Stakeholder Engagement in a Patient‐Activation Behavioral Intervention for Prescription Opioid Patients (ACTIVATE)

Does, Monique; Kline-Simon, Andrea H.; Aguilar, Nancy Charvat; Marino, Catherine; Campbell, Cynthia I.

doi:10.17294/2330-0698.1561

Cited by 2 publications

(1 citation statement)

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“…Owing to a legacy of medical disenfranchisement that dates back to the colonisation of the Americas by Europeans and enslavement of Africans [200], there is steep distrust of the health-care system and cultural animus around the joint processes of social and economic marginalisation and criminalisation that have been stoked [201]. Providers and advocates can more directly address relational chasms with racial/ethnic minorities through targeted outreach, education and engagement efforts, as well as acknowledgment of this stark historical context [202][203][204][205].…”

Section: Discussionmentioning

confidence: 99%

Opioid use, prescribing and fatal overdose patterns among racial/ethnic minorities in the United States: A scoping review and conceptual risk environment model

Ezell,

Pho,

Ajayi

et al. 2024

Drug and Alcohol Review

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IssuesTo date, there has been no synthesis of research addressing the scale and nuances of the opioid epidemic in racial/ethnic minority populations in the United States that considers the independent and joint impacts of dynamics such as structural disadvantage, provider bias, health literacy, cultural norms and various other risk factors.ApproachUsing the “risk environment” framework, we conducted a scoping review on PubMed, Embase and Google Scholar of peer‐reviewed literature and governmental reports published between January 2000 and February 2024 on the nature and scale of opioid use, opioid prescribing patterns, and fatal overdoses among racial/ethnic minorities in the United States, while also examining macro, meso and individual‐level risk factors.Key FindingsResults from this review illuminate a growing, but fragmented, literature lacking standardisation in racial/ethnic classification and case reporting, specifically in regards to Indigenous and Asian subpopulations. This literature broadly illustrates racial/ethnic minorities' increasing nonmedical use of opioids, heightened burdens of fatal overdoses, specifically in relation to polydrug use and synthetic opioids, with notable elevations among Black/Latino subgroups, in addition uneven opioid prescribing patterns. Moreover, the literature implicates a variety of unique risk environments corresponding to dynamics such as residential segregation, provider bias, overpolicing, acculturative stress, patient distrust, and limited access to mental health care services and drug treatment resources, including medications for opioid use disorder.ImplicationsThere has been a lack of rigorous, targeted study on racial/ethnic minorities who use opioids, but evidence highlights burgeoning increases in usage, especially polydrug/synthetic opioid use, and disparities in prescriptions and fatal overdose risk‐phenomena tied to multi‐level forms of entrenched disenfranchisement.ConclusionThere is a need for further research on the complex, overlapping risk environments of racial/ethnic minorities who use opioids, including deeper inclusion of Indigenous and Asian individuals, and efforts to generate greater methodological synergies in population classification and reporting guidelines.

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Section: Discussionmentioning

confidence: 99%