Disparities Experienced by Racial Minorities Contribute to Treatment Gaps and Lack of Access to Resources and Supports for Substance Use Disorders.

Background and objectives: Problematic substance use among older adults is rising. Although rates of substance use disorder (SUD) are higher among younger populations, the percentage of older adults with SUD had the highest increase between 2020 and 2021 of any age demographic. Disparities experienced by racial minorities contribute to treatment gaps and lack of access to SUD resources. This study explores the perspectives of low-income, urban-dwelling, primarily racial minority older adults on SUD treatment and recovery.

Research design and methods: Adults aged 50 years and older residing in urban low-income apartment buildings in Richmond, VA who self-identified as having a history of substance use were recruited to participate in semistructured interviews about their beliefs on substance use and aging, perceptions of treatment options and barriers to SUD-related recovery supports, and views around peer support. Interviews were recorded and transcribed. Inductive qualitative thematic analysis of the interviews was conducted using the framework method of analysis.

Results: Interviews were conducted with 16 individuals. The mean age was 65.6 years, 56% identified as male, 25% did not complete high school, 50% reported an annual income under $10,000, and 81.3% were Black. Nine themes were identified from the qualitative analysis: Causes of SUD, stigma and misconceptions about SUD, SUD treatments, SUD self-help, SUD and aging, barriers to treatment, defining recovery, lack of knowledge of current terminology, and the role of technology. They perceive that the reasons underlying SUD differ with age, with younger people more influenced by social pressure/environment and older people by social isolation or loneliness.

Discussion and implications: This study highlights the perspectives of low-income, racial minority older adults providing insights into barriers to SUD treatment and recovery, opportunities for community education, and adaptation of current treatment strategies to meet the needs of this population.