Racial and Ethnic Disparities in Outpatient Substance Use Disorder Treatment Episode Completion for Different Substances

Mennis, Jeremy; Stahler, Gerald J.

doi:10.1016/j.jsat.2015.12.007

Cited by 159 publications

(82 citation statements)

References 76 publications

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“…Unlike other large-scale studies on treatment completion (Arndt et al, 2013;Mennis and Stahler, 2016), in our unadjusted models patients from Black and Minority Ethnicities (BME) were more likely to recover. After controlling for other socio-economic factors, however, this disparity no longer held, highlighting the importance controlling for employment and stable housing (Saloner and Lê Cook, 2013;Hawkins et al, 2014).…”

Section: Integration With the Literaturementioning

confidence: 91%

Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England

Eastwood

Strang²,

Marsden

2017

Drug and Alcohol Dependence

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Section: Integration With the Literaturementioning

confidence: 91%

Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England

Eastwood

Strang²,

Marsden

2017

Drug and Alcohol Dependence

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“…We selected race for use in the final model because previous studies have implicated racial disparities as a factor predicting substance use treatment outcomes. (Mennis & Stahler, 2015; Weinstein et al, 2017; Wells, Klap, Koike, & Sherbourne, 2001)…”

Section: 0 Methodsmentioning

confidence: 99%

Very early disengagement and subsequent re-engagement in primary care Office Based Opioid Treatment (OBOT) with buprenorphine

Hui

Weinstein

Cheng

et al. 2017

Journal of Substance Abuse Treatment

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Introduction Patients with opioid use disorder often require multiple treatment attempts before achieving stable recovery. Rates of disengagement from buprenorphine are highest in the first month of treatment and termination of buprenorphine therapy results in return to use rates as high as 90%. To better characterize these at-risk patients, this study aims to describe: 1) the frequency and characteristics of patients with very early disengagement (≤1 month) from Office Based Opioid Treatment (OBOT) with buprenorphine and 2) the frequency and characteristics of patients who re-engage in care at this same OBOT clinic within 2 years, among the subset of very early disengagers. Methods This is a retrospective cohort study of adult patients enrolled in a large urban OBOT program. Descriptive statistics were used to characterize the sample and the proportion of patients with very early (≤1 month) disengagement and their re-engagement. Multivariable logistic regression models were used to identify patient characteristics associated with the outcomes of very early disengagement and re-engagement. Potential predictors included: sex, age, race/ethnicity, education, employment, opioid use history, prior substance use treatments, urine drug testing, and psychiatric diagnoses. Results Overall, very early disengagement was unusual, with only 8.4% (104/1234) of patients disengaging within the first month. Among the subset of very early disengagers with 2 years of follow-up, the proportion who re-engaged with this OBOT program in the subsequent 2 years was 11.9% (10/84). Urine drug test positive for opiates within the first month (AOR: 2.01, 95% CI: 1.02–3.93) was associated with increased odds of very early disengagement. Transferring from another buprenorphine prescriber (AOR: 0.09, 95% CI: 0.01–0.70) was associated with decreased odds of very early disengagement. No characteristics were significantly associated with re-engagement. Conclusions Early disengagement is uncommon; however, continued opioid use appeared to be associated with higher odds of treatment disengagement and these patients may warrant additional support. Re-engagement was uncommon, suggesting the need for a more formal explicit system to encourage and facilitate re-engagement among patients who disengage.

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“…Given our study setting and patient population, low prescribing rates may also reflect disparities in care among racial/ ethnic minorities and the urban poor, as seen in other studies. 5 Over the last several decades, clinical, research, and policy interventions have increased the rates of TUD pharmacotherapy prescribing. 6 Similar efforts are needed to identify and treat patients with concurrent substance use disorders, with a focus on addressing racial/ethnic disparities.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy Prescribing to Patients with Concurrent Tobacco and Alcohol Use Disorder in a Large, Urban, Integrated Health System

et al. 2019

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Racial and Ethnic Disparities in Outpatient Substance Use Disorder Treatment Episode Completion for Different Substances

Cited by 159 publications

References 76 publications

Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England

Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England

Very early disengagement and subsequent re-engagement in primary care Office Based Opioid Treatment (OBOT) with buprenorphine

Pharmacotherapy Prescribing to Patients with Concurrent Tobacco and Alcohol Use Disorder in a Large, Urban, Integrated Health System

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