Black Americans Receive Evidence-Based Cannabis Use Disorder Treatment at Half the Rate of White Americans

Black patients with CUD received evidence-based psychotherapy (CBT or MET) in 18% of treatment episodes vs. 35% for White patients (adjusted OR=0.48). Hispanic patients also received less evidence-based treatment (24%, aOR=0.62). Disparities persisted after controlling for insurance type, facility characteristics, geographic region, and disorder severity. The gap was largest in outpatient settings.

Retrospective analysis of 1.2 million CUD treatment episodes in the Treatment Episode Data Set (TEDS) from 2015-2020. Multilevel logistic regression controlling for patient, facility, and geographic factors.

Cannabis use disorder treatment should be equitable. This large-scale analysis reveals systematic racial disparities in the quality of CUD treatment that cannot be explained by insurance, geography, or clinical factors alone.

Racial disparities in healthcare are well-documented, but this study quantifies the gap specifically for cannabis use disorder treatment. As CUD prevalence increases with legalization, ensuring equitable access to evidence-based treatment becomes more urgent.

Administrative data cannot capture treatment quality details. TEDS may not represent all treatment settings. Therapist characteristics not captured. Patient preferences not measured. 2015-2020 data may not reflect current patterns.