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Buprenorphine Treatment Divide by Race/Ethnicity and Payment

Educational Objective
To understand the relationship between race, ethnicity and economic factors and buprenorphine treatment.
1 Credit CME

Opioid mortality rates continue to increase throughout the United States1; however, growth in buprenorphine hydrochloride treatment for opioid use disorder (OUD) might be limited to communities with higher income and low percentages of racial/ethnic minorities.2 Buprenorphine, a partial opioid agonist, is 1 of 3 evidence-based medications for treating OUD and can legally be prescribed in office-based settings.

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Article Information

Accepted for Publication: March 12, 2019.

Corresponding Author: Pooja Lagisetty, MD, MSc, NCRC B16-Floor 2, 2800 Plymouth Rd, Ann Arbor, MI 48109 (lagiset@med.umich.edu).

Published Online: May 8, 2019. doi:10.1001/jamapsychiatry.2019.0876

Author Contributions: Dr Lagisetty and Mr Ross had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Lagisetty.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Lagisetty, Ross, Maust.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Ross.

Administrative, technical, or material support: Lagisetty, Clay.

Supervision: Lagisetty, Maust.

Other - mentoring: Bohnert.

Conflict of Interest Disclosures: None reported.

References
1.
Alexander  MJ, Kiang  MV, Barbieri  M.  Trends in black and white opioid mortality in the United States, 1979-2015.  Epidemiology. 2018;29(5):707-715. doi:10.1097/EDE.0000000000000858PubMedGoogle ScholarCrossref
2.
Hansen  H, Siegel  C, Wanderling  J, DiRocco  D.  Buprenorphine and methadone treatment for opioid dependence by income, ethnicity and race of neighborhoods in New York City.  Drug Alcohol Depend. 2016;164:14-21. doi:10.1016/j.drugalcdep.2016.03.028PubMedGoogle ScholarCrossref
3.
Breen  CT, Fiellin  DA.  Buprenorphine supply, access, and quality: where we have come and the path forward.  J Law Med Ethics. 2018;46(2):272-278. doi:10.1177/1073110518782934PubMedGoogle ScholarCrossref
4.
Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. Results from the 2017 National Survey on Drug Use and Health: Detailed Tables. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf. Published September 7, 2018. Accessed April 2, 2019.
5.
Andrews  CM, Grogan  CM, Smith  BT,  et al.  Medicaid benefits for addiction treatment expanded after implementation of the Affordable Care Act.  Health Aff (Millwood). 2018;37(8):1216-1222. doi:10.1377/hlthaff.2018.0272PubMedGoogle ScholarCrossref
6.
Parran  TV, Muller  JZ, Chernyak  E,  et al.  Access to and payment for office-based buprenorphine treatment in Ohio.  Subst Abuse. 2017;11:1178221817699247.PubMedGoogle Scholar
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