Resources To Overcome Treatment Disparities In Addiction Care For Minorities

Due to the disparities in addiction care, minorities in the U.S. are less likely to receive addiction treatment and to complete treatment programs than their white counterparts.

If left untreated, an alcohol addiction or drug addiction can lead to problems at work, relationship issues, legal difficulties, and health issues. All of these disrupt daily life, and can, ultimately, be fatal.

For this reason, it’s essential that anyone living with a substance use disorder has access to competent care. 

Solutions exist for ensuring that all people in need of addiction treatment get the care they need.

Addiction Treatment Disparities Minorities Face

Substance abuse is a serious issue in the U.S., yet the vast majority of people who require addiction treatment aren’t receiving it.

In 2018, just 18% of people who needed treatment for substance use disorders received it, according to Yale researchers. For Black and Hispanic Americans, it was just 8% to 10%. 

There is also a four-to-five-year treatment entry delay for Black Americans who do seek care.

Rates of substance abuse among American Indian/Alaska Native (AI/AN) populations are higher than the general U.S. population, but members of these communities are statistically less likely to receive treatment.

These disparities in treatment and the resulting outcomes must be addressed in order to establish health equity in America for all people living with a drug or alcohol addiction.

Below, we’ll discuss some of the most pressing issues minorities face when seeking addiction care in the U.S.

Inadequate Health Insurance Coverage

Healthcare costs are a concern for many Americans, and those without health insurance coverage may be reluctant to seek care.

Recent data shows that 21.2% of AI/AN people, 19% of Hispanic people, and 10.9% of Black people don’t have any health insurance, versus 7.2% of non-Hispanic whites.

The expansion of Medicaid through the Affordable Care Act (ACA) in 2010 did provide more Americans with healthcare coverage, but many states in the Southeast haven’t adopted these changes.

These states represent the highest number of uninsured Americans, as well as the highest populations of Black people.

Socioeconomic Factors

Social and economic factors such as income, education, and community safety can have a big impact on a person’s overall health, stress levels, and access to care.

For example, living in poverty might make someone less likely to seek care because they are overwhelmed by stress, uninsured, or unable to get to appointments.

Although poverty levels for non-Hispanic white Americans have remained relatively steady over the last several decades, there is a recent drop in minority poverty rates.

However, these rates are still much higher than the 7.3% poverty rate for white Americans, at 18.8% for Black Americans and 15.7% for Hispanic Americans.  

Greater unemployment and housing instability also contribute to considerably lower rates of treatment program completion among Black, Hispanic, and AI/AN people.

Biased Drug Policies

A historically biased legal system has also made it difficult for minorities to receive treatment for drug abuse in the United States.

The way Black Americans were treated during the crack epidemic of the 1980s and the way people are treated today during the opioid epidemic is just one example of contrasting responses.

While the former ignited the War on Drugs and led to longer prison sentences for people caught using or dealing crack, the latter is seen as a public health emergency with more leniency for offenders. 

Prejudice and racism can be seen in the “Terry frisks,” or searches that don’t require a warrant or probable cause, spurred by the War on Drugs.

Of the 45,000 of these searches made in New York City in 1998 and 1999, 35,000 found nothing, and 67% of the people searched were Black or Hispanic. 

Recognizing racial biases and having compassion for all people with substance use disorders can go a long way toward ensuring that everyone receives the care they need. 

Lack Of Cultural Competence Among Healthcare Workers

When addiction treatment providers are unaware of the cultural influences surrounding a person’s substance abuse, they are unable to provide the best treatment and care.

This misunderstanding of how values, beliefs, and attitudes differ can result in incomplete treatment programs and poorer results following treatment.

An analysis of over 72,000 people who received addiction treatment revealed that Black Americans were less likely than non-Hispanic whites to reduce substance use after treatment.

Less Likely To Receive Buprenorphine Treatment

Buprenorphine is one of three evidence-based prescriptions approved for the treatment of opioid use disorder. It helps people safely detox from opioids and can help them maintain their recovery.

Recent studies show that Black Americans, who experience opioid abuse at nearly the same rate as white Americans, are much less likely to be prescribed buprenorphine. 

Some prescribers only accept cash payments for the prescription, creating further barriers for some people.

Research also shows that minorities are provided shorter treatment cycles for lifesaving addiction medications than white patients are.

Overcoming Addiction Care Disparities Among Minorities

Being aware of the disparities that exist for minority populations in the U.S. in need of addiction treatment care is the first step toward achieving treatment equity.

The next step is taking action to eliminate barriers to addiction treatment care and outcomes.

More Minorities As Treatment Providers

One solution that would help address the lack of cultural awareness among treatment providers is to train and hire more minority addiction treatment specialists.

Living with an addiction can be an isolating experience, which makes having care providers who look like you and understand your needs all the more important.

This can help establish trust, which is essential for a successful recovery.

Motivational interviewing (MI) and the community reinforcement approach have proven especially helpful for AI/AN people in recovery from substance abuse.

Faith-based programs held in local churches are another approach that is seeing success within Black and Brown communities.

Training On Cultural Competence Issues

In addition to hiring more minorities, addiction treatment centers can train their current employees on cultural issues that have a significant impact on substance use and abuse.

This includes being aware that minorities are disproportionately affected by chronic illness compared to white Americans, which can impact their finances and mobility, creating barriers to treatment.

Training programs that teach culturally responsive care include Recognizing and Eliminating disparities in Addiction through Culturally informed Healthcare (REACH).

Another option is Achieving Culturally Competent and Equitable Substance use Services (ACCESS). Both are university programs backed by federal or local mental health funds.

Continued Expansion And Acceptance Of Medicaid

Although the number of minorities in America who don’t have health insurance remains high, more people have found coverage since Medicaid’s expansion via the ACA.

However, states that have not expanded Medicaid have twice as many uninsured citizens as states that have adopted Medicaid’s expansion.

Members of minority groups in states without expansion are less likely to have insurance coverage than those in states that have expanded Medicaid.

The gap between white Americans who don’t have insurance and members of minority groups who don’t have insurance is also larger in these states.

How Minorities Can Find Treatment For Mental Health Disorders

Mental health is just as critical as physical health to our overall well-being. Mental illness is common in the U.S., with one in five adults experiencing a mental illness each year. 

There are several ways members of minority groups who are uninsured can go about finding competent mental health preventative care and treatment options.

Here are a few steps to take to find the care you need:

• A quick screening at Healthcare.gov can tell you if you qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or another health insurance option.
• If you do qualify, you can get help finding healthcare providers who accept Medicaid.
• If you don’t qualify, or if you can’t access Medicaid, try searching for a community clinic in your area. These clinics typically offer free or low-cost options.
• Search for online free or low-cost mental health care options specific to your race or ethnicity.
• Once you do find a provider, ask them if they have experience working with people in your minority group.

How Minorities Can Find Treatment For Substance Abuse Disorders

In addition to determining eligibility for health insurance assistance at Healthcare.gov, members of minority groups can search for free or low-cost addiction treatment or rehab centers online.

There are dozens of free rehab centers across the U.S., and many are able to provide care for people who live out of state.

Look for centers that are accredited by reputable national accrediting bodies, and make sure that they have experience treating people within your minority group. 

What To Look For In A Drug Rehabilitation Program

Some questions to ask before beginning treatment to ensure that the treatment team can provide the care you need include:

• Do you have experience working with people in my racial/ethnic group?
• What services do you offer pertaining to my racial/ethnic group?
• Will I have access to minority-focused recovery groups?
• What are my options for paying for treatment? Do you accept Medicaid (if applicable)?
• What aftercare addiction services do you provide?

A care team that understands your needs will be happy to answer any questions you may have and will provide answers that offer practical information for you.

Don’t hesitate to call other treatment centers if you believe your needs won’t be met.

Resources For Addiction Treatment Providers

Many treatment centers want to provide robust addiction services that meet a wide variety of needs but don’t always know how to do so.

The following resources are a good place to start for meeting the treatment needs of members of minority groups:

• American Psychiatric Association’s Best Practice Highlights for Treating Diverse Patient Populations: best treatment practices related to each specific minority group 
• National Association for Alcoholism and Drug Abuse Counselors’ Position Statement on Critical Issues in the Black Community: a resource for learning more about addiction treatment disparities for Black Americans and how to overcome them
• National Hispanic and Latino Addiction Technology Transfer Center Network: New Mexico-based association that helps educate the addiction and recovery healthcare workforce serving Hispanic and Latino communities
• Yale University’s Recognizing and Eliminating disparities in Addiction through Culturally informed Healthcare (REACH) Program: Yale University partnered with the American Academy of Addiction Psychiatry to offer this program teaching culturally informed behavioral healthcare.
• Boston University’s Achieving Culturally Competent and Equitable Substance use Services (ACCESS) Program: Boston University and the Health Resources Services Administration’s training program for providing culturally responsive behavioral healthcare

Resources For Minorities Seeking Addiction Care

One of the best things that people belonging to minority groups can do to ensure that their treatment needs will be met is to advocate for their own care.

This can be difficult to do when facing a health challenge such as a substance use disorder, but there are resources available to help.

Resources For AI/AN People Seeking Addiction Treatment

The following are resources for AI/AN people looking for addiction treatment services and support. 

• Centers for Medicare & Medicaid Services’ Division of Tribal Affairs: plentiful Medicare and Medicaid-related resources for AI/AN people along with substance abuse resources
• Indian Health Services’ Substance Abuse and Suicide Prevention Program: free information and resources from the government for AI/AN people living with addiction and other mental health issues
• National Center on Substance Abuse and Child Welfare’s Tribal Community Resources: a wide variety of free substance abuse treatment resources for AI/AN communities, including an addiction treatment locator
• Rural Health Information Hub: resources from the U.S. Department of Health and Human Services for AI/AN people experiencing substance abuse 
• Substance Abuse and Mental Health Services Administration (SAMHSA)’s Office of Tribal Affairs: the branch of the federal government dedicated to meeting the addiction services needs of AI/AN people 
• Unspoken Words Podcast: Three Native Americans share their stories of addiction to support other indigenous people facing the same issues.
• White Bison: a nonprofit organization founded and run by members of the AI/AN community dedicated to culturally based approaches to addiction prevention and treatment among AI/AN people

Resources For Black People Seeking Addiction Treatment

The following are resources for Black Americans looking for addiction treatment services and support. 

• Imani Breakthrough Project: a faith-based harm-reduction recovery program for members of the Black community living with an addiction
• National Alliance on Mental Illness’ Black/African American Identity and Cultural Dimensions: resources related to all aspects of mental health among Black communities in the U.S.
• National Association of Black Counselors: an advocacy and membership organization dedicated to helping Black Americans find mental health services
• SAFE Project’s Addiction & Mental Health Resources for the Black Community: a wide variety of free resources for Black Americans living with addiction or other mental health conditions
• SAMHSA’s Behavioral Health Equity for Black/African Americans: addiction resources from the U.S. government for Black Americans, including national surveys, federal initiatives, etc.
• Sober Black Girls Club Podcast: Two young Black women share their stories of recovery and living a sober life in support of others in recovery.

Resources For Hispanic People Seeking Addiction Treatment

The following are resources for Hispanic people looking for addiction treatment services and support. 

• Checking In Podcast: a mental health and substance abuse-focused podcast that features interviews with people working to establish health equity for Latino communities
• National Alliance on Mental Illness’ Hispanic/Latinx American Identity and Cultural Dimensions: Resources related to all aspects of mental health among Hispanic/Latino communities in the U.S.
• Partnership to End Addiction: Available in Spanish, this website offers resources to help parents prevent teenage substance abuse.
• SAFE Project’s Addiction & Mental Health Resources for the Latinx and Hispanic Communities: a wide variety of free resources for Latino and Hispanic Americans living with addiction or other mental health conditions
• SAMHSA’s Behavioral Health Equity for Hispanic/Latino Americans: substance abuse resources and support for Hispanic/Latino Americans including survey reports, agency initiatives, etc.
• Yeah No, I’m Not OK Podcast: Substance abuse and other mental health issues among Latinos and other people of color are the topics of this podcast hosted by Latina actor Diane Guerrero.