(PS4-C69) Addiction and Racism: Preliminary Examination of Racial/ethnic Trauma Symptoms Among People of Color (POC) Admitted to a Residential Addiction Treatment Program for Opioid Use Disorder (OUD)

Background: Racial health disparities have been highlighted in response to the COVID-19 pandemic where, relative to their white counterparts, people of color (POC) evidence worse outcomes, die at a greater rate, and struggle disproportionately with illnesses (Volkow, 2021). Racial inequities and health disparities are also evidenced in substance use disorders (SUD), where POC are more likely to be imprisoned following drug arrests (Nicosia et al., 2013) and POC struggling with opioid use disorders (OUD) are less likely to be prescribed medication assisted treatment for OUD (Lagisetty et al., 2019). Additionally, POC evidence more severe posttraumatic stress symptoms following trauma exposure relative to their white counterparts (Bird et al., 2021). While decades of research suggest that POC have faced disproportionate harm by drug-use and trauma exposure, very little research has examined the role of experienced race-based trauma or ethnic discrimination on SUD severity. The current study presents preliminary data from a recently funded and on-going clinical trial that focuses on baseline measurements collected from POC admitted to a residential addiction treatment facility. The study aims to determine the degree to which specific race-based trauma variables associate with OUD severity and general mental health.

Methods: The current study reflects baseline eligibility assessments collected from participants (n = 13) newly admitted into a residential addiction treatment program. All participants had an OUD diagnosis and completed an assessment battery, which included the Opioid Craving Scale (OCS; McHugh et al., 2021), Timeline Followback (TLFB; Sobell, 1992), and global mental health (PROMIS; Hays et al., 2009). Additionally, the Perceived Ethnic Discrimination Questionnaire (PEDQ; Brondolo et al., 2005) was used to assess the degree of exposure to race-based maltreatment over the course of one’s lifetime and the Trauma Symptoms of Discrimination Scale (TSDS; Williams et al., 2018) was used to assess race-based trauma symptoms stemming from race-based maltreatment. Preliminary statistical analyses examined pearson correlations to test the hypotheses that PEDQ and TSDS would correlate with all primary outcome variables. 

Results: All POC participants endorsed prior exposure to discrimination, with race-discrimination being the most common (83.3%), followed by social class-discrimination (75%), and religious-discrimination (42%). Exposure to discrimination (PEDQ) significantly correlated with trauma symptoms of discrimination (TSDS; r = .719, p = .004), and overall mental health (r = -.760, p = .002). However, neither discrimination nor trauma symptoms of discrimination significantly correlated with opioid craving or past 30-days drug-use.

Discussion: Preliminary results from a limited sample (n = 13) suggests that assessing discrimination and subsequent race-based trauma symptoms as salient features in relation to overall mental health for POC pursuing treatment for OUD recovery. Within continued recruitment and a larger sample size, future statistical tests will investigate the role of race, race-based discrimination, and subsequent trauma symptoms on OUD severity and treatment response.