Racial/ethnic Disparities in Patterns and Correlates of Adolescent Treatment Completion from Publicly Funded Outpatient Substance Abuse Treatment Programs

BACKGROUND: Recovery from substance abuse (SA) depends, in part, on completion of recommended treatment. This study assesses differences in rates and correlates of treatment completion (TC) among adolescents admitted to publicly funded SA programs.

METHODS: We used admission and discharge linked data from Treatment Episodes Data Set(2001-2004). Analytic sample consisted of adolescents (12-17 years) with valid data on variables of interest (n=73,100). We conducted multivariate logistic regression analyses to examine racial/ethnic differences in rates and correlates of TC.

RESULTS: We found significantly lower TC rates among African Americans (33.5%) and Hispanics (39.4%) compared to Whites (45.1%) both before and after adjustment for covariates (p <.05). Among all groups, TC rates were higher among adolescents who were employed, privately insured, and stayed in treatment longer. In contrast, TC rates were lower among adolescents who used drugs more frequently, those who self- or family-referred for treatment, and those who had multiple prior admissions. Type, number, route and age at first use of drugs and co-occurring psychiatric disorders were related to TC differently among different racial/ethnic groups. For example, earlier age of drug use initiation and current use of multiple drugs were negatively associated with TC among Whites but not among African Americans.

CONCLUSIONS: There are large differences in TC rates between minority and White adolescents in publicly funded outpatient SA programs. These disparities are only partially explained by socio-economic and substance abuse differences. Efforts to understand and reduce racial/ethnic disparities in TC would require examination of broader contextual and structural factors.