Abstract
Introduction: The COVID-19 pandemic collided with the opioid epidemic and longstanding health inequities to exacerbate the disproportionate harms experienced by persons with opioid use disorder (OUD) who self-identify as from racial and ethnic minority groups. Disrupted access to harm reduction services (e.g., naloxone, sterile syringes, recovery support) is one pathway whereby COVID-19 might exacerbate health disparities. We tested the hypothesis that persons receiving medication for opioid use disorder (MOUD) who self-identify as from racial/ethnic minority groups would experience more disruptions in access to harm reduction services than persons identifying as non-Hispanic White, even when controlling for severity of opioid use and sociodemographics (e.g., education, income, biological sex, age).
Methods: Analyses used data from a cluster randomized trial that had enrolled 188 patients, all of whom had provided baseline data on sociodemographics and severity of opioid use, across eight opioid treatment programs. Data collectors re-contacted participants between May and June 2020 and 133 (71% response rate) agreed to complete a survey about access to harm reduction services.
Results: Twenty-six respondents (20%) identified as from racial/ethnic minority groups (predominantly Black, Hispanic, and/or biracial). Between 7% and 27% of respondents reported disrupted access to harm reduction services. Logistic regressions indicated that persons identifying as from racial/ethnic minority groups were 8-10 times more likely than persons identifying as non-Hispanic White to report reduced access to naloxone and sterile syringes (p < .01), even when accounting for potential confounding variables.
Conclusions: This report concludes with a discussion of potential outreach strategies and policies to advance more equitable access to essential harm reduction services.
Keywords: COVID-19; Disparities; Harm reduction; Inequity; Opioids.
【저자키워드】 COVID-19, harm reduction, Disparities, Inequity, Opioids., 【초록키워드】 Treatment, opioids, COVID-19 pandemic, severity, randomized trial, Sex, Epidemic, Health, pathway, Cluster, age, group, medication, patients, Hispanic, Hypothesis, Health inequity, Regression, confounding variables, Support, reduction, black, Racial, white, participant, disorder, Complete, enrolled, tested, reported, indicated, eight, provided, receiving, reduced, groups, exacerbate, baseline, Disrupted, used data, 【제목키워드】 group, medication, reduction, Racial, disorder, receiving, Person,