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The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013-.
Background: The health and well-being of the United States is improved by the extent to which the entire population has access to substance use treatment if it is needed. Understanding whether non-Hispanic African-Americans or blacks with alcohol and illicit drug abuse problems seek and receive specialty treatment may help improve treatment and outreach programs for this population. Methods: Data from combined 2003 to 2011 National Survey on Drug Use and Health (NSDUH) provide a look at the need for and receipt of substance use treatment among African Americans in the United States. Results: This report indicates that African Americans were less likely than persons of other racial and ethnic groups to need alcohol use treatment in the past year (6.8 vs. 7.8 percent) but more likely to need illicit drug use treatment (4.1 vs. 3.0 percent). Among individuals who needed but did not receive treatment in the past year, African Americans were more likely than persons from other racial and ethnic groups to feel the need for and make an effort to get treatment (2.8 vs. 1.4 percent). Conclusion: This report highlights variations in substance use treatment need and receipt between blacks and persons of other racial and ethnic groups. Among those who needed treatment for illicit drug or alcohol use in the past year, African Americans were more likely than persons from other racial and ethnic groups to receive specialty treatment and they were also more likely to recognize their need for treatment and more likely to make an effort to receive specialty treatment.
The 2010 Census notes that 12.3 percent of the population (38.9 million people) are non-Hispanic African-Americans or blacks (hereafter called blacks).1 The Substance Abuse and Mental Health Services Administration (SAMHSA) is committed to reducing disparities in access to and quality of care for racial and ethnic minorities.2 The overall health and well-being of the Nation is improved by the extent to which the entire population has access to substance use treatment if it is needed. Understanding whether blacks with alcohol and illicit drug abuse problems seek and receive specialty treatment may help improve treatment and outreach programs for this population.
The National Survey on Drug Use and Health (NSDUH) gathers information about needs for substance use treatment, use of services, and reasons people do not receive treatment. NSDUH classifies persons as needing substance use treatment if they meet the criteria for substance dependence or abuse (based on symptoms they report) or if they received substance use treatment at a specialty facility in the past year.3,4,5 Respondents are also asked if there was a time in the past 12 months when they felt they needed substance use treatment.
This issue of The NSDUH Report looks at the need for and receipt of substance use treatment among blacks and persons from other racial and ethnic groups aged 12 or older.6 Estimates in this report are annual averages based on combined 2003 to 2011 data.
Among those aged 12 or older, blacks and persons from other racial and ethnic groups were equally likely to need treatment for substance use in the past year. That is, 9.1 percent of blacks (2.6 million persons) and 9.3 percent of persons from other racial and ethnic groups (20.4 million persons) needed treatment for illicit drug or alcohol use (Figure 1). Although blacks were less likely than persons from other racial and ethnic groups to need treatment for alcohol use (6.8 vs. 7.8 percent), they were more likely to need treatment for illicit drug use (4.1 vs. 3.0 percent).
Need for Substance Use Treatment in the Past Year among Blacks Aged 12 or Older, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
Among those aged 12 or older in need of substance use treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment. An estimated 403,000 blacks (15.2 percent) and 2.0 million persons from other racial and ethnic groups (9.6 percent) needed and received specialty treatment for illicit drug or alcohol use (Figure 2). Among those in need of alcohol treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment for alcohol use (13.5 vs. 7.6 percent). Similarly, among those in need of illicit drug use treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment for illicit drug use (21.3 vs. 17.3 percent).
Receipt of Specialty Substance Use Treatment in the Past Year among Blacks Aged 12 or Older in Need of Treatment, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
An estimated 2.2 million blacks needed but did not receive specialty substance use treatment in the past year, compared with 18.4 million persons for other racial and ethnic groups. Among blacks who needed but did not receive substance use treatment, 92.0 percent did not feel the need for treatment, 5.2 percent felt the need for treatment but did not make an effort to get it, and 2.8 percent felt the need for treatment and made an effort to get it (Figure 3). In comparison, among persons from other racial and ethnic groups, 95.1 percent did not feel the need for treatment, 3.5 percent felt the need for treatment but did not make an effort to get it, and 1.4 percent felt the need for treatment and made an effort to get it.
Past Year Perceived Need for and Effort Made to Receive Specialty Treatment among Blacks Aged 12 or Older Needing but Not Receiving Substance Use Treatment, Compared with Persons of Other Races/Ethnicities, Aged 12 or Older: 2003 to 2011
Blacks who were 12 to 17 or 18 to 25 years of age were less likely than persons in the same age groups from other racial and ethnic groups to need specialty treatment (Table 1). Compared with their counterparts in other racial and ethnic groups, blacks aged 26 or older were more likely to need specialty treatment and were more likely to receive it. Black females were less likely than females of other racial and ethnic groups to be in need of treatment (5.4 vs. 6.5 percent), but black males were more likely to need treatment than males of other races and ethnicities (13.5 vs. 12.3 percent).
Need for and Receipt of Treatment at a Specialty Facility for Substance Use in the Past Year among Blacks Aged 12 or Older, Compared with Persons from Other Races/Ethnicities, by Demographic Characteristics: 2003 to 2011.
Among those with incomes less than 100 percent of the Federal Poverty Level, blacks were less likely than persons from other racial and ethnic groups to need substance use treatment (11.7 vs. 12.8 percent) but no more likely to receive treatment if they needed it. Among those with incomes greater than 200 percent of the Federal Poverty Level, blacks were less likely than persons from other racial and ethnic groups to need treatment (7.7 vs. 8.5 percent) but more likely to receive treatment if they needed it (11.6 vs. 7.6 percent). Blacks with health insurance coverage were less likely to need specialty treatment (7.7 vs. 8.3 percent) and more likely to receive treatment if they did need it (15.4 vs. 8.7 percent).
SAMHSA aims to reduce the impact of substance abuse and improve access to quality behavioral health services and support. This report shows that blacks are more likely to need illicit drug use treatment than individuals from other racial and ethnic groups. Among those who needed treatment for illicit drug or alcohol use in the past year, blacks are more likely than persons from other racial and ethnic groups to receive specialty treatment. Blacks with a substance use problem are more likely to recognize their need for treatment and more likely to make an effort to receive specialty treatment. This report highlights variations in substance use treatment need and receipt between blacks and persons of other racial and ethnic groups. The findings presented here may help guide efforts to address access to specialty treatment facilities and outreach programs for the black population.
Lipari, R.N. and Hager, C. Need for and Receipt of Substance Use Treatment among Blacks. The CBHSQ Report: February 21, 2013. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.
Humes, K. R., Jones, N. A., & Ramirez, R. R. (2011, March). Overview of race and Hispanic origin: 2010 (Census Brief C2010BR-02). Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau.
U.S. Department of Health and Human Services. (2011, April). HHS action plan to reduce racial and ethnic health disparities: A Nation free of disparities in health and health care. Washington, DC: Author.
Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically, including data from original methamphetamine questions but not including new methamphetamine items added in 2005 and 2006.
NSDUH defines dependence on or abuse of alcohol and illicit drugs using criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which include such symptoms as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past year. For details, see: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Substance use treatment at a specialty facility is defined as treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient services only), and mental health centers; it excludes treatment received in an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient.
NSDUH asks a series of questions about race/ethnicity. First, respondents are asked about their Hispanic origin; then they are asked to identify which racial grouping best describes them: white, black/African American, American Indian or Alaska Native, Native Hawaiian, other Pacific Islander, Asian, or other. Respondents may select more than one race. For this report, respondents identifying themselves as Hispanic were assigned to the other race/ethnicity group regardless of their racial identification. Black or African American refers to persons identifying themselves as black or African American only. Persons identifying themselves as black or African American and another racial group are included in the category of persons selecting two or more races.
All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS.
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