TY - JOUR
KW - Academic Medical Centers
KW - Adult
KW - African Americans
KW - Age of Onset
KW - Ambulatory Care Facilities
KW - Analgesics, Opioid/therapeutic use
KW - cocaine
KW - Cocaine-Related Disorders/epidemiology
KW - Female
KW - Humans
KW - Linear Models
KW - Male
KW - Mental Disorders/epidemiology
KW - Methadone/therapeutic use
KW - Middle Aged
KW - Minority Health
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - Prognosis
KW - Sex Factors
KW - Social Networking
KW - Substance Abuse Detection
KW - Treatment Outcome
KW - Urban Population
KW - Violence/statistics & numerical data
KW - African American
KW - Drug
KW - Gender
KW - Heroin
KW - medication-assisted treatment
KW - Methadone
KW - opioid use disorder
KW - Sex
KW - Urban
AU - J. J. Lister
AU - S. Brown
AU - M. K. Greenwald
AU - D. M. Ledgerwood
A1 - 
AB - Background: African American patients with opioid use disorder (OUD) have demonstrated poorer methadone maintenance treatment (MMT) outcomes compared with white patients. This issue is further complicated in urban settings, where African Americans experience high rates of poverty and publicly funded treatment. Despite interrelated factors that disadvantage African Americans, the literature focusing on this population is scant. To address this shortcoming, we conducted the first investigation of gender differences and gender-specific MMT outcome predictors among African Americans (or any racial minority population). This study provides gender-specific findings to improve African American MMT outcomes. Methods: We studied 211 African American patients (male: n = 137, 64.9%) at an urban, university-affiliated MMT clinic. We used existing intake data to assess baseline demographic, substance use, mental health, and interpersonal factors. Primary outcomes were 3-month drug(+) (positive) urine drug screen (UDS) results and treatment retention. Results: Women were more likely (than men) to endorse histories of interpersonal violence, substance abuse in their social network, and mental health problems. Men reported a greater likelihood (than women) for early opioid-use onset and a lack of prior MMT. There were no gender differences in 3-month drug(+) UDS or treatment retention. In multivariable analyses among women, no baseline factors predicted 3-month opioid(+) UDS and physical abuse history predicted a higher proportion of 3-month cocaine(+) UDS. Among men, primary injection opioid use and older age best predicted a higher proportion of 3-month cocaine(+) UDS and parent substance abuse predicted shorter retention. In both gender-stratified analyses, higher proportions of 3-month opioid(+) UDS and cocaine(+) UDS predicted shorter retention. Conclusions: This study offers an analysis of gender differences in risk factors, MMT outcomes, and gender-specific predictors among African American patients. MMT clinics should tailor assessment and treatment protocols to address gender-specific needs.
AD - School of Social Work, Wayne State University , Detroit , Michigan , USA.; Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit , Michigan , USA.; School of Social Work, Wayne State University , Detroit , Michigan , USA.; Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit , Michigan , USA.; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University , Detroit , Michigan , USA.; Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit , Michigan , USA.
BT - Substance abuse
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 2
CY - United States
DO - 10.1080/08897077.2018.1547810
IS - 2
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Background: African American patients with opioid use disorder (OUD) have demonstrated poorer methadone maintenance treatment (MMT) outcomes compared with white patients. This issue is further complicated in urban settings, where African Americans experience high rates of poverty and publicly funded treatment. Despite interrelated factors that disadvantage African Americans, the literature focusing on this population is scant. To address this shortcoming, we conducted the first investigation of gender differences and gender-specific MMT outcome predictors among African Americans (or any racial minority population). This study provides gender-specific findings to improve African American MMT outcomes. Methods: We studied 211 African American patients (male: n = 137, 64.9%) at an urban, university-affiliated MMT clinic. We used existing intake data to assess baseline demographic, substance use, mental health, and interpersonal factors. Primary outcomes were 3-month drug(+) (positive) urine drug screen (UDS) results and treatment retention. Results: Women were more likely (than men) to endorse histories of interpersonal violence, substance abuse in their social network, and mental health problems. Men reported a greater likelihood (than women) for early opioid-use onset and a lack of prior MMT. There were no gender differences in 3-month drug(+) UDS or treatment retention. In multivariable analyses among women, no baseline factors predicted 3-month opioid(+) UDS and physical abuse history predicted a higher proportion of 3-month cocaine(+) UDS. Among men, primary injection opioid use and older age best predicted a higher proportion of 3-month cocaine(+) UDS and parent substance abuse predicted shorter retention. In both gender-stratified analyses, higher proportions of 3-month opioid(+) UDS and cocaine(+) UDS predicted shorter retention. Conclusions: This study offers an analysis of gender differences in risk factors, MMT outcomes, and gender-specific predictors among African American patients. MMT clinics should tailor assessment and treatment protocols to address gender-specific needs.
PP - United States
PY - 2019
SN - 1547-0164; 0889-7077
SP - 185
EP - 193
EP - 
T1 - Gender-specific predictors of methadone treatment outcomes among African Americans at an urban clinic
T2 - Substance abuse
TI - Gender-specific predictors of methadone treatment outcomes among African Americans at an urban clinic
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 30888262
U3 - 10.1080/08897077.2018.1547810
VL - 40
VO - 1547-0164; 0889-7077
Y1 - 2019
ER -