OBJECTIVE The authors examined racial/ethnic and socioeconomic disparities in receiving treatment for alcohol use disorder (AUD). METHODS A retrospective cohort study was conducted that included adults (≥18 years) with AUD from the All of Us Controlled Tier database v7. Outcomes were lifetime receipt of FDA-approved medications (disulfiram, acamprosate, and naltrexone), psychotherapy (individual, family, and group-based session), and combination treatment (medication and psychotherapy). The study examined treatment receipt by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, other), insurance (private, Medicare, Medicare and Medicaid, Medicaid, Veteran Affairs [VA], none), income (<$10K, $10-<$50K, $50-$100K, >$100K), and area deprivation index (ADI) quintiles. Multivariable logistic and multinomial logistic regressions were used to assess the association between patient characteristics and treatment receipt. RESULTS The cohort consisted of 18,692 patients (mean age=57.1 years; 60.7% were male; 47.1% were non-Hispanic White). Almost 70% received no treatment, 11.4% received medication, 24.0% received psychotherapy, and 4.9% received combination treatment. In adjusted analysis, non-Hispanic Black (aOR=0.78, 95% CI=0.69-0.89) and Hispanic (aOR=0.75, 95% CI=0.64-0.88) individuals were less likely to receive medication than non-Hispanic White counterparts. There was no association between race/ethnicity and receipt of psychotherapy or combination treatment. Compared with private insurance, dual eligibility was associated with less use of medication, Medicare and Medicaid with less use of medication and combination treatment, and VA and no insurance with more use of psychotherapy and combination treatment. Higher income and lower ADI were positively associated with all treatment types. CONCLUSIONS There are disparities in AUD treatment by race/ethnicity, socioeconomic status, and insurance. Systematic approaches are required to improve equitable access to effective treatment.

中文翻译：

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我们所有参与者在酒精使用障碍治疗方面的差异。


目的 作者检查了接受酒精使用障碍 （AUD） 治疗的种族/民族和社会经济差异。方法 进行了一项回顾性队列研究，其中包括来自 All of Us Controlled Tier 数据库 v7 的 AUD 成人 （≥18 岁）。结局是终生接受 FDA 批准的药物 （双硫仑、阿坎酸和纳曲酮）、心理治疗 （个人、家庭和团体会议） 和联合治疗 （药物和心理治疗）。该研究按种族/族裔（非西班牙裔白人、非西班牙裔黑人、西班牙裔、其他）、保险（私人、医疗保险、医疗保险和医疗补助、医疗补助、退伍军人事务部 [VA]、无）、收入（<$10K、$10-<$50K、$50-$100K、>$100K）和地区剥夺指数 （ADI） 五分位数检查了治疗收据。多变量 logistic 和多项 logistic 回归用于评估患者特征与治疗接受之间的关联。结果 该队列由 18,692 名患者组成 （平均年龄 = 57.1 岁;60.7% 为男性;47.1% 为非西班牙裔白人）。近 70% 的患者未接受治疗，11.4% 接受药物治疗，24.0% 接受心理治疗，4.9% 接受联合治疗。在调整后的分析中，非西班牙裔黑人 （aOR=0.78,95% CI=0.69-0.89） 和西班牙裔 （aOR=0.75,95% CI=0.64-0.88） 个体接受药物治疗的可能性低于非西班牙裔白人。种族/族裔与接受心理治疗或联合治疗之间没有关联。与私人保险相比，双重资格与较少使用药物相关，Medicare 和 Medicaid 与较少使用药物和联合治疗相关，而 VA 和无保险与更多地使用心理治疗和联合治疗相关。 较高的收入和较低的 ADI 与所有治疗类型呈正相关。结论 AUD 治疗因种族/民族、社会经济地位和保险而异。需要系统的方法来提高公平获得有效治疗的机会。