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Racial Inequality in Receipt of OUD Medications

Following events such as nonfatal drug overdoses, use of medications for treating opioid use disorder (OUD) differed based on race and ethnic background, according to an analysis of Medicare data. “The high incidence of ambulatory visits in all groups showed that disparities persisted despite frequent health care contact,” conclude the authors.

Medicare fee-for-service data for 2016-19 were searched for index events related to OUD such as nonfatal overdose treated in an emergency department or inpatient setting, hospitalization with injection drug use–related infection, or inpatient or residential rehabilitation or detoxification care. These pattterns in the receipt of medications to treat OUD (buprenorphine, naltrexone, and naloxone), the receipt of high-risk medications (opioid analgesics and benzodiazepines), and health care utilization within 180 days of the events showed these patterns based on race or ethnicity: “We identified 25,904 OUD-related index events among 23,370 beneficiaries, with 3,937 events (15.2%) occurring among Black patients, 2,105 (8.1%) among Hispanic patients, and 19,862 (76.7%) among White patients. In the 180 days after the index event, patients received buprenorphine after 12.7% of events among Black patients, after 18.7% of those among Hispanic patients, and after 23.3% of those among White patients; patients received naloxone after 14.4%, 20.7%, and 22.9%, respectively; and patients received benzodiazepines after 23.4%, 29.6%, and 37.1%, respectively. Racial differences in the receipt of medications to treat OUD did not change appreciably from 2016 to 2019 (buprenorphine receipt: after 9.1% of index events among Black patients vs. 21.6% of those among White patients in 2016, and after 14.1% vs. 25.5% in 2019). In all study groups, patients had multiple ambulatory visits in the 180 days after the index event (mean number of visits, 6.6 after events among Black patients, 6.7 after events among Hispanic patients, and 7.6 after events among White patients).”

Source: New England Journal of Medicine