Virtual Conference
Mental Health 2022

Erick Guerrero

Fellow at Yale University, United States of America

Title: Workforce Diversity and Disparities in Opioid Treatment Wait Time and Retention


Background: We seek to determine the role of workforce diversity in improving opioid treatment wait time and retention for individuals self-identified as Black/African American or Latino/Hispanic. We account for the role of Medicaid-expansion and treatment structure among opioid treatment programs (OTP) located across the United States. 

Methods: We examined four waves of the National Drug Abuse Treatment System Survey (NDATSS), a nationally representative longitudinal dataset (2010- 2017), to assess the effect of OTPs’ structure, organization, and service delivery on wait time to treatment and retention in treatment. We conducted comparative and predictive analysis in an analytic sample of programs (162 in 2000, 173 in 2005, 282 in 2014, and 300 in 2017). We considered the moderated effect of workforce diversity and treatment structure on wait time and retention. 

Results: The main findings suggest significant differences in wait time and in retention. Average waiting days decreased in the last two waves of the NDATSS (2014-2017) (post Medicaid expansion per the Affordable Care Act), while retention rates varied across years. Key findings show that programs with both a higher percent of African American staff and a higher percent of African American clients were associated with longer wait times to enter treatment. Programs with both a higher percent of Latino staff and a higher percent of Latino clients were negatively associated with retention in treatment. 

Discussion: Findings show decreases in wait time over the years with significant variation in retention during the same period. Workforce diversity was associated with higher wait time and lower retention when programs also had high percentages of African American and Latino clients. Findings have implications for OTPs in minority communities to enhance wait time (access) and retention (engagement).   


Dr. Erick Guerrero completed his doctoral degree at the University of Chicago in 2009 and received tenure as an associate professor at the University of Southern California in 2016. Dr. Guerrero has a background in clinical psychology and organizational behavior. As a clinician, he has provided counseling for the past twenty-three years. As an organizational researcher, Dr. Guerrero has published more than seventy peer-reviewed manuscripts and three books on racial/ethnic and gender disparities and the implementation of evidence-based practices in healthcare in the United States and Mexico. Funded by the US National Institutes of Health, he is currently co-leading four research studies to respond to COVID-19 and opioid overdose public health crises. Dr. Guerrero is a fellow at Yale University’s Innovation to Impact program, and director of the I-LEAD Institute, a research and consulting firm in Silicon Beach, California.