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Comorbidities and Race/Ethnicity Among Adults with Stimulant Use Disorders in Residential Treatment.

Journal of Ethnicity in Substance Abuse 2015;14(1):79-95. [doi: 10.1080/15332640.2014.961109]

Katherine Sanchez, PhD, MSSW (University of Texas, Arlington, TX Node), Karen G. Chartier, PhD (Virginia Commonwealth University), N. Robrina Walker, PhD, Thomas Carmody, PhD, Chad D. Rethorst, PhD, Kolette M. Ring, Adriane M. dela Cruz, Madhukar H. Trivedi, MD (all from UT Southwestern Medical Center, TX Node).

Comorbid physical and mental health problems are associated with poorer substance abuse treatment outcomes; however, little is known about these conditions among stimulant abusers at treatment entry. This study compared racial and ethnic groups on baseline measures of drug use patterns, comorbid physical and mental health disorders, quality of life, and daily functioning among cocaine and stimulant abusing/dependent patients. Baseline data from a multi-site, randomized clinical trial of vigorous exercise as a treatment strategy for a diverse population of stimulant abusers (N=290) were analyzed (National Drug Abuse Treatment Clinical Trials Network protocol CTN-0037).

Significant differences between groups were found on drug use characteristics, stimulant use disorders, and comorbid mental and physical health conditions. White, Black, and Hispanic participants reported varied demographic characteristics, substance use patterns and diagnoses, and comorbid mental and physical health conditions. Blacks were more likely to use alcohol and to be diagnosed with a cocaine use disorder only, whereas Whites were more likely to use methamphetamines and a variety of other illicit drugs and to be diagnosed with both a cocaine and other stimulant use disorder or other stimulant use disorder only. Hispanics, similar to Blacks, were more likely to use alcohol, but their rates of methamphetamine use and diagnoses for cocaine and other stimulant use disorder or other stimulant use disorder only fell in between Whites and Blacks. Additionally, Blacks in this study reported fewer psychiatric disorders and symptoms of depression, and better mental health status and well-being than Whites or Hispanics; however, they also reported more comorbid medical conditions, poorer health status, and lower physical and cognitive functioning than other groups. This may be related to barriers to quality medical services for Blacks.

Conclusions: These findings offer implications for stimulant use treatment. They highlight the usefulness of integrating mental and physical health services into substance abuse treatment programs serving racially and ethnically diverse patients. Receipt of primary medical care is associated with lower addiction severity and suggests that efforts to link treatment-seeking substance abusers to primary medical care services should be considered. Integrating mental and physical health care into substance use disorder treatment while paying attention to differences in racial and ethnic groups could have a substantial impact on treatment outcomes. (Article (Peer-Reviewed), PDF, English, 2015)

Keywords: African Americans | Co-occurring disorders | CTN platform/ancillary study | Exercise | Hispanics and Latinos | Integrated medical and behavioral health care | Minority groups | Stimulant abuse | Journal of Ethnicity in Substance Abuse (journal)

Document No: 1118, PMID: 25580933, PMCID: PMC4698967.

Submitted by CTN Dissemination Librarians, 1/21/2015.

Carmody, Thomas mail
Chartier, Karen G.
dela Cruz, Adriane M.
Greer, Tracy L. mail
Rethorst, Chad D. mail
Ring, Kolette M.
Sanchez, Katherine mail
Trivedi, Madhukar H. mail
Walker, N. Robrina mail
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