Black, Hispanic, And Asian Adults In The US Had Substantially Lower Engagement On The Naloxone Care Cascade, 2024.

Racial and ethnic disparities in opioid overdose deaths in the US have widened in recent years, potentially driven by inequitable access to naloxone. This study evaluated engagement across the naloxone care cascade, a framework encompassing awareness, access, training, possession, and use of naloxone. Using a nationally representative US sample, we analyzed data from 57,719 adults who completed the 2024 Survey of Non-Medical Use of Prescription Drugs to characterize differences by race and ethnicity in the degree of contact with any component of the naloxone care cascade. Black, Hispanic, and Asian adults had significantly lower engagement across all steps of the cascade compared with White adults. These trends were similar among a subgroup of adults with recent illicit or nonmedical opioid use. Culturally tailored, equity-focused strategies are needed to address the systemic drivers of racial and ethnic disparities in naloxone engagement.