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Long-Term Morbidity and Mortality among a Sample of Cocaine-Dependent Black and White Veterans

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Abstract

Racial minorities generally exhibit worse health status than do whites. To assess the presence of similar phenomena among long-term cocaine-using veterans, this study examined racial variations in mortality and health status among cocaine-dependent men who were originally recruited at their admissions to cocaine treatment in 1988–1989 and were interviewed approximately 12 years later in 2002–2003. Mortality was higher among whites (15%) than blacks (6%), particularly due to drug overdose. Controlling for socioeconomic factors, cocaine severity, and depression, the racial difference was still significant in the survival analysis. Racial differences were examined in the health status of those interviewed in the 12-year follow-up study (178 blacks and 65 whites), after confirmation of their comparable socioeconomic backgrounds and levels of healthcare access and utilization. Contrary to expectations, few racial differences were found on most health indicators, although the level of cocaine use was higher among blacks. Furthermore, fewer blacks reported having hepatitis or sexually transmitted diseases than did whites. The study results suggest that black cocaine-dependent veterans do not have worse health status when compared with white veterans on most health indicators.

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References

  1. The Commonwealth Fund. Minority Americans lag behind whites on nearly every measure of health care quality. March 6, 2002: Available at: http://www.cmwf.org/media/releases/collins523_release03062002.asp. Accessed July 16, 2003.

  2. Kochanek KD, Murphy SL, Anderson RN, Scott C. Deaths: Final Data For 2002. National Vital Statistics Reports; Vol. 53 No. 5. Hyattsville, Maryland: National Center for Health Statistics; 2004.

    Google Scholar 

  3. National Center for Health Statistics. Health, United States, 2004. Hyattsville, Maryland: National Center for Health Statistics; 2004.

    Google Scholar 

  4. National Center for Health Statistics. Deaths, Percent of Total Deaths, and Death Rates for the 15 Leading Causes of Death in 10-Year Age Groups, by Hispanic Origin, Race for Non-Hispanic Population and Sex: United States, 2000; 2002. Hyattsville, Maryland: National Center for Health Statistics; 2004.

    Google Scholar 

  5. Hargraves JL, Hadley J. The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res. 2003;38:809–829.

    Article  PubMed  Google Scholar 

  6. Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL. Primary care physicians who treat blacks and whites. N Engl J Med. 2004;351:575–584.

    Article  PubMed  CAS  Google Scholar 

  7. Buka SL. Disparities in health status and substance use: ethnicity and socioeconomic factors. Public Health Rep. 2002;117(Suppl 1):S118–S125.

    PubMed  Google Scholar 

  8. Stuber J, Galea S, Ahern J, Blaney S, Fuller C. The association between multiple domains of discrimination and self-assessed health: a multilevel analysis of Latinos and blacks in four low-income New York City neighborhoods. Health Serv Res. 2003;38:1735–1759.

    Article  PubMed  Google Scholar 

  9. Williams DR, Neighbors HW, Jackson JS. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2003;93:200–208.

    PubMed  Google Scholar 

  10. Galea S, Ahern J, Tardiff K, et al. Racial/ethnic disparities in overdose mortality trends in New York City, 1990–1998. J Urban Health. 2003;80:201–211.

    PubMed  Google Scholar 

  11. Patkar AA, Sterling RC, Gottheil E, Weinstein SP. A comparison of medical symptoms reported by cocaine-, opiate-, and alcohol-dependent patients. Subst Abuse. 1999;20:227–235.

    Article  Google Scholar 

  12. Qureshi AI, Suri MF, Guterman LR, Hopkins LN. Cocaine use and the likelihood of nonfatal myocardial infarction and stroke: data from the Third National Health and Nutrition Examination Survey. Circulation. 2001;103:502–506.

    PubMed  CAS  Google Scholar 

  13. Ferri CP, Dunn J, Gossop M, Laranjeira R. Factors associated with adverse reactions to cocaine among a sample of long-term, high-dose users in Sao Paulo, Brazil. Addict Behav. 2004;29:365–374.

    Article  PubMed  Google Scholar 

  14. Lowenstein DH, Massa SM, Rowbotham MC, Collins SD, McKinney HE, Simon RP. Acute neurologic and psychiatric complications associated with cocaine abuse. Am J Med. 1987;83:841–846.

    Article  PubMed  CAS  Google Scholar 

  15. Falck RS, Wang J, Carlson RG, Siegal HA. Crack–cocaine use and health status as defined by the SF-36. Addict Behav. 2000;25:579–584.

    Article  PubMed  CAS  Google Scholar 

  16. Substance Abuse and Mental health Services Administration (SAMHSA). DAWN Series D-26, DHHS Publication No. (SMA) 04-3972. Rockville, Maryland: SAMHSA; 2004.

  17. Rosenheck R, Seibyl CL. Participation and outcome in a residential treatment and work therapy program for addictive disorders: the effects of race. Am J Psychiatry. 1998;155:1029–1034.

    PubMed  CAS  Google Scholar 

  18. Substance Abuse and Mental health Services Administration (SAMHSA). The NSDUH Report: Substance Use, Dependence, and Treatment among Veterans. Rockville, Maryland: SAMHSA; 2005.

  19. Substance Abuse and Mental Health Services Administration (SAMHSA). Treatment Episode Data Set (TEDS) Table 3.2a Admissions by Primary Substance of Abuse, According to Selected Race/Ethnicity/Sex/Age Group TEDS 2002 Percent Distribution. Rockville, Maryland: SAMHSA; 2004.

  20. Hser Y-I, Stark ME, Paredes A, Huang D, Anglin MD, Rawson R. A 12-year follow-up of a treated cocaine-dependent sample. J Subst Abuse Treat. 2006;30:219–226.

    Article  PubMed  Google Scholar 

  21. Nurco D, Balter M, Kinlock T. Studying addicts over time: methodology and preliminary findings. Am J Drug Alcohol Abuse. 1975;2:183–196.

    Article  PubMed  CAS  Google Scholar 

  22. Hser Y, Anglin MD, Powers K. A 24-year follow-up of narcotics addicts. Arch Gen Psychiatry. 1993;50:577–584.

    PubMed  CAS  Google Scholar 

  23. Hser YI, Hoffman V, Grella CE, Anglin MD. A 33-year follow-up of narcotics addicts. Arch Gen Psychiatry. 2001;58:503–508.

    Article  PubMed  CAS  Google Scholar 

  24. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975. Geneva: World Health Organization; 1977.

    Google Scholar 

  25. Ferraro KF, Farmer MM. Utility of health data from social surveys: is there a gold standard for measuring morbidity? Am Sociol Rev. 1999;64:303–315.

    Article  Google Scholar 

  26. Hser YI, Anglin MD, Powers K. Longitudinal patterns of alcohol use by narcotics addicts. Recent Dev Alcohol. 1990;8:145–171.

    PubMed  CAS  Google Scholar 

  27. Greenwell L, Brecht ML. Self-reported health status among treated methamphetamine users. Am J Drug Alcohol Abuse. 2003;29:75–104.

    Article  PubMed  Google Scholar 

  28. Herbeck DM, Hser YI, Lu AT, Stark ME, Paredes A. A 12-year follow-up study of psychiatric symptomatology among cocaine-dependent men. Addict Behav. 2006 Feb 23; [Epub ahead of print].

  29. McCoy CB, Metsch LR, Chitwood DD, Miles C. Drug use and barriers to use of health care services. Subst Use Misuse. 2001;36:789–806.

    Article  PubMed  CAS  Google Scholar 

  30. Young M, Stuber J, Ahern J, Galea S. Interpersonal discrimination and the health of illicit drug users. Am J Drug Alcohol Abuse. 2005;31:371–391.

    Article  PubMed  Google Scholar 

  31. Ibrahim SA, Whittle J, Bean-Mayberry B, Kelley ME, Good C, Conigliaro J. Racial/ethnic variations in physician recommendations for cardiac revascularization. Am J Public Health. 2003;93:1689–1693.

    Article  PubMed  Google Scholar 

  32. Petersen LA, Wright SM, Peterson ED, Daley J. Impact of race on cardiac care and outcomes in veterans with acute myocardial infarction. Med Care. 2002;40:I86–96.

    PubMed  Google Scholar 

  33. Jha AK, Shlipak MG, Hosmer W, Frances CD, Browner WS. Racial differences in mortality among men hospitalized in the Veterans Affairs health care system. JAMA. 2001;285:297–303.

    Article  PubMed  CAS  Google Scholar 

  34. Substance Abuse and Mental Health Services Administration. The NSDUH Report: Methamphetamine Use, Abuse, and Dependence: 2002, 2003, and 2004. Rockville, Maryland: SAMHSA; 2005.

    Google Scholar 

  35. Rawson R, Huber A, Brethen P, et al. Methamphetamine and cocaine users: differences in characteristics and treatment retention. J Psychoact Drugs. 2000;32:233–238.

    CAS  Google Scholar 

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Acknowledgements

Supported in part by grant DA13594 & P30-DA016383 (Dr. Hser) and by Independent Scientist Awards K02DA00139 (Dr. Hser) from the National Institute on Drug Abuse, Bethesda, MD. Special thanks to staff at the UCLA Integrated Substance Abuse Programs for data collection, data analysis, and manuscript preparation.

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Authors and Affiliations

  1. UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Yih-Ing Hser

Authors
  1. Joy C. Yang
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  2. David Huang
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  3. Yih-Ing Hser
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Correspondence to Yih-Ing Hser.

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Yang, Huang, and Hser are with the UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

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Yang, J.C., Huang, D. & Hser, YI. Long-Term Morbidity and Mortality among a Sample of Cocaine-Dependent Black and White Veterans. JURH 83, 926–940 (2006). https://doi.org/10.1007/s11524-006-9081-2

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  • DOI: https://doi.org/10.1007/s11524-006-9081-2

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