Abstract
Background Opioid Agonist Treatment (OAT) is the standard of care for the treatment of opioid use disorders. However, most people in treatment do not receive OAT. This study evaluated whether there are racial and/or ethnic differences in OAT receipt among adults entering specialty treatment for opioid use disorders in publicly-funded treatment programs across the U.S. Methods Using data from the national Treatment: Episode Data Base, odds of OAT receipt were compared among black, Hispanic and white clients. Mediation analyses were used to explore whether any racial/ethnic differences in OAT receipt were explained by variation in clinical need or by other treatment, sociodemographic, or geographic characteristics. Interaction terms were used to assess whether this association was modified by primary opioid type. Results Only 28.7% of clients received OAT. Odds of OAT receipt were significantly higher odds among blacks (OR: 2.27(2.14–2.41)) and Hispanics (OR: 1.98(1.88–2.09)), compared to whites. Differences in clinical need accounted for a substantial portion of this difference (76.79% and 49.74%, respectively). Differences persisted after accounting for other potential explanatory variables (adjusted OR: 1.37 (1.24–1.52); 1.21(1.11–1.32)), but were only evident for primary heroin users (adjusted OR: 1.50 (1.34–1.69); 1.29 (1.17–1.42)) and not other opioid users. Conclusions OAT receipt in treatment programs is low overall and particularly lacking among white heroin users. Differences in OAT receipt cannot be fully explained by differences in clinical need. More research is needed to understand and address barriers that underpin these differences so more patients with opioid use disorder can access evidenced-based treatment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 512-518 |
| Number of pages | 7 |
| Journal | Drug and Alcohol Dependence |
| Volume | 178 |
| DOIs | |
| State | Published - Sep 1 2017 |
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Keywords
- Ethnic minorities
- Medication assisted treatment
- Opioid agonist treatment
- Opioid treatment programs
- Opioid use disorder
- Racial disparities
ASJC Scopus subject areas
- Toxicology
- Pharmacology
- Psychiatry and Mental health
- Pharmacology (medical)
Cite this
Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U.S. national sample. / Krawczyk, Noa; Feder, Kenneth A.; Fingerhood, Michael I; Saloner, Brendan.
In: Drug and Alcohol Dependence, Vol. 178, 01.09.2017, p. 512-518.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U.S. national sample
AU - Krawczyk, Noa
AU - Feder, Kenneth A.
AU - Fingerhood, Michael I
AU - Saloner, Brendan
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background Opioid Agonist Treatment (OAT) is the standard of care for the treatment of opioid use disorders. However, most people in treatment do not receive OAT. This study evaluated whether there are racial and/or ethnic differences in OAT receipt among adults entering specialty treatment for opioid use disorders in publicly-funded treatment programs across the U.S. Methods Using data from the national Treatment: Episode Data Base, odds of OAT receipt were compared among black, Hispanic and white clients. Mediation analyses were used to explore whether any racial/ethnic differences in OAT receipt were explained by variation in clinical need or by other treatment, sociodemographic, or geographic characteristics. Interaction terms were used to assess whether this association was modified by primary opioid type. Results Only 28.7% of clients received OAT. Odds of OAT receipt were significantly higher odds among blacks (OR: 2.27(2.14–2.41)) and Hispanics (OR: 1.98(1.88–2.09)), compared to whites. Differences in clinical need accounted for a substantial portion of this difference (76.79% and 49.74%, respectively). Differences persisted after accounting for other potential explanatory variables (adjusted OR: 1.37 (1.24–1.52); 1.21(1.11–1.32)), but were only evident for primary heroin users (adjusted OR: 1.50 (1.34–1.69); 1.29 (1.17–1.42)) and not other opioid users. Conclusions OAT receipt in treatment programs is low overall and particularly lacking among white heroin users. Differences in OAT receipt cannot be fully explained by differences in clinical need. More research is needed to understand and address barriers that underpin these differences so more patients with opioid use disorder can access evidenced-based treatment.
AB - Background Opioid Agonist Treatment (OAT) is the standard of care for the treatment of opioid use disorders. However, most people in treatment do not receive OAT. This study evaluated whether there are racial and/or ethnic differences in OAT receipt among adults entering specialty treatment for opioid use disorders in publicly-funded treatment programs across the U.S. Methods Using data from the national Treatment: Episode Data Base, odds of OAT receipt were compared among black, Hispanic and white clients. Mediation analyses were used to explore whether any racial/ethnic differences in OAT receipt were explained by variation in clinical need or by other treatment, sociodemographic, or geographic characteristics. Interaction terms were used to assess whether this association was modified by primary opioid type. Results Only 28.7% of clients received OAT. Odds of OAT receipt were significantly higher odds among blacks (OR: 2.27(2.14–2.41)) and Hispanics (OR: 1.98(1.88–2.09)), compared to whites. Differences in clinical need accounted for a substantial portion of this difference (76.79% and 49.74%, respectively). Differences persisted after accounting for other potential explanatory variables (adjusted OR: 1.37 (1.24–1.52); 1.21(1.11–1.32)), but were only evident for primary heroin users (adjusted OR: 1.50 (1.34–1.69); 1.29 (1.17–1.42)) and not other opioid users. Conclusions OAT receipt in treatment programs is low overall and particularly lacking among white heroin users. Differences in OAT receipt cannot be fully explained by differences in clinical need. More research is needed to understand and address barriers that underpin these differences so more patients with opioid use disorder can access evidenced-based treatment.
KW - Ethnic minorities
KW - Medication assisted treatment
KW - Opioid agonist treatment
KW - Opioid treatment programs
KW - Opioid use disorder
KW - Racial disparities
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UR - http://www.scopus.com/inward/citedby.url?scp=85023624110&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2017.06.009
DO - 10.1016/j.drugalcdep.2017.06.009
M3 - Article
VL - 178
SP - 512
EP - 518
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
ER -