Need for and Receipt of Substance Use Treatment among Blacks

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).

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).

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.

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).

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.