Examining Racial Disparities in Addiction Treatment
Recent research has shed light on racial disparities in addiction treatment, highlighting the need for a more culturally competent and socially-aware approach in the addiction treatment industry. While many acknowledge drug abuse is a leading public health crisis in the country, racial disparities in addiction treatment are too widespread to ignore.
According to SAMHSA, more than 41 million Americans had a substance use disorder in 2020, yet only 2.7 million received treatment. Of those who needed treatment, white people got help 23.5% of the time, while blacks and Hispanics were 18.6% and 17.6%, respectively.
Another study revealed that Black people were 70% less likely to get a buprenorphine subscription at their visit when controlling for age, sex, and payment method. Most of them have to queue at public clinics every morning for a methadone dose. Buprenorphine is a great alternative to methadone as it can be prescribed by a healthcare provider and taken in the comfort of a private home. No stigma, distrust, or standing in line.
There's also a health equity study of privately insured people who had an overdose and were treated at an ER. The study found that Black people were half as likely to receive overdose treatment compared to white patients. And with the opioid crisis spreading among other ethnic groups like Hispanics and Blacks, this finding is particularly concerning.
The evidence presented in the research demonstrates racial disparities in addiction treatment in the United States. White people are more likely to receive addiction treatment than Black and Hispanic people, which is troubling, as it suggests that certain groups are being underserved and overlooked in the healthcare system. Here's a look at drivers of racial disparities.
Systemic Racism in Healthcare
Although disparities in treatment are multifaceted, race ethnicity is a common theme all through. Systemic racism in healthcare and society at large may contribute to the disparities in addiction treatment outcomes. For example, structural barriers such as limited access to quality healthcare and social determinants of health may disproportionately affect communities of color, leading to greater challenges in accessing and completing addiction treatment.
Inadequate Health Insurance
Inadequate insurance coverage is another major contributor to health disparities. Despite significant efforts to expand access to mental healthcare, many individuals, especially those from racial minority groups, still do not have adequate insurance coverage. Medicaid is the largest payer of mental health services in the United States, and the Affordable Care Act (ACA) expanded Medicaid eligibility to cover more individuals.
However, 12 states are yet to adopt ACA Medicaid expansion. Of these 12 states, 7 are in the southeast region, where most of the US Black population resides. States like Florida and Mississippi have a Black population of 15% and 37%, while the US has a population of 12.4%. This lack of insurance coverage in these states disproportionately affects Black individuals, limiting their access to addiction treatment and other mental healthcare services.
Older Americans Seeking Help and Blacks Being Terminated from Treatment
Current research also highlights two often overlooked aspects of substance use disorder trends. These aspects include facts that Americans 50+ years are increasingly seeking substance treatment and that older Black citizens starting treatment have higher rates of being terminated from treatment and not finishing treatment compared to their white counterparts.
Lack of Culturally Competent Healthcare Providers
A lack of cultural competency among treatment providers may result in an inadequate understanding of black patients' unique challenges and needs, leading to suboptimal treatment approaches.
The Need to Ensure that Care is Ethnically, Racially, and Culturally Appropriate
The addiction treatment industry needs to be more socially aware of systemic racism and its impact on treatment outcomes and people's lives. Substance use disorders affect individuals from all racial and ethnic backgrounds, but access to care and treatment outcomes are unequal across these groups. Historically, communities of color have faced significant barriers to accessing addiction treatment, including a lack of culturally appropriate care and systemic racism in healthcare systems.
To ensure that care is ethnically, racially, and culturally appropriate, the addiction treatment industry must recognize and address systemic racism in healthcare systems. This means increasing diversity among treatment providers and staff, acknowledging and addressing implicit biases, and providing training and education to ensure that providers have the cultural competence necessary to provide effective care to all patients. This includes healthcare training at schools of medicine across the country.
Cultural competence is the ability of healthcare providers to understand and address the unique needs and perspectives of patients from different cultures and backgrounds. In addiction treatment, cultural competence means understanding how addiction and substance use disorders impact different communities and developing treatment plans tailored to each patient's individual needs and preferences.
Research has shown that culturally appropriate care can improve treatment and health outcomes for patients of color. Studies have found that patients are more likely to remain engaged in addiction treatment when they receive care from providers who understand their cultural experiences and can provide culturally appropriate care in addition to the standard of care. Besides, other steps like partnering with local leaders and organizations that aim to reduce inequalities have increased trust and minimized stigma against treatment, which is essential in mental health and addiction treatment.
In addition to improving treatment outcomes, providing culturally appropriate care is a matter of social justice. The addiction treatment industry must recognize that systemic racism and other forms of oppression play a significant role in addiction and substance use disorders and work to address these issues in their policies, practices, and treatment approaches.
- MICRA (Motivational Interviewing and Community Reinforcement Approach) is an example of a culturally responsive intervention that has been successful. MICRA is an evidence-based treatment approach for SUD developed specifically for American Indian and Alaskan Native populations. It incorporates cultural values and traditions into the treatment process.
- The IMANI Breakthrough Recovery Program is another example of a culturally responsive intervention that has been successful. This faith-based initiative addresses substance use disorders (SUD) in Black and Brown communities by providing culturally tailored and trauma-informed support through wellness coaches and group meetings held in local churches.
The addiction treatment industry must take a socially-aware approach to ensure that care is ethnically, racially, and culturally appropriate.
This requires acknowledging and addressing systemic racism in healthcare systems, increasing diversity among treatment providers and staff, and providing training and education to ensure that providers have the cultural competence necessary to provide effective care to all patients. By doing so, the addiction treatment industry can improve treatment outcomes and promote social justice for all patients.
At More Than Rehab, we support this approach to addiction treatment and strive to provide culturally competent care to all our patients. We recognize the importance of addressing racial disparities in addiction treatment and are committed to promoting equity in our services. We believe every patient deserves to be treated with respect, dignity, and compassion, regardless of race, ethnicity, or cultural background.
Our team of highly trained and diverse professionals is dedicated to providing individualized care that considers each patient's unique needs and circumstances. We believe that by taking a socially-aware approach to addiction treatment, we can make a positive impact on our patients' lives and contribute to creating a more just and equitable society.