Racial Inequality in Receipt of Medications for Opioid Use Disorder in Nationwide Outpatient Settings-A Cross-sectional Study.

Abstract

The surge in drug overdose fatalities in the USA, particularly from synthetic opioids, highlights the need for effective interventions. Medication for opioid use disorder (MOUD) shows promise in treatment, but disparities in access persist. This study was designed to investigate disparities in MOUD receipt in the outpatient settings for patients diagnosed with opioid use disorder (OUD). Observational cohort study. The nationwide electronic medical record (EMR) from the IQVIA Ambulatory EMR-US database was utilized, comprising 32,929 patients diagnosed with OUD between January 2014 and September 2022. The analysis focused on Black and White populations, the majority of whom have commercial insurance. Access to FDA-approved medications for OUD treatment within 180 days after index OUD diagnosis across the USA were measured by medication receipt rate, average days of medication supply, and retention rate. Notable racial disparities were identified in MOUD receipt, with Black population having significantly lower rates than White. State-level disparities were also evident, with 25 out of 41 states showing lower MOUD receipt rates among Black than in White population. Quarterly trends in receipt rates showed lower rates among Black population in most years. Additionally, the average days of supply for MOUD prescriptions were lower for Black population across most states. Significant racial and state-level disparities exist in MOUD receipt among patients in outpatient settings. The study underscores the need for targeted interventions to address these inequities in MOUD access.