Opioid use disorder

Racial and ethnic minorities with opioid use disorder (OUD); have a significantly lower odds of receiving a prescription for buprenorphine compared with their white counterparts; new research shows. Investigators used two large databases that included 13.4 million outpatient visits in 2012-2015 to compare buprenorphine prescriptions; in white patients versus those of other races and ethnicities.

They found that white patient 35 times more likely to have an outpatient visit that included buprenorphine; prescription compared with people of color. Moreover, outpatient visits in which buprenorphine by almost 40% in 2004-2007 and 2012-2015. Almost 40% of prescriptions were paid for in cash and almost 35% by private insurance; the number of buprenorphine visits by self-pay patients dramatically increased.

The opioid-related mortality

The researcher the study basically showed that there are large racial discrepancies in which Americans receive buprenorphine; which is one of the evidence-based treatments for opioid addiction. Although opioid-related mortality rates continue to rise throughout the United States; growth in buprenorphine treatment for OUD “might limited to communities with higher income and low percentages of racial and ethnic minorities.

These surveys provide nationally representative estimates of ambulatory care provided in the United States by nonfederally employed physicians; as well as capturing physician-reported medications prescribed during each office visit; demographic characteristics of patients; expected source of payment. Researchers limited their sample to visits during which buprenorphine was prescribed in 2012-2015 to test the association of race/ethnicity with receipt of buprenorphine prescription; using a logistic regression model adjusted for age, sex, and payment method.

The buprenorphine prescription

Black patients found to have a significantly lower odds of receiving a buprenorphine prescription after researchers accounted for payment method, sex, and age (adjusted OR, 0.23; 95% CI, 0.13 – 0.44). “Many patients opt to self-pay because their insurance is not sufficiently comprehensive or they do not want to disclose that they have a substance use disorder,” he pointed out.

“Alternatively, buprenorphine treatment for many doctors is ‘off the grid,’ meaning that they prefer to operate outside of insurance programs which are unfortunate because of the real financial burden; it implies for patients. He noted one limitation of the study the data end in 2015 and “they still do not know how much this picture will change with continued implementation; of the Affordable Care Act Medicaid Expansion.

“My big take-home message is that policymakers need to not just declare victory if more patients are treated with buprenorphine; they should also pay attention to whether buprenorphine prescribers are in diverse communities and willing to accept all forms of insurance payment. “I hope that this study can spin on future studies and policies for ways to ensure that everyone has good access to the treatment they need.