Racially related health disparities and alcoholism treatment outcomes

Published studies comparing the outcomes of black and white patients with alcohol dependence have produced mixed results. We hypothesized that among alcoholic outpatients blacks would have worse outcomes than whites. A sample of 38 blacks and 136 whites were assessed prospectively at baseline and 6-12 months using a naturalistic study design. At baseline, blacks had less education, employment, and income than whites, and they were less likely to be married. They also were more likely to have family histories of substance abuse, previous episodes of treatment, cocaine use disorders, antisocial personality disorder, and poor physical health. Between baseline and follow-up, blacks received less treatment for alcohol dependence than whites. Such differences would seem to favor worse outcomes which were not found. Blacks, however, reported more social support for sobriety than whites. They also had better rates of study retention than whites, suggestive of either higher levels of motivation or stronger alliances with the treatment center. Future studies of racial differences should include measures of social support for sobriety, motivation for treatment, and treatment alliance.