Racial and ethnic inequities in substance use treatment among women with opioid use disorder.

IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL American Journal of Drug and Alcohol Abuse Pub Date : 2024-01-02 Epub Date: 2024-01-31 DOI:10.1080/00952990.2023.2291748
Joy D Scheidell, Maya Pitre, Barbara Andraka-Christou
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Abstract

Background: Research describes inequities in substance use treatment, but few studies focus specifically on racial and ethnic disparities in a range of aspects of substance use treatment among women with opioid use disorder (OUD).Objective: To examine whether substance use treatment (i.e. receipt, sources, barriers) differs by race and ethnicity among women with opioid use disorder (OUD) and to identify factors associated with treatment gap (i.e. needing treatment but not receiving it).Methods: We performed cross-sectional analyses using National Survey on Drug Use and Health 2015-2019 data, restricted to non-Hispanic Black, non-Hispanic White, and Hispanic women with past-year OUD (unweighted n = 1089). We estimated the prevalence of aspects of treatment among racial and ethnic groups, and used modified Poisson regression to estimate correlates of reported treatment gap.Results: Approximately 68% of White versus 87% of Black and 81% of Hispanic women with OUD had a treatment gap (p-value 0.0034). Commonly reported barriers to treatment included prioritization, affordability, and stigma. Older age was associated with lower prevalence of treatment gap among all women [prevalence ratio (PR) = 0.83, and 95% confidence interval (CI): 0.76, 0.92], while criminal legal involvement and healthcare coverage was associated with a lower prevalence of treatment gap among Hispanic and White women only (past year arrest: Hispanic women PR = 0.38, 95% CI: 0.17, 0.86; White women PR = 0.62, 95% CI: 0.47, 0.82).Conclusions: Receipt of treatment is low among women with OUD, especially Black and Hispanic women. Intersectional intervention approaches are needed to increase access and reduce inequities.

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患有阿片类药物使用障碍的妇女在药物使用治疗方面的种族和民族不平等。
背景:研究描述了药物使用治疗中的不公平现象,但很少有研究专门关注患有阿片类药物使用障碍(OUD)的女性在药物使用治疗的一系列方面存在的种族和民族差异:研究患有阿片类药物使用障碍(OUD)的女性在药物使用治疗(即接受、来源、障碍)方面是否存在种族和民族差异,并确定与治疗差距(即需要治疗但未接受治疗)相关的因素:我们使用《2015-2019 年全国药物使用和健康调查》数据进行了横截面分析,仅限于非西班牙裔黑人、非西班牙裔白人和西班牙裔女性上一年的 OUD 患者(未加权 n = 1089)。我们估算了种族和民族群体中治疗方面的流行率,并使用修正的泊松回归估算了报告治疗差距的相关因素:约 68% 的白人、87% 的黑人和 81% 的西班牙裔女性 OUD 患者存在治疗差距(P 值为 0.0034)。常见的治疗障碍包括优先级、经济承受能力和耻辱感。在所有女性中,年龄越大,治疗差距发生率越低[患病率比(PR)= 0.83,95% 置信区间(CI):0.76, 0.92],而仅在西班牙裔女性和白人女性中,刑事法律介入和医疗保健覆盖率与治疗差距发生率较低有关(过去一年被捕的西班牙裔女性:PR = 0.83,95% 置信区间(CI):0.76, 0.92):西班牙裔女性 PR = 0.38,95% CI:0.17,0.86;白人女性 PR = 0.62,95% CI:0.47,0.82):患有 OUD 的妇女接受治疗的比例较低,尤其是黑人和西班牙裔妇女。需要采取跨部门干预方法来增加治疗机会并减少不平等现象。
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来源期刊
CiteScore
4.70
自引率
3.70%
发文量
68
期刊介绍: The American Journal of Drug and Alcohol Abuse (AJDAA) is an international journal published six times per year and provides an important and stimulating venue for the exchange of ideas between the researchers working in diverse areas, including public policy, epidemiology, neurobiology, and the treatment of addictive disorders. AJDAA includes a wide range of translational research, covering preclinical and clinical aspects of the field. AJDAA covers these topics with focused data presentations and authoritative reviews of timely developments in our field. Manuscripts exploring addictions other than substance use disorders are encouraged. Reviews and Perspectives of emerging fields are given priority consideration. Areas of particular interest include: public health policy; novel research methodologies; human and animal pharmacology; human translational studies, including neuroimaging; pharmacological and behavioral treatments; new modalities of care; molecular and family genetic studies; medicinal use of substances traditionally considered substances of abuse.
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