Racial/ethnic disparities in patterns and correlates of treatment completion from publicly funded outpatient substance abuse treatment programs

Background: Successful recovery from substance abuse (SA) depends, in part, on completion of recommended treatment. This study examines racial/ethnic differences in rates and correlates of treatment completion among adults discharged from publicly funded SA programs.

Methods: Admission and discharge linked data from Treatment Episode Data Set (2001-2004) were used. Analytic sample consisted of adults discharged from outpatient SA treatment programs with valid data on variables of interest (N=542,623). Bivariate comparisons and logistic regressions were performed to examine racial/ethnic differences in: 1) completion rates before and after adjusting for demographic, socio-economic, and SA characteristics; and 2) correlates of treatment completion by estimating separate models for each group.

Results: Completion rates were significantly lower for African Americans (32.5%) and Hispanics (38.4%) compared to Whites (42.5%), both before and after adjustment for demographic, socio-economic and SA factors (p < .001). Differences in these covariates accounted for 32-40% of the differences in completion rates between minorities and Whites. Correlates of treatment completion were remarkably similar across groups. For all groups, completion rates were higher among men, older, married, more educated, employed, and privately insured patients, and were lower among patients who used drugs more frequently, used multiple drugs, had multiple prior admissions, and who inhaled or injected drugs. SA-related factors were stronger correlates of treatment completion than demographic or socio-economic factors.

Conclusions: There are large differences in rates of outpatient SA treatment completion between minorities and Whites in publicly funded programs. These disparities are only partially explained by demographic, socio-economic, and SA related differences.