The CRHC and the Center for Health Equity Research and Promotion are proud to announce a new publication: "Racial/Ethnic Differences in the Medical Treatment of Opioid Use Disorders Within the VA Healthcare System Following Non-Fatal Opioid Overdose" by CRHC authors Drs. Utibe Essien, Jane M. Liebschutz, Chester B. Good, Thomas R. Radomski, Leslie R. M. Hausmann, Michael J. Fine, and Walid Gellad.
The study assess the association of race/ethnicity with the prescribing of opioids and medication to treat opioid use disorder after a non-fatal opioid overdose. Based on a national cohort of 16,210 patients with a non-fatal opioid overdose in the Veterans Health Administration, the study found no racial or ethnic differences in changes in opioid prescribing after the overdose. Prescribing of medications for opioid use disorder for patients following an overdose was low, with less than 4% received medication to treat opioid use disorder in the 30 days after the overdose, with statistically higher rates in black and Hispanic patients.
Lead author Dr. Utibe Essien described the study findings in a Twitter thread:
Thrilled to share my first VA paper (and first visual abstract!) with my all-star @vaequity @PittGIM mentor team, on racial and ethnic differences in the medical treatment of opioid use disorder within the VA following a non-fatal opioid overdose. Prior studies ( @LarochelleMarc et al.) showed that opioid prescribing and the use of medications for opioid use disorder (MOUDs) remains low, even after a non-fatal overdose. Further, a recent paper by @PoojaLagisetty showed racial disparities in MOUD.
— Utibe Essien (@UREssien) January 22, 2020
In our study we examined patients managed in the VA to assess whether race/ethnicity was associated with: 1) opioid prescribing before and after a non-fatal opioid overdose and, 2) receipt of MOUD (i.e., buprenorphine, methadone, and naltrexone) following opioid overdose. After overdose: 1) frequency of receiving opioids was reduced by 18.3, 16.4, and 20.6 % in whites, blacks, and Hispanics (not statistically significant). 2) few received MOUDs (2.9% white, 4.6% black, and 5.5% Hispanic). Black and Hispanic patients had higher odds of receipt.
— Utibe Essien (@UREssien) January 22, 2020
Understanding some of the factors associated with this seemingly paradoxical racial difference in prescribing (e.g., rurality, bias/stigma, access to care) will be important for ensuring equitable care for all patients during the critical time period of an opioid overdose.
— Utibe Essien (@UREssien) January 22, 2020
This thread is available on Twitter or through the Thread Reader App.
The study was published in the Journal of General Internal Medicine on January 21, 2020. Other co-authors included Floretina E. Sileanu, Xinhua Zhao, Carolyn T. Thorpe, and Maria K. Mor.
February 7, 2020 • Michelle Woods