Racial inequity in medication treatment for opioid use disorder: Exploring potential facilitators and barriers to use

Hollander, Mara A.G.; Chang, Chung‐Chou H.; Douaihy, Antoine; Hulsey, Eric; Donohue, Julie M.

doi:10.1016/j.drugalcdep.2021.108927

Cited by 45 publications

(21 citation statements)

References 30 publications

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“…Black and White enrollees initiated care at similar rates (ie, there were small racial differences in the likelihood of using any primary care), implying that racial differences in primary care (and other) utilization tended to emerge after care was initiated, which may be consistent with evidence that even when access barriers are overcome, Black patients receive worse care and experience the health care system differently as a result of medical racism, discrimination by health care professionals, and differences in how physicians perceive them . For example, we found that Black adults were 48% less likely to receive treatment with pharmacotherapy for opioid use disorders, which was consistent with prior literature showing racialized access to these medications . While racial differences in the quality measures were nuanced (eg, Black enrollees had higher rates of preventive screenings but lower utilization of care for acute and chronic conditions), Black adults and children had higher emergency department utilization, including for avoidable reasons, reinforcing the idea that disparities in primary care reflect underuse.…”

Section: Discussionsupporting

confidence: 72%

“… 25 , 26 , 27 , 45 , 56 , 57 For example, we found that Black adults were 48% less likely to receive treatment with pharmacotherapy for opioid use disorders, which was consistent with prior literature showing racialized access to these medications. 28 , 58 While racial differences in the quality measures were nuanced (eg, Black enrollees had higher rates of preventive screenings but lower utilization of care for acute and chronic conditions), Black adults and children had higher emergency department utilization, including for avoidable reasons, reinforcing the idea that disparities in primary care reflect underuse.…”

Section: Discussionmentioning

confidence: 99%

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Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees

et al. 2022

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Key Points Question Are there racial differences in health care spending and utilization for low-income individuals in the US who are covered by the Medicaid program? Findings In this cross-sectional study of 1 966 689 Black and White Medicaid enrollees in 3 states, Black enrollees used fewer services, including primary care, and generated lower spending than White enrollees, but were more likely to utilize the emergency department for avoidable reasons. Differences persisted among enrollees residing in the same zip codes who were treated by the same health care professionals. Meaning The results of this study suggest that stark differences in spending and primary care use exist between Black and White Medicaid enrollees, and additional steps to ensure equity are needed.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees

et al. 2022

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“…Previous studies have shown that there is a disparity in treatment; blacks are less likely to receive treatment compared to non-Hispanic whites(Hollander, Chang, Douaihy, Hulsey, & Donohue, 2021). Structural differences in healthcare could be a contributing factor for racial disparities in opioid overdose.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Opioid-related Mortality Across United States Census Regions from 1999-2020

Addimulam¹,

Gupta²,

Mahalingam³

et al. 2022

Preprint

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Background: Opioid-related mortality has been on a sharp rise in the decade. This study aims to provide insight into the difference in mortality between white and black population in various census regions of the United States between 1999-2020. Methods: The data was extracted from multiple cause of death files from CDC Wonder database. The International Classification of Disease (ICD-10) codes used to extract data include F11 (mental and behavioral disorders due to use of opioids); T40.0 (Opium); T40.1 (Heroin); T40.2 (Other opioids); T40.3 (Methadone); T40.4 (Other synthetic narcotics). The regression analysis was conducted using Joinpoint statistical software. Results: The black population in the Midwest census region showed the highest age-adjusted mortality in the year 2020 (46.14 per 100,000). This was followed by the black (32.71 per 100,000) and white population (30.5 per 100,000) in the northeast census regions respectively. Overall, the opioid-related mortality followed a similar trend across all census regions. Except south census region where age-adjusted mortality was comparable between the black and white populations, blacks had higher opioid-related mortality in all other census regions. Conclusion: This study provides concise evidence of inequality in opioid-related deaths among various US census regions. Policy changes focused to certain regions are required to significantly address the underlying factors related to disparities in opioid-related mortality among the black population.

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“…Moreover, disparities between Whites and Blacks/Hispanics in accessing OUD treatment are found among subpopulations that may be in especially vulnerable situations. For example, Black Medicaid enrollees are less likely than White Medicaid enrollees to start MAT ( Hollander et al, 2021 ); Black and Hispanic women with OUD during pregnancy are less likely than their White counterparts to receive MAT in the year before delivery ( Schiff et al, 2020 ); and non-incarcerated Black individuals with criminal justice involvement are less likely than their White counterparts to have OUD treatment paid for by a court or by private insurance ( Sanmartin et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic residential segregation and the availability of opioid and substance use treatment facilities in US counties, 2009–2019

DiNardi¹,

Swann²,

Kim³

2022

SSM - Population Health

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Racial inequity in medication treatment for opioid use disorder: Exploring potential facilitators and barriers to use

Cited by 45 publications

References 30 publications

Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees

Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees

Disparities in Opioid-related Mortality Across United States Census Regions from 1999-2020

Racial/ethnic residential segregation and the availability of opioid and substance use treatment facilities in US counties, 2009–2019

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