KINGSTON, R.I. — October 1, 2021 — A University of Rhode Island doctoral student has been awarded a national grant to examine more effective treatments for alcohol use disorder among underserved populations.
This disparity in the care certain groups receive for alcohol use disorder is the topic of a study by a fourth-year Ph.D. student in clinical psychology. Silvi Goldstein has been awarded a Ruth L. Kirschstein Predoctoral Individual National Research Service Award, a two-year grant that will fund her efforts to inform the science community on culturally competent treatment, helping lead to more effective and more accessible treatment options for underserved populations.
The study, funded through the National Institute on Alcohol Abuse and Alcoholism, is a secondary analysis of data collected during a study Goldstein participated in when she was an undergraduate at the University of Washington in Seattle. That study, led by now Washington State University Professor Susan Collins, examined extended-release Naltrexone and harm reduction counseling as ways to reduce alcohol-related harm and improve quality of life among people experiencing homelessness and severe alcohol use disorder.
Researchers studied typical services participants received in shelters and community-based health centers, and compared the outcomes among three groups of participants — one receiving harm reduction therapy alone; one getting harm reduction therapy along with taking Naltrexone, a drug to reduce alcohol cravings; and one receiving harm reduction therapy with a placebo. Behavioral harm reduction treatment combined with the medication was shown to decrease alcohol use and improve quality of life outcomes.
Goldstein will now take the study a step further, examining whether these improvements are similar across different race and sex groups. She aims to discover whether treatment outcomes vary for underserved populations.
“We know alcohol use disorder has disproportionally negative effects among racial minorities, especially among Native American and Black Americans, who are experiencing disproportionate harm from alcohol use disorder,” Goldstein said. “Women also experience disproportionate harm from alcohol use disorder, and are equally understudied. If the point of harm reduction treatment is to reduce harm and improve quality of life, we want to make sure it is working equally well for clients who are experiencing disproportionate harm compared to, say, white folks.”
Working with College of Health Sciences professors Nicole Weiss, Sarah Feldstein-Ewing and Manshu Yang, Goldstein will spend the next two years poring through the data to determine health outcomes for the underserved race and sex populations she is targeting. She ultimately hopes to advise the health community on how to better serve those populations.
“In addition to alcohol-related health disparities, my interests include historical trauma and racial discrimination; also access to resources,” Goldstein said. “We know that people who have more access to resources still drink, but have less harm, so we’re looking at social inequities that may be contributing to more harm when people use alcohol. Is it related to historical trauma? Is it related to racial discrimination? Is it related to social policy? My opinion is it’s probably related to all those things.”
In addition to finding answers to such questions, the Kirchstein award also aims to teach young researchers how to do so. The two-year award is intended to “enable promising predoctoral students with potential to develop into productive, independent research scientists.” Goldstein aims to improve treatment outcomes for her underserved populations, while at the same time gaining experience to propel her career in academic research.
“My goal for this study is to be able to report on health disparities and health inequities that are racialized and be able to say how we can best adapt and develop culturally competent treatments for people who are underserved,” Goldstein said. “By informing the science community on culturally competent treatment, we can look at how we adapt different treatments to make them more accessible and to help the people who really need it the most. What really drives me is the social justice aspect, so finding ways to look at ameliorating racial and health inequities, and finding ways to create better treatments.”