Zhu Yuhui, Cousins Sarah J, Clingan Sarah E, Mooney Larissa J, Saxon Andrew J, Evans Elizabeth A, Hser Yih-Ing
Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
J Racial Ethn Health Disparities. 2024 Dec 28. doi: 10.1007/s40615-024-02273-w.
Racial and ethnic differences in long-term outcomes associated with medications for opioid use disorder (MOUD) are poorly understood.
The present analyses were based on 751 participants with opioid use disorder (OUD) who were initially recruited from opioid treatment programs located in California, Connecticut, Oregon, Pennsylvania, and Washington and participated in a randomized controlled trial and at least one follow-up interview. 9.6% (n = 72) of the participants self-identified as Non-Hispanic (NH) Black, 16.0% (n = 120) Hispanic, and 74.4% (n = 559) NH White. We tested racial and ethnic differences in psychiatric or social functioning, substance use and treatment participation.
From the baseline to the end of follow-up interview, compared with NH White, Hispanic participants had a significantly greater proportion of months reporting any opioid use (45.5% vs. 32.5%, p < 0.001) and a smaller proportion of months receiving any MOUD (47.7% vs. 58.1%; p < 0.05), particularly receipt of buprenorphine treatment (8.3% vs. 14.9%; p < 0.01). At the third follow-up interview, data from the Addiction Severity Index (ASI) indicated that Hispanic participants had greater severity in employment problems (0.72 vs. 0.58; p < 0.001), while Black participants had less severity in drug problems (0.11 vs. 0.16; p < 0.05) compared to NH Whites.
The study found that Hispanic participants had higher rates of opioid use (heroin and prescription opioids), but few received MOUD (buprenorphine and methadone) during the follow-up period, which suggests that effective strategies are needed to increase access to MOUD among Hispanics. Additionally, addressing employment challenges might also help improve long-term outcomes for all populations with OUD.
人们对与阿片类物质使用障碍药物治疗（MOUD）相关的长期结果中的种族和民族差异了解甚少。
本分析基于751名患有阿片类物质使用障碍（OUD）的参与者，他们最初是从加利福尼亚州、康涅狄格州、俄勒冈州、宾夕法尼亚州和华盛顿州的阿片类物质治疗项目中招募的，并参与了一项随机对照试验和至少一次随访访谈。9.6%（n = 72）的参与者自我认定为非西班牙裔（NH）黑人，16.0%（n = 120）为西班牙裔，74.4%（n = 559）为NH白人。我们测试了精神或社会功能、物质使用和治疗参与方面的种族和民族差异。
从基线到随访访谈结束，与NH白人相比，西班牙裔参与者报告使用任何阿片类物质的月份比例显著更高（45.5%对32.5%，p < 0.001），接受任何MOUD治疗的月份比例更小（47.7%对58.1%；p < 0.05），尤其是接受丁丙诺啡治疗的比例（8.3%对14.9%；p < 0.01）。在第三次随访访谈中，成瘾严重程度指数（ASI）的数据表明，与NH白人相比，西班牙裔参与者在就业问题上的严重程度更高（0.72对0.58；p < 0.001），而黑人参与者在药物问题上的严重程度更低（0.11对0.16；p < 0.05）。
该研究发现，西班牙裔参与者使用阿片类物质（海洛因和处方阿片类药物）的比例较高，但在随访期间很少接受MOUD治疗（丁丙诺啡和美沙酮），这表明需要有效的策略来增加西班牙裔人群获得MOUD治疗的机会。此外，应对就业挑战也可能有助于改善所有患有OUD人群的长期结果。
