Prior Experiences of Discrimination and Early Termination of Substance Use Treatment Among Black and Hispanic Patients

OBJECTIVE: This study aimed to examine the association between prior experiences of discrimination and premature treatment discharge among Black or African American and Hispanic or Latine patients receiving substance use treatment. METHODS: Participants were 1,372 adults who identified as Black, Hispanic, or both and who presented for admission to one of 66 substance use disorder treatment facilities in the United States in 2022. Participant data were derived from a larger dataset collected by a third-party treatment outcomes provider, with standardized measures administered across treatment sites. Measures included the Everyday Discrimination Scale and instruments for anxiety, depression, and substance craving. Treatment staff recorded information about patient discharge status, classified as standard discharge, administrative discharge, elopement, or leaving against staff advice. The association between patient-reported experiences of discrimination (assessed at intake) and mode of discharge from behavioral health treatment was examined in a multinomial logistic regression model with adjustment for level of care, anxiety, depression, substance craving, employment status, primary substance, and age. RESULTS: When key variables were controlled for, reporting a higher frequency of discrimination experiences was associated with increased odds of treatment elopement relative to standard discharge (OR=1.05, p=0.020). CONCLUSIONS: Findings revealed that a higher frequency of patient-reported discrimination experiences, reported at intake, was associated with elopement. This study highlights the impact of discrimination on treatment outcomes and the importance of assessing patients' experiences of discrimination in their day-to-day lives at the beginning of treatment.