Bpeople with a deficiency are much less likely than other Americans to receive buprenorphine, an important drug for treating opioid use disorders, according to a new study.
According to the analysis, white patients requiring addiction treatment were prescribed more than twice as much buprenorphine as black patients in the six months prior to an addiction-related emergency. The treatment gap persisted at a similar rate in the six months following an overdose, hospitalization, or admission to rehab.
The studypublished Wednesday in the New England Journal of Medicine, used data on insurance claims from 2016 to 2019 to analyze more than 23,000 Medicare beneficiaries who qualified for the safety net program because of a disability.
The analysis highlights a dual crisis in American addiction medicine: Few people with opioid addiction have access to the highly effective drugs used to treat the condition, and those receiving the drugs are disproportionately white.
Opioid overdose rates among black people have also skyrocketed in recent years and into 2020 surpassed the death rate per capita among whites for the first time in more than two decades.
In addition to receiving buprenorphine at a higher rate, white patients were also much more likely than black patients to live near a provider of the medication and remain in treatment for months after they were first prescribed it, the study said. study. The authors of the paper cited “racial health care segregation, varying incarceration rates, disproportionate participation in Medicaid, and increases in fentanyl use in urban areas, which tend to have larger Black and Hispanic populations” as among the contributing factors to the racial disparity in access to addiction treatment.
The US currently records more than 80,000 opioid overdose deaths per year, largely caused by fentanyl. Fentanyl overdose death rates are highest among American Indians and Alaska Natives, and next among black people, with 33.1 and 31.3 annual deaths per 100,000 people, respectively, according to recent data of the Centers for Disease Control and Prevention.
White people score slightly lower at 24.6 deaths, than Hispanic people at 14.1, than Asian individuals at 2.3.
Even aside from the stark racial disparities in which patients receive buprenorphine, the drug has become increasingly difficult to use in recent years as fentanyl has become ubiquitous in the U.S. drug supply. Fentanyl is so potent that patients who begin treatment often experience “hasty withdrawal” – excruciating withdrawal symptoms caused by the switch to buprenorphine, which is much weaker.
The other common drug used for opioid addiction, methadone, can help patients seeking drug treatment, but is very limited and only accessible in specialty clinics where patients often have to show up in person each day to receive a single dose.
The study also found that naloxone, the rescue medication used to reverse opioid overdoses, was similarly much more likely to be prescribed to white patients than to black patients.
Naltrexone, a third drug used to help prevent opioid cravings in people recovering from opioid addiction, was also prescribed to black patients at a disproportionately low rate.
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