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改善研究种族差异在获得药物治疗阿片类药物使用障碍。

Improving Research on Racial Disparities in Access to Medications to Treat Opioid Use Disorders.

机构信息

From the RTI International, Durham, NC (TLM, L-SAG, RP); American Society of Addiction Medicine, Rockville, MD (GMM); and Thomas Jefferson University, Philadelphia, PA (LW).

出版信息

J Addict Med. 2023;17(3):249-257. doi: 10.1097/ADM.0000000000001104. Epub 2022 Oct 27.

Abstract

OBJECTIVES

The aims of the study are to review the current research on the association between access to medications for opioid use disorders (MOUD) and race, to identify gaps in research methods, and to propose new approaches to end racialized disparities in access to MOUD.

METHODS

We conducted a literature review of English language peer-reviewed published literature from 2010 to 2021 to identify research studies examining the association between race and use of, or access to, MOUD.

RESULTS

We reviewed 21 studies related to access to MOUD for Black and White populations. Of the 21 studies, 16 found that Black individuals had lower use of, or access to, MOUD than White individuals, 2 found the opposite among patients in specialty addiction treatment, 1 found that the difference changed over time, and 2 found that distance to opioid treatment programs was shorter for Black residents than for White residents.

CONCLUSIONS

To improve future research, we recommend that researchers (1) be clearer on how race is conceptualized and interpreted; (2) explicitly evaluate the intersection of race and other factors that may influence access such as income, insurance status, and geography; (3) use measures of perceived racism, unconscious bias, and self-identified race; (4) collect narratives to better understand why race is associated with lower MOUD access and identify solutions; and (5) evaluate the effect of policies, programs, and clinical training on reducing racial disparities. A multitude of studies find that Black individuals have lower access to MOUD. Researchers must now identify effective solutions for reducing these disparities.

摘要

目的

本研究旨在回顾目前关于获得阿片类药物使用障碍(MOUD)药物与种族之间关系的研究,确定研究方法中的差距,并提出新方法以消除 MOUD 获得方面的种族差异。

方法

我们对 2010 年至 2021 年期间发表的英语同行评议文献进行了文献回顾,以确定研究种族与 MOUD 的使用或获取之间关系的研究。

结果

我们共审查了 21 项关于黑人和白人获得 MOUD 的研究。在这 21 项研究中,有 16 项发现黑人群体使用或获得 MOUD 的比例低于白人群体,2 项在专门的成瘾治疗患者中发现相反的结果,1 项发现差异随时间变化,2 项发现黑人群体与白人群体相比,到阿片类药物治疗项目的距离更近。

结论

为了改进未来的研究,我们建议研究人员(1)更清楚地说明如何概念化和解释种族;(2)明确评估种族与其他可能影响获取的因素(如收入、保险状况和地理位置)的交叉点;(3)使用感知种族主义、无意识偏见和自我认同种族的衡量标准;(4)收集叙述,以更好地了解为什么种族与较低的 MOUD 获得相关,并确定解决方案;(5)评估政策、计划和临床培训对减少种族差异的影响。大量研究发现,黑人群体获得 MOUD 的机会较低。研究人员现在必须确定减少这些差异的有效解决方案。

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