As the nation has again reached a record number of overdose deaths, many believe increased access to medication-assisted treatment (MAT) could help. However, more needs to be done to increase MAT access for people of color specifically.
At least, that’s the argument Barbara Andraka-Christou made in a recent article published in the June edition of the journal Health Affairs. In it, she makes the case for increasing access to financial and medical resources for Black, non-white Hispanics and Native Americans struggling with opioid use disorder (OUD).
“A multifaceted approach is needed to address racial and ethnic disparities in treatment and retention with medication for OUD,” Andraka-Christou said in the article. “The Biden administration’s stated commitment to advancing racial equity is an important first step toward pursuing policies to reduce disparities in treatment with medication for OUD.”
The eight-page paper analyzed various data on the OUD trends of different racial groups. A lawyer, Andraka-Christou is also an assistant professor in the department of health management and informatics at the University of Central Florida.
The article points to the OUD death rate from 2013 to 2017 to get its message across. OUD deaths among whites increased ninefold during the time span; meanwhile, they jumped twelvefold for the Hispanic population and eighteenfold for the Black community.
MAT — using drugs like buprenorphine and methadone — is widely considered to be the gold standard of care for treating OUD. However, only 16% of speciality substance use disorder (SUD) treatment programs nationwide offer MAT for OUD, Andraka-Christou cited.
She went on to note that no algorithm exists for matching people with the right MAT drug. However, people of color are more likely to be administered methadone — which traditionally has been more stigmatized given the high likelihood of death if misused. Meanwhile, white patients more often use buprenorphine.
Andraka-Christou noted that the disparity, which compounds OUD access issues for people of color, is further aggravated by the fact that SUD treatment facilities are less likely to offer MAT for OUD if the majority of the patient population is not white. Additionally, she cited data showing that the number of whites visiting treatment facilities for buprenorphine prescriptions is more than three times that of other races.
To remedy the problems people of color face in trying to access MATs, Andraka-Christou proposed an increase in grant funding for Federally Qualified Health Centers (FQHCs) to administer buprenorphine. Another solution, she believes, could be expanding Medicaid, which could increase OUD treatment access for low-income and uninsured individuals, many of whom are people of color.
OUD treatment access has become a particularly critical issue in the fight against the opioid epidemic, as provisional data released in April by the Centers for Disease Control and Prevention (CDC) showed that a record 87,203 Americans died from drug overdoses in a 12-month period ending in September 2020.
Shortly after the data was released, the Department of Health and Human Services (HHS) announced that it was issuing new guidelines to allow for more clinicians to prescribe MATs. However, the guidelines only apply to buprenorphine.
Within the last few months, a bipartisan Senate group has also introduced legislation that would boost funding in the fight against SUD, which includes such measures as increased methadone prescription access.
