(WITHDRAWN) Racial Disparities in Substance Use Treatment Completion Among Older Adults

Background: Racial disparities in substance use among young adults has been well-documented in the substance use literature but little attention has been paid to older adults. In the general population Black/African American and Hispanic older adults have been found to have high prevalence of substance use disorders as well as low treatment completion rates compared to Whites. The rising number of older adults reporting to substance use treatment programs posits a need to examine if these disparities are consistent in older adulthood. While being an older adult has been found to be positively associated with substance use treatment completion, racial disparities in treatment completion rates among this population have yet to be examined.

Methods: This cross-sectional study utilized data from the most recent Treatment Episode Data (TEDS-D) from SAMHSA, which documents discharges from a publicly funded substance use treatment program in the United States. A total of 17, 942 older adults reported to a substance use treatment program in 2017 and 6,653 met the criteria for the study. Chi square tests were used to analyze group differences and a binary logistic regression was used to predict substance use treatment completion.

Results: Results show that White older adults were 60% more likely to complete a substance use treatment program than Black/African American older adults (OR=1.6). Hispanic older adults were 30% more likely to complete a substance use treatment program than White older adults (OR=1.3). Gender, level of education, employment status, primary substance of use and frequency of use were also significant predictors of substance use treatment completion when adjusted for other predictors. Marital status was not a significant predictor of substance use treatment completion in the bivariate and multivariate results.

Conclusion: These results support the findings from similar studies with younger adults and support the theory that racial disparities are prevalent across the lifespan. While a significant disparity was found between White and Black/African American older adults, Hispanic older adults actually had a higher likelihood of completing treatment than White older adults. Practitioner interventions should focus on treatment retention among Black/African American older adults while considering cultural, historical and systemic factors that could cause voluntary termination of substance use treatment among Black/African older adults. Further implications for practice, research and policy are discussed.