Despite efforts to address the epidemic of deaths from drug overdose in the United States, drug-overdose deaths are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in the White population.
“Numerous trials have documented the efficacy of medications for opioid use disorder and other SUD interventions. But such treatments are often less available to members of historically marginalized groups than to White patients,” noted Carlos Blanco, M.D., Ph.D., of the National Institute on Drug Abuse (NIDA), Elisabeth U. Kato, M.D., M.R.P., of the Agency for Healthcare Research and Quality, and others in a Perspective piece in the New England Journal of Medicine.
“Ensuring that all people with SUD receive evidence-based treatment will require overcoming barriers to high-quality care, such as lower rates of adequate health insurance among Black, Latinx, and American Indian and Alaska Native populations than among White populations; a dearth of community-based clinicians who treat uninsured and underinsured people; stigma surrounding SUDs; underinvestment by the public sector in historically marginalized communities; and limited access to digital tools in many of these communities,” they continued.
Addressing such disparities also requires research, including studies to further the understanding of the effects of social determinants of health (for example, housing and employment) on patients’ engagement with treatment for substance use disorders and advances in data collection.
The authors wrote, “Ensuring that research reduces disparities will require multiple steps,” including the following:
- Include members of underrepresented groups in the development of preventive interventions and treatments.
- Recruit study participants from historically underrepresented groups, including those with varying levels of education. Ensure that studies are large enough to measure differences in outcomes according to race and ethnic group.
- Establish equitable partnerships with people who have or have had substance use disorders and their families, clinicians, policymakers, payers, and advocates. Share study findings with participating communities.
- Diversify the scientific workforce.
- Measure the effects of policies and interventions on equity.
“Applying an equity lens to efforts to address the worsening overdose epidemic and other SUD-related harms is critical to eliminating racial and ethnic disparities and improving health outcomes,” the authors concluded. “Such an approach could also serve as a framework for narrowing disparities in other patient populations.”
For related information, see the Psychiatric News article “Opioid Overdose Death Rate Rose Faster for People of Color.”
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