The 130th Annual Meeting of APHA

4237.0: Tuesday, November 12, 2002 - 5:24 PM

Abstract #45859

Gender, cultural, and structural barriers facing African-American crack-abusers

Wendee Wechsberg, PhD, Wendy K.K. Lam, PhD, and William A. Zule, DrPH. Substance Abuse Treatment Evaluations and Interventions, Research Triangle Institute, PO Box 12194, 3040 Cornwallis Drive, Research Triangle Park, NC 27709-2194, 919-541-6422,

African-American crack abusers in need of public health and treatment assistance are more likely found on the streets than in treatment. Gender differences have been found among substance abusers, though community agencies are often ill equipped to cope with different service demands within this under served population. This paper presents an ongoing study funded by the National Institute on Drug Abuse of a pretreatment intervention designed to reduce treatment barriers for out-of-treatment African-American crack abusers. To explore these issues, we collected data from both crack users (female: n=105, male: n=247) and treatment program staff (n=56). At baseline, significant gender differences were found, with men more likely to be homeless and have a high school education, and women more likely to be heavy crack users, to be responsible for all their children, and to have insurance. Although 71 participants were referred for treatment, only 10% of men and 2% of women actually entered treatment (p=0.06). To examine potential barriers, we administered a questionnaire to staff in two treatment programs serving study participants. Staff identified major treatment barriers for crack-using clients including lack of childcare, insurance, and lack of cultural sensitivity of treatment programs, suggesting potentially gender- and culture-related barriers facing African-American crack-users. Over 80% of staff respondents reported strong interest and need for training on issues related specifically to African-American crack-users. These preliminary results underscore the importance of involving community agencies to address treatment barriers.

Learning Objectives:

Keywords: Barriers to Care, Gender

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Drug Use Problems and Addiction Issues

The 130th Annual Meeting of APHA