Racial health disparities are a significant barrier to maintaining good health and quality of life for communities of colour in the United States. Identifying how these disparities show up in addiction treatment settings, and how to address them, is a critical goal for helping all people with substance abuse struggles achieve recovery. This blog by Keshika Vasuja is going to discuss the racial disparities in terms of substance abuse. Health research in the United States shows that people of colour—including Black, Hispanic, Latinx, Native American, and Asian Americans—generally have different levels of access to addiction treatment services compared to white Americans. These differences in access to treatment, and health outcomes, vary among racial and ethnic groups. Examples of racial disparities in addiction treatment include differences in: • access to quality treatment • receiving an accurate diagnosis • being diverted to addiction treatment rather than the criminal justice system • rates for completing treatment programs for drug and alcohol abuse • length of stay in a treatment program • recovery rates While some may prefer to point to individual behaviours to explain why these disparities exist, the reality is that racial health disparities are systemic issues that cannot be treated solely as individual problems. Drug and alcohol abuse affects millions of people in the United States each year, according to data compiled by U.S. federal health agencies. Both substance abuse and acute withdrawal from drugs and alcohol can have life-threatening consequences for people without access to quality treatment and a social safety net. People of all racial and ethnic backgrounds may share common risk factors—such as a family history of substance abuse, co-occurring mental illness, and early exposure to drugs and alcohol. However, people of colour (POC), especially those who are low-income, are more likely to experience disparities in access to care compared to their white counterparts. Several factors can influence this, including: • racial bias • inadequate financial resources (including lack of health insurance) • stigma in communities of colour • disproportionate criminalization of drug and alcohol use in Black and Brown communities Non-white populations are less likely to be referred to addiction treatment, are less likely to have the financial resources to pay for treatment, and are more likely to be diverted into the criminal justice system for illicit drug use and other drug-related crimes. Each year, the Substance Abuse and Mental Health Services Administration (SAMHSA) collects national data on substance abuse and addiction in the U.S through the National Survey on Drug Use and Health (NSDUH). According to 2018 survey data: • about 2.2 million Black Americans over the age of 18 had a substance use disorder (SUD) • 1 in 7 Black American adults with substance abuse issues struggled with both alcohol and illicit drug use • about 1.1 million Black American adults had a mental illness in addition to substance abuse BLACK AMERICANS Compared to white Americans, Black Americans have slightly higher rates of past-month illicit drug and marijuana use, but lower rates of heavy drinking. National data shows that Black Americans are more likely than other racial groups to seek and receive treatment at a speciality facility. Rates of recovery among Black Americans following treatment, however, are lower than the general population. Black Americans are more likely than other racial groups to be referred to as inpatient addiction treatment through criminal justice settings. Black Americans make up 33% of drug-related incarcerations despite representing only 12.5% of those who use illicit drugs. Black Americans are more likely to be arrested, convicted, and incarcerated for drug-related crimes than white Americans, despite having similar rates of illicit drug use. Access to financial resources and legal protections may be important contributors to this. These disproportionate rates of arrests and incarceration are significant, considering the effects incarceration can have on health and livelihood. Incarceration can lead to poverty, poor health, repeat offences, violence, and lower quality of life. HISPANIC AND LATINX According to 2018 national survey data in Hispanic and Latinx communities: • Hispanics have similar rates of substance use disorders compared to the general population. • Puerto Ricans have the highest heavy drinking rates among Hispanic Americans and are three times more likely to develop alcohol use disorder (AUD) compared to non-white, non-Hispanic Americans. • About 7.1% of Hispanics have a substance use disorder (SUD) compared to 7.4% of the general population. Hispanics and Black Americans are more likely to have shorter inpatient stays for substance abuse, and tend to fare worse after treatment. Hispanics are also incarcerated at disproportionately high rates and have less access to speciality treatment services, especially those that are culturally competent. According to SAMHSA, nearly 90% of Hispanic Americans with substance abuse issues are unable to receive the specialized treatment they need. Among those in treatment for substance abuse, Hispanics are more likely to be houseless. Housing instability, unemployment, and low socioeconomic status can be major barriers to completing addiction treatment programs. Native American communities experience some of the highest rates of drug and alcohol abuse among all racial groups, despite making up a small portion of the population. Factors believed to contribute to this include disproportionate rates of discrimination, access to healthcare, historical trauma, poverty, and high levels of unemployment. Native Americans are also at increased risk for several other health issues, including high rates of suicide, mental illness, diabetes, and heart disease. NATIVE AMERICANS According to 2018 SAMHSA survey data: • one in 11 Native American adults struggle with a substance use disorder • rates of alcohol and marijuana abuse among reservation-based Native American students are 3.4 times higher than those of the general U.S. student population • nearly 25% of Native Americans report binge-drinking in the past month Like Hispanics and Black Americans in treatment settings, Native American patients are more likely to be unemployed and are less likely to complete treatment. Low access to culturally competent treatment services, as well as economic and geographic barriers, are believed to contribute to poorer treatment outcomes. ASIAN AMERICANS On a population level, Asian Americans have lower rates of drug and alcohol abuse compared to other racial and ethnic groups. About 5.3% of Asians, Native Hawaiians, and other Pacific Islanders reported having a substance use disorder in 2018. This is lower than the national average. According to the 2018 national survey data: • Alcohol and drug abuse rates tend to be lower among recent Asian immigrants. • Within Asian American subgroups, Japanese Americans have the highest rates of heavy drinking. • Filipino and Vietnamese American adults have the highest rate of illicit drug use (7.9%) among Asian American subgroups. Despite lower rates of substance abuse and addiction, there are several obstacles Asian Americans who do seek treatment might face within a treatment setting. These include a lack of culturally competent treatment services and bias-based around the model minority myth. The model minority myth is a harmful stereotype that imposes exceedingly high expectations on all Asian individuals as high achievers destined for success. Expectations imposed by this stereotype may also affect Asian Americans’ likelihood of seeking treatment for mental health and substance abuse issues. The ethnic diversity within the umbrella term, “Asian Americans”, may also disguise or make it more difficult to identify the specific risk factors and rates of addiction among ethnic subgroups. Within a treatment centre, strategies to achieve this goal might include:
• hiring treatment providers of colour who may be uniquely capable of identifying the needs of racially marginalized patients and effective treatment approaches • offering a wide array of traditional and holistic treatment services • incorporating diverse cultural values into treatment programs, such as considerations for spirituality, religion, and cultural identity • expanding access to specialty treatment services for low-income patients • addressing potential language barriers by employing bilingual staff members Many people who struggle with substance abuse and addiction require weeks, months, or even years of professional support to achieve full recovery. Helping patients of colour achieve addiction recovery may also require addressing barriers that can extend beyond a 30 - to a 90-day treatment program. While entering an inpatient or residential treatment setting for substance abuse can be critical for immediate stabilization, healing from addiction is not a quick process. Having access to a full continuum of care, including outpatient support, can be very important for supporting people on their recovery journeys. Unfortunately, many economic barriers to this make it difficult for people to access the long-term care they may need. These barriers can include being low-income, housing instability, or lacking transportation. Addressing racial disparities in addiction treatment settings requires a real effort to work with all patients to help them succeed within a treatment program and in their lives beyond. Works Cited: https://www.addictionresource.net/racial-disparities-addiction-treatment/#:~:text=Racial%20health%20disparities%20are%20a%20significant%20barrier%20to,all%20people%20with%20substance%20abuse%20struggles%20achieve%20recovery. https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Substance-Abuse/data https://www.addictioncenter.com/news/2019/10/racial-disparities-opioid-addiction-treatment/
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Welcome to our blog, Medquity!Here we will post extra articles on health disparities to display the profound health inequities in our healthcare system. These are updated every other weekend, so check back regularly! Archives
July 2021
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