Racial and economic inequalities limit access to medications for opioid use disorder and persist even when dispensed in pharmacies, according to a study published in The Journal of Opioid Use Disorder. Report on drug and alcohol addictionp.1 The authors said the findings underscore the need for policy action to promote drug equity.
Social and economic barriers affect access to medications for opioid use disorder / Simone – stock.adobe.com
The opioid epidemic continues to have a significant impact in the United States. According to CDC data, there were 81,083 opioid-related deaths in 2023.2 In addition, not everyone is affected equally by the health crisis. Death rates are rising fastest among the black and Hispanic populations.3 Racial and ethnic inequalities are known to impact access to MOUD, but data are lacking on whether these persist at the time of delivery.
READ MORE: FDA approves nalmefene injection for opioid overdose
“While there have been notable policy changes over the past decade that have improved access to medications for opioid use disorder and made progress in combating racial inequality, these efforts have not addressed whether patients are actually getting their prescriptions filled,” said Dan Hartung, co-author of the study, in a press release.3
A team of researchers from Oregon State University and Johns Hopkins University conducted a study to examine the associations between county-level racial and classist phenomena and restricted dispensing of buprenorphine in pharmacies. The data comes from a previous study that quantified the frequency of barriers encountered by patients seeking to fill buprenorphine prescriptions at pharmacies across the United States.4
The new study involved 858 pharmacies in 473 counties that answered a phone call phrased as if a patient were asking for a buprenorphine prescription. Pharmacies’ responses were categorized into three different groups: able to dispense buprenorphine, unable to dispense it, or unwilling to communicate buprenorphine availability over the phone.
The researchers found that 675 of the pharmacies studied dispensed buprenorphine and 183 restricted dispensing. Pharmacies in the most racially segregated and economically disadvantaged counties were 2.66 times more likely to restrict dispensing of buprenorphine. Pharmacies in counties with high levels of racial economic segregation were also more likely to restrict the drug. Although similar associations were observed with economic segregation, there were no associations with ethnic or racial segregation alone.
Limitations of the study include that the study may not have included some counties with high overdose burdens in recent years, that there was inadequate representation of pharmacies in rural areas, that people who did not live in homes were excluded, and that the measure of restricted dispensing does not capture delays due to storage problems or depleted inventories. The authors noted that these limitations likely led to an underestimation of the impact of racial economic segregation.
“These barriers to dispensing medications in pharmacies could exacerbate inequalities in access to treatment,” said Kyle Moon, the study’s lead author, in a press release.3 “And it shows that future policies to improve health equity must target dispensing capacity to expand the capacity that already exists to make it easier for providers to prescribe buprenorphine.”
READ MORE: Resource Center for Substance Use Disorders
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