Cultural factors and attrition in drug abuse treatment

The present study examined how race related to attrition in drug abuse treatment. 165 male voluntary admissions to an inpatient Substance Abuse Unit were tested at admission on functioning, motivation, attitudes, symptoms, and mood-using reliable and valid scales. One week later they completed a 12-factor scale measuring perception of the treatment milieu. Data were analyzed in a 2 x 2 factorial design of analysis of variance. There were 106 White subjects and 59 Blacks. The dropout rate for Blacks and Whites was 63%. Two factors measured at intake, motivation and social functioning, showed statistically significant interactions between race and attrition. Four ward perception factors showed a differential effect related to race and attrition. The White dropout and completer did not differ in how they perceived the ward. Blacks, however, who perceived the environment as being more insightful, spontaneous, autonomous, and practical remained. Although Blacks and Whites differed on many variables, only six showed race-related differences in attrition. Having higher motivation and poorer adjustment influenced Whites to stay. Factors in the environment, however, influenced Blacks. What might be considered a more "therapeutic" milieu was effective in helping Blacks remain in treatment. Knowledge of these cultural differences could help in designing treatment programs.