School-Based Services May Eliminate Substance Treatment Disparities: Results From a Nonrandomized Program Evaluation

Area of Science:

• Adolescent Health
• Substance Use Disorders
• Health Disparities

Background:

• Significant health disparities exist in adolescent substance use disorder treatment access and engagement.
• Existing treatment models may not adequately reach or engage all adolescent populations.

Purpose of the Study:

• To compare treatment outcomes between school-based and clinic-based adolescent substance use disorder services.
• To determine if school-based substance use disorder treatment can reduce disparities in access and engagement.

Main Methods:

• A retrospective chart review compared adolescents in school-based (n=531) and clinic-based (n=523) substance use disorder treatment.
• Data included baseline demographics, clinical diagnoses, sessions completed, self-reported abstinence, and urine drug screens.

Main Results:

• The school-based sample had higher proportions of female and Hispanic/Latinx adolescents.
• Similar rates of negative urine drug screens and self-reported abstinence were observed between settings.
• Significant differences in total session completion were noted, with a notable interaction effect of race/ethnicity by location.

Conclusions:

• School-based substance use disorder treatment enhances care access and engagement for female, African American, and Hispanic/Latinx adolescents.
• Outcomes are not diminished by providing treatment in a school-based setting.
• School-based models show promise in mitigating disparities in adolescent substance use disorder treatment.