Ethnic differences in utilization of drug treatment services and outcomes among Proposition 36 offenders in California

Abstract

This study examined whether ethnic differences exist in access to care, receipt of services, and associated outcomes of 1,057 offenders participating in California's Proposition 36. Data are based on intake and 3-month follow-up interviews conducted as part of a multisite prospective treatment outcome study. Logistic regressions were conducted to examine ethnicity and other predictors of treatment placement and services intensity. Across ethnic groups, services intensity in several domains was inadequately matched to need, and few services besides substance abuse treatment were provided. Blacks and Hispanics received alcohol and employment services that were not commensurate with their greater need. Although Blacks were more likely to be placed in residential programs, their employment status worsened from intake to follow-up. There were few other ethnic differences in outcomes. Assessing and eliminating ethnic-associated differences in health service delivery, even as moderate as our findings revealed, may improve program processes and outcomes.

Engagement in outpatient substance abuse treatment and employment outcomes

“…Among client characteristics, being younger than 45 years of age, having a high school education or more, and being employed at baseline predicted a higher probability of being employed in the year after treatment index. Also, clients who began substance use in the age ranges of (11)(12)(13)(14), (15)(16)(17) and (18)(19)(20) were more likely to be employed than those reporting first use at 21 and older. On the other hand, clients who reported opiate use in the last 30 days and clients with a treatment index occurring during the fourth quarter in 2008 were significantly less likely to be employed in the year following their index.…”

“…African Americans often enter treatment with more problematic work histories than their White or Latino counterparts, and their employment problems sometimes worsen from treatment intake to follow-up. 16 Men report higher employment rates at treatment entry, while women have shown a greater increase in employment after treatment than men, though their earnings from work do not increase as much as for men. 17,18 To conduct this analysis, the research team went beyond the more typical approach of analyzing administrative and client self-reported data from solely the substance abuse treatment system.…”

Racial and Ethnic Differences in Substance Abuse Service Needs, Utilization, and Outcomes in California

“…Few studies have examined racial and ethnic differences in outcomes of individuals who abuse drugs other than narcotics, and most have found no significant racial or ethnic differences in alcohol, drug, legal, or psychiatric outcomes (3,4,12,22). The exceptions have been findings that compared with whites, Hispanics were more likely to have better family and social outcomes (3) and to have a shorter time to relapse following treatment for methamphetamine abuse (23).…”

“…Among methamphetamine abusers in community treatment, compared with Hispanics, whites received a greater number of services overall and, in particular, a greater number of services addressing their alcohol and psychiatric problems (3). Another study also reported Hispanics' infrequent use of psychiatric services, as well as African Americans' reduced likelihood to utilize legal services despite greater need in this area (12).…”

“…The exceptions have been findings that compared with whites, Hispanics were more likely to have better family and social outcomes (3) and to have a shorter time to relapse following treatment for methamphetamine abuse (23). Also, in a study of drug offenders, African Americans had poorer employment outcomes compared with Hispanics and whites (12). There is a notable lack of research examining African American and Hispanic substance abuse outcomes.…”