The purpose of the current study was to explore ethnic differences in drug abstinence self-efficacy among recovering individuals. Levels of abstinence self-efficacy among African Americans and European Americans increased, decreased, and then increased again over the year. Drug abstinence self-efficacy remained stable over time among Latinos in this study. It is possible that, although they have reported positive experiences in Oxford House, Latinos may not receive the same benefits other groups gain from participation in Oxford House. Another possible explanation for the lack of change in abstinence selfefficacy among Latinos in Oxford House may be that factors outside the house and support networks may lower expectations for recovery. These factors may include inability to find work, experiences of discrimination, or lack of access to care. Future research needs to explore the social networks of Latinos in Oxford House as well as the experiences of this ethnic group in this program and in the community.
Background: Since its U.S. FDA approval in 2002, buprenorphine has been available for maintenance treatment of opiate dependence in primary care physicians' offices. Though buprenorphine was intended to facilitate access to treatment, disparities in utilization have emerged; while buprenorphine treatment is widely used in private care setting, public healthcare integration of buprenorphine lags behind.
Results: Through a review of the literature, we found that U.S. disparities are partly due to a shortage of certified prescribers, concern of patient diversion, as well as economic and institutional barriers. Disparity of buprenorphine treatment dissemination is concerning since buprenorphine treatment has specific characteristics that are especially suited for low-income patient population in public sector healthcare such as flexible dosing schedules, ease of concurrently treating co-morbidities such as HIV and hepatitis C, positive patient attitudes towards treatment, and the potential of reducing addiction treatment stigma.
Conclusion: As the gap between buprenorphine treatment in public sector settings and private sector settings persists in the U.S., current research suggests ways to facilitate its dissemination.