The analysis of 15 years of prescription data showed that the racial disparities are widening.
By Emily Baumgaertner, New York Times
November 9, 2022
Researchers have long known that racial and ethnic minorities are less likely to be prescribed lifesaving addiction treatment options than white people.
But even when Black and Hispanic patients start a prescription for buprenorphine — the most popular medication to help those in recovery fight cravings — the typical duration of their treatment is shorter than that of white patients, according to a new data analysis published Wednesday in JAMA Psychiatry.
The analysis, which sorted through 15 years of prescription data by race and ethnicity, also revealed that the percentage of minority patients who remained on buprenorphine for more than 180 days — the minimum recommended duration — was significantly below that of white patients.
Racial and ethnic gaps in length of treatment have consistently widened, particularly in recent years, the researchers said. The divide reflects structural barriers — such as inconsistent employment or medical care — some groups face even after they begin working toward recovery.
The new analysis is part of an ongoing research project that aims to “dig into the granular data for really specific measures of effectiveness — like treatment duration — that could set the stage for eventually closing the gaps,” said Mohammad Jalali, an assistant professor at Harvard Medical School who co-wrote the paper with several colleagues.
Medication-assisted treatment for opioid use disorder has been a subject of debate in the United States because drugs like buprenorphine (also known by the brand name Suboxone) and methadone are also opioids. Some officials worry that the approach encourages drug use.
Optimal length of buprenorphine treatment is a source of “very lively, active debate” among clinicians and researchers, said Erin Stringfellow, one of the study’s co-authors. Some urge patients to eventually wean off the opioid, but others believe it is best to continue a medication-assisted treatment plan indefinitely.
Still, the minimum recommended duration for buprenorphine treatment is six months, so all experts agreed: The treatment figures for all groups in 2020, the most recent available year, were far too low.
For white patients, the median treatment duration was about 53 days; for Black patients, about 44 days; and for Hispanic patients, less than 40.“There’s no debate here. Fifty days is not long enough for anyone,” Dr. Stringfellow said.
Racial and Ethnic Disparities in Buprenorphine Treatment Duration in the US.
Dong H, Stringfellow EJ, Russell WA, Jalali MS.
JAMA Psychiatry. 2022 Nov 9. doi: 10.1001/jamapsychiatry.2022.3673. Online ahead of print.
Photo credit: Brian L. Frank for The New York Times