Reports from uncontrolled trials and surveys suggest that there are disparities in substance-use outcomes for minoritised racial and ethnic populations, yet few of these disparities have emerged from randomised clinical trials (RCTs). We conducted a systematic review of RCTs published in English of Black or Latinx adults with any non-nicotine substance use disorder that reported rates of treatment initiation, engagement, or substance-use outcome by race or ethnicity. Study quality was assessed by the Joanna Briggs Institute appraisal tool and a Yale internally validated quality assessment. Of the 5204 studies, 50 RCTs met the inclusion criteria, all done in the USA, 24 compared treatment initiation, engagement, or outcome across races or ethnicities and 26 compared these same factors within a race. Few RCTs have reported outcomes specifically for Black or Latinx populations, with nine reporting significant differences by race or ethnicity. Significant differences were found in all studies that evaluated the baseline differences in social determinants. This Review explains the need for optimisation of RCTs to inform the design, delivery, and dissemination of treatment to historically excluded communities.

来自非对照试验和调查的报告表明，少数种族和族裔人群的物质使用结果存在差异，但随机临床试验 (RCT) 中很少出现这些差异。我们对以英语发表的黑人或拉丁裔成人患有任何非尼古丁物质使用障碍的随机对照试验进行了系统评价，这些随机对照试验报告了按种族或民族划分的治疗开始率、参与率或物质使用结果。研究质量由 Joanna Briggs Institute 评估工具和耶鲁内部验证的质量评估进行评估。在 5204 项研究中，50 项 RCT 符合纳入标准，均在美国完成，24 项比较了跨种族或种族的治疗开始、参与或结果，26 项比较了种族中的这些相同因素。很少有随机对照试验报告了专门针对黑人或拉丁裔人群的结果，其中九项报告了种族或民族的显着差异。在评估社会决定因素基线差异的所有研究中发现了显着差异。本综述解释了优化 RCT 的必要性，以便为历史上被排除在外的社区的治疗设计、实施和传播提供信息。