Racial and ethnic differences in factors affecting treatment of alcohol and drug use disorders

Because minorities disproportionately experience negative consequences of alcohol/drug misuse, it is important to study race/ethnic variation in characteristics influencing treatment utilization. Using the Andersen-Newman Behavioral Model of Health Services Use we explore predisposing, enabling, and need factors related to past-year (PY) treatment utilization in individuals with PY alcohol and drug use disorders (AUD, n=3182; DUD, n=728). Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a representative sample of non-institutionalized U.S. adults &ge18 years. Regarding factors associated with AUD treatment, the relationships of family history of AUD (negative) and early-onset AUD (positive) were significant only among Hispanics. The positive association with severity (number of symptoms) was stronger among Hispanics than Whites, and the positive association with urban residence was greater among Blacks than Whites. Regarding factors associated with DUD treatment, the positive relationship with education was significant only for Whites, and marriage had a negative association only among Hispanics. Early DUD onset was negatively associated with treatment among Hispanics but positively among Blacks and Whites; the association with prior-to-the-past year treatment for mood/anxiety disorders was negative among Blacks but positive for Whites and Hispanics; and frequency of drug use was positively associated among Hispanics compared to negatively among Blacks. The positive association with urban residence in Blacks was stronger than for Whites. As numerous factors seem to operate differently among race/ethnic groups, targeted interventions for AUD/DUD may be necessary to overcome differential social, cultural, and logistical barriers in race/ethnic subsets of the population.