Skip to main content

Advertisement

Log in

Women’s Barriers to Specialty Substance Abuse Treatment: A Qualitative Exploration of Racial/Ethnic Differences

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

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, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  CAS  PubMed  Google Scholar 

  4. Weisner C, Schmidt L. Gender disparities in treatment for alcohol problems. JAMA. 1992;268(14):1872–6.

    Article  CAS  PubMed  Google Scholar 

  5. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. Brienza RS, Stein MD. Alcohol use disorders in primary care: do gender-specific differences exist? J Gen Intern Med. 2002;17(5):387–97.

    PubMed Central  PubMed  Google Scholar 

  8. 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.

    Article  CAS  PubMed  Google Scholar 

  9. Thom B. Sex differences in help-seeking for alcohol problems-1. The barriers to help-seeking. Br J Addict. 1986;81(6):777–88.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  11. 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.

    Google Scholar 

  12. Weisner C. The alcohol treatment-seeking process from a problems perspective: responses to events. Br J Addict. 1990;85(4):561–9.

    Article  CAS  PubMed  Google Scholar 

  13. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  17. 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.

  18. Pinedo M, Zemore SE, Rogers S. Understanding barriers to specialty treatment among Latinos. J Subst Abuse Treat. 2018;94:1–8.

    Article  PubMed Central  PubMed  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. Ajzen I. From intentions to actions: a theory of planned behavior. In: Action control. Springer; 1985. p. 11–39.

  24. 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.

    Article  Google Scholar 

  25. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  26. 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.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  Google Scholar 

  28. 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.

    Article  CAS  PubMed  Google Scholar 

  29. 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

    Google Scholar 

  30. 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.

    Article  Google Scholar 

  31. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  32. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  33. 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.

    Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. Copello AG, Velleman RD, Templeton LJ. Family interventions in the treatment of alcohol and drug problems. Drug Alcohol Rev. 2005;24(4):369–85.

    Article  PubMed  Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. Kumpfer KL, Alvarado R, Whiteside HO. Family-based interventions for substance use and misuse prevention. Subst Use Misuse. 2003;38(11–13):1759–87.

    Article  PubMed  Google Scholar 

  38. Liddle HA. Family-based therapies for adolescent alcohol and drug use: research contributions and future research needs. Addiction. 2004;99(s2):76–92.

    Article  PubMed  Google Scholar 

  39. Greenfield SF, Grella CE. Alcohol & drug abuse: what is” women-focused” treatment for substance use disorders? Psychiatr Serv. 2009;60(7):880–2.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Scott MC, Wahl OF. Substance abuse stigma and discrimination among African American male substance users. Stigma Res Act. 2011;1(1):60–6.

    Google Scholar 

  41. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  42. 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.

    Article  PubMed  Google Scholar 

  43. 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.

    Article  Google Scholar 

  44. 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

  45. 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.

    Article  CAS  PubMed  Google Scholar 

  46. 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.

    Article  Google Scholar 

  47. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  48. 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.

    Article  Google Scholar 

  49. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Worthen MG. An invitation to use craigslist ads to recruit respondents from stigmatized groups for qualitative interviews. Qual Res. 2014;14(3):371–83.

    Article  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Pinedo.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-019-00933-2

Keywords

Navigation