Willingness to receive substance abuse treatment in a primary care setting among African American cocaine users

Introduction:  Access to substance abuse treatment (SAT) is an increasing public health concern across the U.S. Integration of SAT with primary care (PC) may help improve access.  Willingness of substance abusers to receive SAT within a PC setting may be an important factor to consider when implementing models of SAT/PC integration. The study examines this willingness in African American cocaine abusers in rural vs. urban settings.

Methods: Data were obtained from the Rural and Urban African American Cocaine Users’ Perceived Need for Care: Follow-Up Study on Medical Care. Rural vs. urban differences in willingness to receive SAT in a PC setting were assessed using logistic regression.

Results: The study found that after adjusting for covariates, rural cocaine users had 0.15 (95% CI: 0.05, 0.40) times the odds of being willing to receive SAT in a PC setting than urban participants (p<0.001). Additionally, those who rated the overall medical care in their community as the best possible had 0.22 (95% CI: 0.07, 0.73) times the odds of being willing to receive SAT in a PC setting than those who rated it as less than the best possible (p<0.05).

Discussion: The findings indicated that both rural residence and high perceived quality in the medical care in a users’ community were associated with a decreased willingness to receive SAT in a PC setting. Further research into the mechanisms causing these differences will be beneficial in informing policy makers, primary care physicians, and other health professionals how to better approach integration of SAT and PC.