Disparities in Criminal Justice Outcomes After Beginning Treatment for Substance Use Disorders: The Influence of Race/Ethnicity and Place.

Objective: This study examined whether racial/ethnic disparities exist in posttreatment arrests and assessed the extent to which community characteristics account for such disparities. Method: Administrative data on clients (N = 10,529) receiving publicly funded services in Washington State were linked with criminal justice and census data. Multilevel survival models were used for two outcomes measuring time (in days) to any arrest and to any substance-related arrest. Community characteristics included a factor measuring community economic disadvantage and the proportions of residents in the client's residential census tract who were Black, Latino, or American Indian/Alaskan Native. Results: When we controlled for age, sex, substance use, referral source, and prior criminal justice involvement, Black clients (hazard ratio = 1.47, p < .01) had a higher hazard of any arrest compared with White clients, and Black (HR = 1.27, p< .05) and Latino (HR = 1.20, p < .05) clients had a higher hazard of a substance-related arrest. Clients living in census tracts with a higher proportion of Black residents had a higher hazard of any arrest (HR = 1.25, p < .01) as well as substance-related arrests (HR = 1.39,p <.01). Community characteristics did not account for racial/ethnic disparities in arrests but provided an independent effect. Conclusions: Disparities in arrest outcomes are influenced by both individual- and community-level factors; therefore, strategies for reducing disparities in this treatment outcome should be implemented at both levels.