Substance use improvement depends on Race/Ethnicity: Outpatient treatment disparities observed in a large US national sample

Sahker, Ethan; Pro, George; Sakata, Masatsugu; Furukawa, Toshi A

doi:10.1016/j.drugalcdep.2020.108087

Cited by 37 publications

(15 citation statements)

References 28 publications

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“…Our results are consistent with nationally representative data and evidence from other regions demonstrating racial inequities in various aspects of OUD treatment services. Critically, though there is substantial research documenting the existence of racial inequities in SUD treatment, [24][25][26] the current findings reveal increases in inequities following the influx of federal funding to address the opioid overdose crisis in 2017. To our knowledge, this growing inequity has only been documented in one recent study using nationally representative pharmacy claims.…”

Section: Discussionmentioning

confidence: 68%

Outcomes of State Targeted/Opioid Response grants and the Medication First approach: evidence of racial inequities in improved treatment access and retention

Winograd¹,

Budesa²,

Banks³

et al. 2023

Preprint

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Since 2017, Missouri has used federal funds to increase access to medication for opioid use disorder (OUD) within the State’s publicly-funded substance use specialty treatment system through a ‘Medication First’ approach. Results from a statewide assessment of the first year of State Targeted Response implementation showed increases and improvements in overall treatment admissions, medication utilization, and treatment retention in the first year of funding. The current manuscript, which focuses on the St. Louis region, the epicenter of Missouri’s overdose crisis, examines whether improvements were experienced equally among Black and White clients. Results from negative binomial regressions indicate that White individuals in St. Louis experienced larger increases in treatment admissions and utilization of medications for OUD than Black individuals, and Black clients were retained in treatment for shorter lengths of time than White clients. In Missouri, rates of drug overdose deaths are more than three times higher for Black people than White people. Racial inequities in OUD treatment utilization and retention must be intentionally targeted and corrected as one component of reducing this sizable disparity in fatalities.

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Section: Discussionmentioning

confidence: 68%

Outcomes of State Targeted/Opioid Response grants and the Medication First approach: evidence of racial inequities in improved treatment access and retention

Winograd¹,

Budesa²,

Banks³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…First, while our data set includes all individuals with a billing claim in the state of Massachusetts, we were unable to include racial or ethnic data, in spite of known inequities in outcomes in both oral health 48 and SUD care for people of color. 49,50 Secondly, injectable naltrexone may be used off-label to treat alcohol use disorder, and we are unable to identify individuals who were prescribed naltrexone for this reason as SUD diagnostic codes are excluded from the claims database. We were also unable to include individuals treated with methadone.…”

Section: Discussionmentioning

confidence: 99%

Dental care utilization in Massachusetts before and after initiation of medication for opioid use disorder: A cross‐sectional study of a state all‐payer claims database

Simon

Choudhary

Ticku

et al. 2021

J Public Health Dent

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Background Individuals with opioid use disorder (OUD) are at higher risk of poor oral health. Medication for opioid use disorder (MOUD) has been shown to improve outcomes for patients with OUD, but it is unknown how initiation of MOUD affects access to oral health services. Methods This was a retrospective analysis of all individuals in the Massachusetts All‐Payer Claims Database prescribed oral buprenorphine‐naloxone or injectable naltrexone from 2013 to 2016. We evaluated dental utilization in the year before and after beginning MOUD. A logistic regression predicting dental utilization was conducted. Results Among the 54,791 individuals, rates of dental utilization were low both before and after MOUD (10.5% and 10% with a dental visit, respectively). Of those who did not have a dental visit in the year before starting MOUD, 95.1% did not have a dental visit in the year after. Rates of various procedure types were comparable before and after MOUD. In a logistic regression, a prior dental visit was associated with 9.82 times the odds (95% CI 9.14–10.55) of having a dental visit after starting MOUD; increasing age, being prescribed naltrexone, having a mood disorder or HIV, year of initiation or being on Medicaid were also associated with having a dental visit. Male patients and those with Medicare or private insurance were less likely to have a dental visit. Conclusions Initiating MOUD did not substantially result in increased dental access or substantial changes in dental procedures received. Patients receiving treatment for OUD may require additional support to access dental care.

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“…Analyses of state level data and data on opioid users in large metropolitan areas show that racial minorities are less likely than Whites to complete treatment ( Arndt et al., 2013 ; Stahler and Mennis, 2018 ). Blacks are also less likely than Whites to experience improvement in substance use outcomes (including use of opioids) upon discharge ( Sahker et al., 2020 ). While these studies recognize that individual-level factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Substance use improvement depends on Race/Ethnicity: Outpatient treatment disparities observed in a large US national sample

Cited by 37 publications

References 28 publications

Outcomes of State Targeted/Opioid Response grants and the Medication First approach: evidence of racial inequities in improved treatment access and retention

Outcomes of State Targeted/Opioid Response grants and the Medication First approach: evidence of racial inequities in improved treatment access and retention

Dental care utilization in Massachusetts before and after initiation of medication for opioid use disorder: A cross‐sectional study of a state all‐payer claims database

The association between medication for opioid use disorder and employment outcomes in the U.S.: The relevance of race and ethnicity

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