Racial Disparities in Opioid Overdose Deaths in Massachusetts

Liao, Che-Yi; Garcia, Gian‐Gabriel P.; DiGennaro, Catherine; Jalali, Mohammad S.

doi:10.1001/jamanetworkopen.2022.9081

Cited by 12 publications

(10 citation statements)

References 6 publications

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“…However there was recognition that health disparities related to SUDs, including opioid use disorders (OUDs), had increased, especially during the COVID-19 pandemic. 16,17 In addition, HIV and HCV coinfection has been long known to be associated with psychiatric illness severity, substance use, poverty, homelessness, incarceration, urban residence, and minority status. 18 Therefore, the GT curriculum was augmented in 2019 to create a summer program to expose students to clinical experiences and didactic sessions that would focus on behavioral health (SUDs and other mental illness) in addition to HIV and HCV.…”

Section: Introductionmentioning

confidence: 99%

Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

Antoine,

Manogue,

Blue

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Creating empathetic health care professionals is critical to addressing the health equity challenges of today, particularly because it relates to vulnerable populations. Methods: To assess the impact of the Johns Hopkins Center for AIDS Research Generation Tomorrow Summer Health Disparities Scholars (GTSHDS) program on students' empathy toward individuals living with substance use disorder and differential impact on empathy related to the COVID-19 pandemic, the Attitudes towards Mental Illness Questionnaire (AMIQ), an assessment of stigmatizing attitudes, was administered. Preprogram and postprogram participation AMIQ survey data were compared using paired t tests to explore changes within the program year. Unpaired t tests were used to characterize differences between the mean scores across the 2 student cohorts. Results: Both GTSHDS cohorts displayed postprogram increase in empathy. Mean 2019 cohort AMIQ scores shifting from −1.4 (SD 2.01) to −0.8 (SD 2.35) (P = 0.54), and the 2022 cohort shifting from −3.67 (SD 2.01) to −3 (SD 1.61) (P = 0.79). On average, individual scores improved by 2.2 (SD 1.65) points in the 2019 cohort and 2.4 (SD 1.86) points in the 2022 cohort (P = 0.83). Although these were not statistically significant, they suggested a trend toward more empathy. Conclusions: Preliminary data suggest that programs such as GTSHDS that expose students to various aspects of health care principles can prepare future health care professionals in a manner that may reduce health care disparities. Future research with larger population sizes is needed to understand the impacts of the curriculum on empathy and related concepts to achieving health equity.

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Section: Introductionmentioning

confidence: 99%

Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

Antoine,

Manogue,

Blue

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…The epidemic has impacted some geographical regions more than others: Massachusetts had the tenth highest rate of drug overdose deaths (31.8 per 100,000) in the United States from 1999 to 2017 3 . Between March 2020 and March 2021, Massachusetts recorded 2103 deaths involving opioids, 4 with more than 90% involving the synthetic opioid fentanyl 5 . Although effective long-term medications such as methadone or buprenorphine exist, many persons who use opioids encounter barriers to treatment access such as stigma, lack of provider availability or knowledge, and logistical challenges 6 .…”

mentioning

confidence: 99%

Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

et al. 2023

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Objectives Civil commitment has increasingly served as a court-based legal intervention for severe opioid use, but little research has examined the civil commitment (CC) hearing process from the perspective of the person who is committed. Despite documented gender differences in opioid use and experiences within the legal system, past research has also not investigated gender differences in perceptions of the CC process for persons who use opioids. Methods Participants were 121 persons (43% female) with opioid use who were interviewed upon arrival at the CC facility about their experience of the CC hearing process in Massachusetts. Results Two thirds of participants were taken to the commitment hearing by police, and 59.5% shared a cell with others while waiting. Overall, the commitment intake process at the courthouse took over 5 hours. Participants spent, on average, less than 15 minutes with their lawyer before the hearing, and a majority of CC hearings lasted less than 15 minutes. Once transferred to a CC facility, opioid withdrawal management began within 4 hours. Compared with women, men reported longer wait times between the hearing and transfer, as well as longer wait times for withdrawal management at the facility (P < 0.05). Women perceived worse interactions with the judge and greater dissatisfaction with the commitment process compared with men (P < 0.05). Conclusions There were few gender differences in the experience of CC. However, overall, participants reported a lengthy court process and low levels of perceived procedural justice.

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“…Injection drug use (IDU) places individuals at high risk for mortality from overdose and infectious disease (eg, HIV). 3 Furthermore, drug use and injection-related harms disproportionally affect racial and ethnic minority groups, 1,4 with larger increases in opioid-related mortality observed among Black people versus other races 5,6 and evidence of a higher HIV prevalence among Black people who inject drugs (PWID) versus Hispanic or White PWID. 7 There are calls for increased surveillance on IDU and poly-IDU trends to track threats, guide treatment response, 8 and better understand and respond to alarming racial disparities in use.…”

mentioning

confidence: 99%

“…7 There are calls for increased surveillance on IDU and poly-IDU trends to track threats, guide treatment response, 8 and better understand and respond to alarming racial disparities in use. 5,9 However, to our knowledge, no work has quantified stimulant and opioid injection in Boston, Massachusetts, nor investigated trends by race. It is critical to determine whether the trends observed in the Western US may persist in Boston, Massachusetts, and to assess potential racial disparities in patterns of IDU.…”

mentioning

confidence: 99%

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Injection of Methamphetamine Has Increased in Boston, Massachusetts: 5 Waves of Centers for Disease Control and Prevention State Surveillance Data

et al. 2022

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ObjectivesIn the United States, the number of overdose deaths related to opioids in combination with stimulants has increased; however, the Northeast has typically been less impacted by stimulant overdose. Injection drug use (IDU) results in high mortality from overdose and infectious disease and there are racial disparities observed in overdose death rates. We examined trends in stimulant and opioid IDU, including trends stratified by race, using 5 waves of cross-sectional state surveillance data.MethodsData came from the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance system Boston, Massachusetts site, which includes 5 waves of data (2005–2018) among adults in the Boston metropolitan area reporting IDU (N = 2550). Outcome measures were type of substance injected in the past 12 months (heroin, prescription opioids, “speedball,” cocaine, crack, and/or methamphetamine).ResultsParticipants were 70% male, 58% non-Hispanic White, and injected a mean of 3 different drugs in the past 12 months. From 2015 to 2018, there was a more than 2-fold increase in injection of methamphetamine (15% vs 38%, P < 0.001), a pattern which held across racial groups. Combination heroin and methamphetamine injection increased from 2015 (15%) to 2018 (35%, P < 0.001). Multiple drug injection (injecting >1 drug) increased significantly across years compared with single drug injection (P = 0.03).ConclusionsFindings suggest that increased use of methamphetamine and opioids extends to Boston. There is an urgent need for enhanced screening of methamphetamine use among those using opioids and increased access and payor coverage of efficacious treatments for stimulant and opioid use disorders (eg, contingency management and medication treatment for opioid use disorder).

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Racial Disparities in Opioid Overdose Deaths in Massachusetts

Cited by 12 publications

References 6 publications

Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

Gender Differences in Civil Commitment Hearing Experience for Persons Who Use Opioids

Injection of Methamphetamine Has Increased in Boston, Massachusetts: 5 Waves of Centers for Disease Control and Prevention State Surveillance Data

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