The Relationship of Socioeconomic Factors and Substance Abuse Treatment Dropout.

Abstract

Background: Treatment dropout in substance use disorder (SUD) programs poses a significant challenge to achieving successful outcomes and leads to legal and financial issues. Socioeconomic factors have been identified as key contributors to treatment attrition; yet, the specific impact of patients' socioeconomic conditions remains underexplored. The purpose of this study is to examine the relationship between socioeconomic factors and SUD treatment dropout. Methods: We conducted a retrospective analysis of socioeconomic factors associated with treatment dropout among individuals with alcohol, marijuana, and heroin substance abuse. Logistic regression was used to examine the association between patients' socioeconomic factors and treatment dropout. Adjusted odds ratios were calculated to quantify the strength of these associations. Results: Our findings demonstrate that demographic factors and financial status, including age (12-19 years), Black or African American race, and reliance on public assistance, correlate with an increased likelihood of treatment dropout. Black or African American patients receiving public assistance exhibit elevated dropout rates in ambulatory services, while patients of other single races without private insurance show higher dropout rates in detox services. Individuals aged 18-49 who are not part of the labor force have increased dropout rates in rehab services. Interestingly, patients in dependent living situations, who pay for services through private insurance or receive them at no charge, experience lower dropout rates as the number of arrests increases. Conversely, independently living patients with prior SUD treatments have higher dropout rates compared to those undergoing treatment for the first time. Conclusions: This study underscores the critical importance of addressing financial barriers to treatment access and retention in order to improve outcomes for individuals with substance use disorders (SUDs). Targeted interventions that support economically disadvantaged populations are essential for reducing treatment dropout rates and enhancing the effectiveness of SUD treatment programs.