Incarceration as a Reason for US Alcohol and Drug Treatment Non-completion: a Multilevel Analysis of Racial/Ethnic and Sex Disparities

J Behav Health Serv Res. 2020 Oct;47(4):464-475. doi: 10.1007/s11414-020-09703-7.

Abstract

Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015-2016 Treatment Episode Dataset-Discharges. Among a sample restricted to treatment non-completers (n = 306,008), 5% terminated treatment because they became incarcerated (n = 13,082), which varied widely by demographics and by state. In Idaho, 46% of African Americans terminated treatment because they became incarcerated. Women had lower odds of treatment non-completion than men, and the effect of sex was strongest among African Americans (adjusted odds ratio [aOR] = 0.30, 95% confidence interval [95% CI] = 0.26-0.34). Among men, all racial/ethnic minority groups demonstrated significantly higher odds of treatment non-completion due to incarceration compared with Whites, and the strongest effect was among African Americans (aOR = 1.37, 95% CI = 1.29-1.44). Incarceration as a reason for treatment non-completion disproportionately affects African Americans and men and varies by state. Interventions targeting incarceration alternatives should be availed to racial/ethnic minorities already participating in treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcoholism / ethnology*
  • Alcoholism / therapy*
  • Black or African American / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Multilevel Analysis
  • Patient Compliance
  • Patient Dropouts / ethnology*
  • Patient Dropouts / statistics & numerical data
  • Prisoners / statistics & numerical data*
  • Racial Groups / statistics & numerical data*
  • Sex Distribution
  • United States
  • White People