A quartet of researchers, three with Harvard Medical School’s Massachusetts General Hospital Institute for Technology Assessment, and the fourth with McGill University, has found that there are ethnic and racial disparities in the availability and duration of treatment for people with addictions prescribed the drug buprenorphine.
In their Research Letter written for the U.S. State Department and published in JAMA Psychiatry, the group describes what they found when they studied addiction patient information obtained from IQVIA, a health information technology company.
Over the past several years, the use and abuse of opioids in the United States has reached levels that have prompted some in the medical community to describe it as a crisis. Drugs such as oxycontin and fentanyl have been overprescribed and have been made and sold illegally, leading to widespread abuse and sometimes death from overdose. Prior work has led to the development of drugs to help people addicted to opioids wean themselves off—one of the most prominent is buprenorphine.
In this new effort, the researchers noted evidence that not everyone has equal access to the drug and that such access may be impacted by race or ethnicity. To learn more, they asked for and obtained access to a database, owned and run by the health technology company IQVIA, containing information on thousands of patients and millions of prescriptions filled by doctors covering the years 2006 to 2020.
The researchers found evidence of disparities in the ways that buprenorphine was prescribed and also in the duration of treatment. Most in the medical community suggest that the minimum amount of time an addict should take the drug is six months.
In their study, they found that while approximately 84.1% of white patients in the database had access to buprenorphine, the same was true for just 8.1% of black patients and 6.3% of Hispanic patients. They also found that the average treatment duration time for white patients was 53 days; that fell to 44 days for black patients and just 40 days for Hispanic patients. They also noted that the numbers have grown worse in more recent years.
The researchers were not able to isolate a reason for the disparities they found in treatment options, but suggested more work is required.
Huiru Dong et al, Racial and Ethnic Disparities in Buprenorphine Treatment Duration in the US, JAMA Psychiatry (2022). DOI: 10.1001/jamapsychiatry.2022.3673
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