Department of Psychology, Virginia Commonwealth University, 806 W. Franklin St, Richmond, VA, 23284, USA.
Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 1250 E. Marshall St, Richmond, VA, 23298, USA.
J Racial Ethn Health Disparities. 2022 Aug;9(4):1557-1567. doi: 10.1007/s40615-021-01095-4. Epub 2021 Jul 12.
Largely due to structural racism, Black people with substance use disorder have worse outcomes than their White counterparts. The opioid epidemic has amplified these racial disparities. Little is known about strengths that buffer against the systemic issues that disproportionately impact Black adults with opioid use disorder (OUD), particularly those receiving buprenorphine for OUD. The objectives of this study are to (1) assess psychosocial and clinical predictors of OUD outcomes and (2) explore differences in OUD outcomes by gender among a sample of Black adults receiving buprenorphine. This is a secondary data analysis of a cross-sectional survey and medical record review with a convenience sample recruited from an addiction medicine clinic. Analyses included Black participants who provided at least one urine drug test during the study period (n = 98). Prospective 6-month OUD outcomes (treatment retention, substance use recurrence, and buprenorphine continuation) were abstracted from the medical record. Univariate analyses explored differences by gender. Multivariate regressions assessed predictors of OUD outcomes. Participants were 53% women and middle-aged (47 ± 12 years). The majority (59%) had been in treatment for at least 1 year at study enrollment. Substance use recurrence was common, but many individuals remained in treatment. OUD outcomes did not differ by gender. Older age and absence of injection opioid use history were significant predictors of treatment retention and buprenorphine continuation. When provided access to high-quality treatment, Black adults with OUD demonstrate positive outcomes. Addressing structural racism and developing culturally informed treatment interventions are necessary to improve access to high-quality care for this community.
由于结构性种族主义，患有物质使用障碍的黑人患者比白人患者的预后更差。阿片类药物泛滥加剧了这些种族差异。对于那些接受丁丙诺啡治疗阿片类药物使用障碍（OUD）的黑人成年人，尤其是那些接受丁丙诺啡治疗 OUD 的成年人，缓冲那些不成比例地影响他们的系统性问题的优势知之甚少。本研究的目的是：(1)评估 OUD 结局的心理社会和临床预测因素；(2)在接受丁丙诺啡治疗的黑人成年人样本中，探讨 OUD 结局的性别差异。这是一项横断面调查和病历回顾的二次数据分析，使用便利样本从成瘾医学诊所招募。分析包括在研究期间至少提供一次尿液药物检测的黑人参与者（n = 98）。从病历中提取前瞻性 6 个月 OUD 结局（治疗保留、物质使用复发和丁丙诺啡继续使用）。单变量分析探讨了性别差异。多变量回归评估了 OUD 结局的预测因素。参与者中 53%为女性，年龄中位数为 47 ± 12 岁。大多数人（59%）在研究入组时已经接受治疗至少 1 年。物质使用复发很常见，但许多人仍在接受治疗。OUD 结局在性别上没有差异。年龄较大和无注射类阿片药物使用史是治疗保留和丁丙诺啡继续使用的显著预测因素。当为患有 OUD 的黑人成年人提供高质量的治疗时，他们表现出积极的结果。解决结构性种族主义问题和制定文化敏感的治疗干预措施是必要的，以改善该群体获得高质量护理的机会。
