatment completion persist even after controlling for treatment duration. These results indicate that observed racial and ethnic disparities in treatment completion are not due to differences in length of stay in treatment. Economic, cultural, accessibility, or, potentially, discriminatory, factors may suppress the likelihood of treatment completion for minorities and result in longer treatment durations required for completion. Recognition by treatment providers of the unique challenges to treatment completion faced by minorities may enhance treatment outcomes for minorities in the US.
•Blacks and Hispanics take longer to complete outpatient SUD treatment than Whites.•Treatment duration does not fully explain the racial/ethnic disparity in completion.•For Hispanics, the differential effect of duration on completion varies by substance.•Socioeconomic factors may influence the duration required for treatment completion.