Another health disparity

Blacks unlikely to get addiction treatment

addiction treatment
JOE RAEDLE/GETTY IMAGES/TNS
Bottles of the generic prescription pain medication Buprenorphine are seen in a Florida pharmacy. The narcotic drug is used as an alternative to Methadone to help addicts recovering from heroin use.

BY AUBREY WHELAN
THE PHILADELPHIA INQUIRER / TNS

An addiction treatment drug that health officials around the country have touted as a crucial part of the battle against the opioid epidemic is prescribed far more often to White patients.

The study, authored by researchers at the University of Michigan and published Wednesday in the Journal of the American Medical Association, looked at how often patients of different races and ethnicities were prescribed the treatment drug buprenorphine at doctors’ visits.

Less stigma

Getting the medicine at a doctor’s office is a selling point of the opioid-based treatment medication that has fewer federal regulations attached to it than methadone, which must be doled out at clinics and is more stigmatized.

Patients can take buprenorphine in the privacy of their homes or doctor’s offices, and most patients on buprenorphine do receive the drug in “office-based settings,” the study authors wrote.

Still, doctors need special permission to prescribe buprenorphine, something that isn’t required for the opioid painkillers that may have sparked the addiction crisis.

Millions of visits

The study looked at more than 13 million doctors’ visits in which buprenorphine was prescribed between 2012 and 2015, and found that 12.7 million of those visits were by White patients, compared to just 363,000 for all other races.

That’s despite the fact that national surveys suggest White patients are only slightly more likely than Black patients to use heroin, or to take prescription pills without a doctor’s direction.

Patients prescribed buprenorphine were also more likely to have private insurance, or pay cash, than to have Medicaid. This held even after the Obamacare Medicaid expansion added more people to the public-insurance rolls.

“It makes you question whether people of lower income or those on Medicaid have equitable access to care,” said Pooja Lagisetty, an assistant professor at the University of Michigan and the study’s lead author.

Blacks, Whites victimized

The opioid crisis has been portrayed largely as affecting White Americans. But in cities like Baltimore and Washington, D.C., most victims of fatal overdoses are Black.

In Philadelphia, though Whites made up the largest share of opioid overdose deaths in 2017, deaths among Blacks rose 34 percent, and deaths among Hispanics jumped 60 percent from the prior year.

“We’re all trying to rapidly improve access to treatment,” Lagisetty said. “But we have to be thoughtful about really improving access to treatment for those who need it most.”

Lagisetty said it’s possible some states have policies in place to address racial disparities in treatment. She said the authors hope their paper spurs further research.

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