Women, Black adults, and Hispanic adults do not have equal access to potentially lifesaving opioid treatment.
Longstanding health disparities continue to interfere with equal access to a key opioid treatment method using buprenorphine, a prescription proven to effectively treat opioid dependence or addiction, according to a Mayo Clinic study published in JAMA Network Open.
The study, which examined more than 3,000 completed prescriptions for buprenorphine from more than 72,000 emergency visits between 2014 and 2020, found prescription fills were consistently lower among vulnerable populations, including individuals aged 41 and older, women, Black adults, and Hispanic adults. Additionally, males, younger adults, and non-Hispanic white adults were more likely to receive the treatment.
While buprenorphine was approved by the Food and Drug Administration in 2002 and has been repeatedly proven to effectively treat opioid addiction, the lack of equal access has remained for years. "The persistence of the disparities is frustrating,” said Molly Jeffery, Ph.D., scientific director for Mayo Clinic's Division of Emergency Medicine Research and the study's senior author, in a statement. “This is a truly lifesaving treatment. But it does appear that all groups are gaining access over time, which is what we want to see.”
Researchers attribute the disproportionate barriers to opioid treatment to systemic racism, mistrust of health care professionals and the health care system, a lack of emergency department providers, regulatory requirements, reimbursement issues, as well as addiction and mental health stigmas. The COVID-19 pandemic has also exacerbated opioid misuse and addiction.
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To close the gap, the research team called for more primary care providers to become involved in prescribing buprenorphine as well as the removal of current requirements that limit providers from prescribing the medication.
"The laws that currently limit access to buprenorphine are a legacy of an earlier opioid epidemic from literally 100 years ago. Those laws are based in mistrust of physicians and patients and a fundamental misunderstanding about substance use disorders," Jeffrey said in the statement. "Making it easy to access safe and effective treatment is the best way to fight the epidemic of opioid overdoses, which has gotten worse during the COVID-19 pandemic."