Racial and ethnic disparities in treatment access and outcomes among patients with substance use disorders (SUDs) have widened, despite substantial efforts to address the epidemic of drug-overdose deaths in the United States. Rates of overdose death are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations.1 Members of some of these groups also use medications for opioid use disorder (such as methadone, buprenorphine, and naltrexone) at lower rates, have worse health outcomes in the context of SUD, and are more likely to be targeted by police and incarcerated for drug possession than their White counterparts.2 Addressing the overdose epidemic requires eliminating racial and ethnic disparities — along with socioeconomic, gender-based, and geographic disparities — in SUD prevention and care. Prioritizing research that informs policy could help advance equity in SUD-related outcomes…
Prevention is another key area of focus. It’s important to develop and implement interventions that minimize the chances that people will be unnecessarily exposed to opioids and other drugs or will misuse them. In addition to addressing social determinants of health, preventive interventions could prioritize populations at elevated risk for SUDs, such as people who are prescribed opioids for pain or people who have a family history of SUD or psychiatric conditions but may not have initiated substance use. For people who have started using drugs, early recognition and intervention could prevent escalation of drug use and transition to an SUD. Some such interventions have already been developed, but additional research may be required to ensure that they are acceptable and effective in various racial and ethnic groups and don’t exacerbate inequities.
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Reference
Carlos Blanco, M.D., Ph.D., Elisabeth U. Kato, M.D., M.R.P., Will M. Aklin, Ph.D., Sebastian T. Tong, M.D., M.P.H., Arlene Bierman, M.D., David Meyers, M.D.,
and Nora D. Volkow, M.D. (2022). Research to Move Policy — Using Evidence to Advance Health Equity for Substance Use Disorders. N Engl J Med 2022; 386:2253-2255
DOI: 10.1056/NEJMp2202740
