To explore barriers to specialty substance abuse treatment programs among women with recent substance use disorders by race/ethnicity. Qualitative interviews were conducted with 28 women of White, Black, and Latino racial/ethnic descent who reported a substance use disorder in the past 5 years. Interviews were conducted by telephone and were audio-recorded. A codebook was developed using the Theory of Planned Behavior to code and identify barriers within the domains of attitudes, subjective norms, and perceived control toward specialty treatment. Frequencies for coded themes were then compared across all participants and by race/ethnicity. We identified several key differences in barriers to treatment by race/ethnicity. Attitudinal barriers were more pervasive among the narratives of Latinas relative to Black and White women. Latinas were more likely to report not needing treatment and that treatment would not be effective; Latinas were the only group to describe cultural barriers to treatment. Within the subjective norms domain, namely stigma and lack of support, were key barriers. Stigma was more pervasive among the narratives of Latinas and Black women than White women; Latinas were more likely to report a lack of social support for using treatment than both Black and White women. Findings provide deeper insight into barriers that may be contributing to racial/ethnic disparities in the use of substance abuse treatment among women.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Alvanzo AA, Storr CL, Mojtabai R, Green KM, Pacek LR, La Flair LN, et al. Gender and race/ethnicity differences for initiation of alcohol-related service use among persons with alcohol dependence. Drug Alcohol Depend. 2014;140:48–55.
Greenfield SF, Brooks AJ, Gordon SM, Green CA, Kropp F, McHugh RK, et al. Substance abuse treatment entry, retention, and outcome in women: a review of the literature. Drug Alcohol Depend. 2007;86(1):1–21.
Weisner C. Toward an alcohol treatment entry model: a comparison of problem drinkers in the general population and in treatment. Alcohol Clin Exp Res. 1993;17(4):746–52.
Weisner C, Schmidt L. Gender disparities in treatment for alcohol problems. JAMA. 1992;268(14):1872–6.
Witbrodt J, Mulia N, Zemore SE, Kerr WC. Racial/ethnic disparities in alcohol-related problems: differences by gender and level of heavy drinking. Alcohol Clin Exp Res. 2014;38(6):1662–70.
Zemore SE, Mulia N, Ye Y, Borges G, Greenfield TK. Gender, acculturation, and other barriers to alcohol treatment utilization among Latinos in three National Alcohol Surveys. J Subst Abuse Treat. 2009;36(4):446–56.
Brienza RS, Stein MD. Alcohol use disorders in primary care: do gender-specific differences exist? J Gen Intern Med. 2002;17(5):387–97.
Schober R, Annis HM. Barriers to help-seeking for change in drinking: a gender-focused review of the literature. Addict Behav. 1996;21(1):81–92.
Thom B. Sex differences in help-seeking for alcohol problems-1. The barriers to help-seeking. Br J Addict. 1986;81(6):777–88.
Zemore SE, Murphy RD, Mulia N, Gilbert PA, Martinez P, Bond J, Polcin DL. A moderating role for gender in racial/ethnic disparities in alcohol services utilization: results from the 2000 to 2010 national alcohol surveys. Alcohol Clin Exp Res. 2014;38(8):2286–96.
Room R, Greenfield TK, Weisner C. People who might have liked you to drink less: changing responses to drinking by US family members and friends, 1979-1990. Contemp Drug Prob. 1991;18:573.
Weisner C. The alcohol treatment-seeking process from a problems perspective: responses to events. Br J Addict. 1990;85(4):561–9.
Bond JC, Roberts S, Greenfield TK, Korcha R, Ye Y, Nayak MB. Gender differences in public and private drinking contexts: a multi-level GENACIS analysis. Int J Environ Res Public Health. 2010;7(5):2136–60.
Perron BE, Mowbray OP, Glass JE, Delva J, Vaughn MG, Howard MO. Differences in service utilization and barriers among Blacks, Hispanics, and Whites with drug use disorders. Subst Abuse Treat, Prev Policy. 2009;4(1):3.
Schmidt LA, Ye Y, Greenfield TK, Bond J. Ethnic disparities in clinical severity and services for alcohol problems: results from the National Alcohol Survey. Alcohol Clin Exp Res. 2007;31(1):48–56.
Verissimo ADO, Grella CE. Influence of gender and race/ethnicity on perceived barriers to help-seeking for alcohol or drug problems. J Subst Abuse Treat. 2017;75:54–61.
Rouse BA, Carter JH, Rodriguez-Andrew S. Race/ethnicity and other sociocultural influences on alcoholism treatment for women. In: Recent developments in alcoholism. Springer. 2002. p. 343–367.
Pinedo M, Zemore SE, Rogers S. Understanding barriers to specialty treatment among Latinos. J Subst Abuse Treat. 2018;94:1–8.
Alegria M, Carson NJ, Goncalves M, Keefe K. Disparities in treatment for substance use disorders and co-occurring disorders for ethnic/racial minority youth. J Am Acad Child Adolesc Psychiatry. 2011;50(1):22–31.
Alvarez J, Jason LA, Olson BD, Ferrari JR, Davis MI. Substance abuse prevalence and treatment among Latinos and Latinas. J Ethn Subst Abuse. 2007;6(2):115–41.
Arroyo JA, Westerberg VS, Tonigan JS. Comparison of treatment utilization and outcome for Hispanics and non-Hispanic whites. J Stud Alcohol. 1998;59(3):286–91.
Guerrero EG, Marsh JC, Cao D, Shin H-C, Andrews C. Gender disparities in utilization and outcome of comprehensive substance abuse treatment among racial/ethnic groups. J Subst Abuse Treat. 2014;46(5):584–91.
Ajzen I. From intentions to actions: a theory of planned behavior. In: Action control. Springer; 1985. p. 11–39.
Armitage CJ, Armitage CJ, Conner M, Loach J, Willetts D. Different perceptions of control: applying an extended theory of planned behavior to legal and illegal drug use. Basic Appl Soc Psychol. 1999;21(4):301–16.
Collins SE, Carey KB. The theory of planned behavior as a model of heavy episodic drinking among college students. Psychol Addict Behav. 2007;21(4):498.
Kam JA, Matsunaga M, Hecht ML, Ndiaye K. Extending the theory of planned behavior to predict alcohol, tobacco, and marijuana use among youth of Mexican heritage. Prev Sci. 2009;10(1):41–53.
Mcmillan B, Conner M. Applying an extended version of the theory of planned behavior to illicit drug use among students1. J Appl Soc Psychol. 2003;33(8):1662–83.
Wall A-M, Hinson RE, McKee SA. Alcohol outcome expectancies, attitudes toward drinking and the theory of planned behavior. J Stud Alcohol. 1998;59(4):409–19.
Onwuegbuzie AJ, Teddlie C. A framework for analyzing data in mixed methods research. In: Tashakkori A, Teddlie C, editors. Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage; 2003. p. 351–383
Browne MC, Ford AF, Thomas SB. Take a health professional to the people: a community outreach strategy for mobilizing African American barber shops and beauty salons as health promotion sites. Health Educ Behav. 2006;33(4):425–32.
Derose KP, Griffin BA, Kanouse DE, Bogart LM, Williams MV, Haas AC, et al. Effects of a pilot church-based intervention to reduce HIV stigma and promote HIV testing among African Americans and Latinos. AIDS Behav. 2016;20(8):1692–705.
Luque JS, Ross L, Gwede CK. Qualitative systematic review of barber-administered health education, promotion, screening and outreach programs in African-American communities. J Community Health. 2014;39(1):181–90.
Best DW, Lubman DI. The recovery paradigm: a model of hope and change for alcohol and drug addiction. Aust Fam Phys. 2012;41(8):593.
Copello A, Orford J. Addiction and the family: is it time for services to take notice of the evidence? Addiction. 2002;97(11):1361–3.
Copello AG, Velleman RD, Templeton LJ. Family interventions in the treatment of alcohol and drug problems. Drug Alcohol Rev. 2005;24(4):369–85.
Copello AG, Templeton L, Velleman R. Family interventions for drug and alcohol misuse: is there a best practice? Curr Opin Psychiatry. 2006;19(3):271–6.
Kumpfer KL, Alvarado R, Whiteside HO. Family-based interventions for substance use and misuse prevention. Subst Use Misuse. 2003;38(11–13):1759–87.
Liddle HA. Family-based therapies for adolescent alcohol and drug use: research contributions and future research needs. Addiction. 2004;99(s2):76–92.
Greenfield SF, Grella CE. Alcohol & drug abuse: what is” women-focused” treatment for substance use disorders? Psychiatr Serv. 2009;60(7):880–2.
Scott MC, Wahl OF. Substance abuse stigma and discrimination among African American male substance users. Stigma Res Act. 2011;1(1):60–6.
Van Olphen J, Eliason MJ, Freudenberg N, Barnes M. Nowhere to go: how stigma limits the options of female drug users after release from jail. Subst Abuse Treat Prev Policy. 2009;4(1):10.
Amaro H, Arévalo S, Gonzalez G, Szapocznik J, Iguchi MY. Needs and scientific opportunities for research on substance abuse treatment among Hispanic adults. Drug Alcohol Depend. 2006;84:S64–75.
Amaro H, Nieves R, Johannes SW, Labault Cabeza NM. Substance abuse treatment: critical issues and challenges in the treatment of Latina women. Hisp J Behav Sci. 1999;21(3):266–82.
Mora J. (2002). Latinas in cultural transition: addiction, treatment and recovery. In: The handbook of addiction treatment for women: theory and practice. 2002. p. 323–347
Trepper TS, Nelson TS, McCollum EE, McAvoy P. Improving substance abuse service delivery to Hispanic women through increased cultural competencies: a qualitative study. J Subst Abuse Treat. 1997;14(3):225–34.
Alto KM, McCullough KM, Levant RF. Who is on Craigslist? A novel approach to participant recruitment for masculinities scholarship. Psychol Men Masc. 2018;19(2):319.
Grov C. HIV risk and substance use in men who have sex with men surveyed in bathhouses, bars/clubs, and on Craigslist.org: venue of recruitment matters. AIDS Behav. 2012;16(4):807–17.
Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Comp Rev. 2016;34(3):360–77.
Ramo DE, Hall SM, Prochaska JJ. Reaching young adult smokers through the internet: comparison of three recruitment mechanisms. Nicotine Tob Res. 2010;12:768–75.
Worthen MG. An invitation to use craigslist ads to recruit respondents from stigmatized groups for qualitative interviews. Qual Res. 2014;14(3):371–83.
This work was supported by the National Institutes of Alcohol Abuse and Alcoholism (NIAAA) (P50AA005595). MP’s contribution was partially supported by NIAAA (R01AA027767). YC’s contribution was partially supported by National Center on Minority Health and Health Disparities (Grant No. R21 MD011431). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Pinedo, M., Zemore, S., Beltrán-Girón, J. et al. Women’s Barriers to Specialty Substance Abuse Treatment: A Qualitative Exploration of Racial/Ethnic Differences. J Immigrant Minority Health 22, 653–660 (2020). https://doi.org/10.1007/s10903-019-00933-2
- Substance abuse treatment
- Substance use