Addiction treatment expanded, but still unequal

Key points

  • The number of Medicaid patients receiving opioid use disorder (OUD) medications increased from 47.8% in 2014 to 57.1% in 2018.
  • Compared with their white counterparts, black Medicaid patients are much less likely to receive OUD medications, and they are also less likely to receive therapeutic continuum of care.
  • Pregnant Medicaid patients are more likely to receive continuous drug-assisted treatment to manage OUD.

The state-sponsored Medicaid program provides important support and services to low-income Americans who need medical care, and has proven to be very effective in helping opioid addicts in recent years. Nevertheless, gaps in accessibility still exist.

A recently published large-scale meta-analysis of Medicaid recipients American Medical Association It was found that although access to care has expanded overall, the rate of black patients receiving OUD medication is much lower than that of white patients. This shows that there is an urgent need to further evaluate the distribution of fair treatment by race.

Understand the research

This Medicaid Distributed Research Network (MODRN) study based on more than 1 million patients in 11 states found that the use of drugs used to treat OUD increased from 47.8% in 2014 to 57.1% in 2018.

To determine the quality of care, the researchers evaluated a 6-month continuous medication, a urine drug test order and a behavioral health advisory statement, and whether any other controlled substances related to an increased risk of overdose were prescribed.

Pregnant Medicaid patients are more likely to be prescribed medications as part of the treatment of OUD, especially considering that they are often followed during pregnancy. In the treatment of black or disabled patients, the use of OUD drugs is found to be low.

The limitations of this study covered only 11 states, but included Pennsylvania and the other five states with the highest mortality rates from opioid overdose.

The minority population is disproportionately affected

Addiction doctor and researcher from the University of Calgary and the University of Alberta, S. Monty Ghosh, MD, MBT, Master of Science, Bachelor of Science, FRCPC, ISAM said: “The biggest gain is what we already know exists in other diseases The state is the same. Minorities are disproportionately affected by the opioid crisis for various reasons, and access to and maintenance of care is a key aspect of this impact.”

Given that unfair addiction treatment continues to exist, Ghosh emphasized the importance of the participation of affected communities. “By working with these communities and understanding their barriers and facilitators, we are more likely to understand how to best provide them with resources and address health inequalities,” he said.

S. Monty Ghosh, MD, MBT, MSc, BSc, FRCPC, ISAM

Many people are struggling for basic services such as housing, income and food insecurity, which makes their health needs second only to survival.

— S. Monty Ghosh, MD, MBT, MSc, BSc, FRCPC, ISAM

Black Medicaid patients are much less likely to receive OUD medication, and this treatment is less continuous, while pregnant women are more likely to receive continuous care for medication-assisted OUD.

For a long time, research has proven the link between trauma and addiction, and BIOC individuals face a high risk of negative events due to oppression, so unfair treatment opportunities for addiction have a profound impact.

Ghosh said: “Vulnerable groups and marginalized communities have many barriers to accessing care. Many people are struggling for basic services such as housing, income and food insecurity, which makes their health needs second only to survival. Interesting The thing is, for addiction, substances usually hijack deep-rooted parts of the brain, which is why people prefer substances.”

Health gap crisis

Deidra Thompson, DNP, FNP-C, PMHNP-BC, faculty and staff of the Walden University Master of Science in Nursing Program said: “Opioid use disorders have a major impact on individuals and their families. People die from opioid use disorders every day. This is a crisis. There are health differences in several aspects of healthcare, including access to healthcare and health outcomes.”

Didela Thompson, DNP, FNP-C, PMHNP-BC

People die from opioid use disorders every day. This is a crisis. There are health differences in several aspects of health care, including access to health care and health outcomes.

— Deidra Thompson, DNP, FNP-C, PMHNP-BC

Unfortunately, BIOC individuals continue to die disproportionately from heart disease and avoidable diseases. “Although the environment, socioeconomic status and lifestyle affect a person’s health and access to care, even if these factors are controlled, differences still exist,” she said.

Thompson said: “Healthcare providers and policymakers can take action to close the gap in healthcare by ensuring that every patient is provided with quality care, regardless of race, gender or status. We need greater awareness. And more resources. Patients should actively develop treatment plans and follow treatment recommendations. Opioid use disorder is a disease.”

What this means to you

The stigma of institutional racism and addiction has led to disparities in the medical care of black Medicaid patients struggling with OUD. Since Medicaid eligibility requires low income, the impact of poverty on these dynamics cannot be ignored. Given that pregnant Medicaid patients are more likely to receive continuous drug-assisted treatment to manage OUD, other groups may also achieve this success.

This is why Ghosh said: “Readers can apply this by supporting this group as much as possible and recognizing that they have less access to resources and services and understanding that this may be a problem. It shows that we need to be creative and innovative, Serving marginalized and disadvantaged communities. Typical methods usually do not work, so flexibility and creativity are key.”

.