African-American crack abusers and drug treatment initiation: barriers and effects of a pretreatment intervention.
BACKGROUND
Individual and sociocultural factors may pose significant barriers for drug abusers seeking treatment, particularly for African-American crack cocaine abusers. However, there is evidence that pretreatment interventions may reduce treatment initiation barriers. This study examined the effects of a pretreatment intervention designed to enhance treatment motivation, decrease crack use, and prepare crack abusers for treatment entry.


METHODS
Using street outreach, 443 African-American crack users were recruited in North Carolina and randomly assigned to either the pretreatment intervention or control group.


RESULTS
At 3-month follow-up, both groups significantly reduced their crack use but the intervention group participants were more likely to have initiated treatment.


CONCLUSIONS
The intervention helped motivate change but structural barriers to treatment remained keeping actual admissions low. Policy makers may be interested in these pretreatment sites as an alternative to treatment for short term outcomes.
Wechsberg
Wendee M
WM
Substance Abuse Treatment Evaluations and Interventions Program, Behavioral Health and Criminal Justice Research Division , RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA. wmw@rti.org
Zule
William A
WA
Riehman
Kara S
KS
Luseno
Winnie K
WK
Lam
Wendy K K
WK
D000328:Adult; D001741:Black or African American; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D003144:Communication Barriers; D003159:Community-Institutional Relations; D016578:Crack Cocaine; D055030:Drug Users; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009657:North Carolina; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D015397:Program Evaluation
D016578:Crack Cocaine