在囚禁环境中,阿片类药物使用障碍的初始用药种族差异。

Justin Berk, Jessica Brar, Ariel Hoadley, Rosemarie Martin
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引用次数: 0

摘要

背景:阿片类药物过量危机严重影响着边缘化社区,有色人种的药物过量率更高,治疗障碍也更多。阿片类药物使用障碍和大规模监禁的综合症加剧了种族健康差异。一些囚禁设施提供药物戒毒治疗,但没有重要研究探讨在这些环境中不同种族接受治疗类型的差异。本研究重点关注被监禁者在阿片类药物使用障碍(MOUD)药物偏好方面的种族差异:方法:罗德岛惩教署(RIDOC)开展了一项回顾性队列研究,调查被监禁者对阿片类药物(丁丙诺啡或美沙酮)的偏好。研究利用了 RIDOC 从 2017 年 1 月 1 日至 2022 年 12 月 31 日的电子医疗记录,涉及 3533 个独特的监禁事件。参与者按种族(白人 vs 非白人)和 MOUD 状态(新开始使用 vs 社区继续使用)进行分类,并采用逻辑回归模型进行分析:研究发现,在对 MOUD 类型的偏好上没有直接的种族差异。然而,种族与开始实施 MOUD 状态之间的交互作用对 MOUD 类型偏好有显著影响。在监禁期间开始接受 MOUD 的人中,与白人相比,非白人更倾向于选择丁丙诺啡:这项研究为种族、监禁和 MOUD 偏好的交叉提供了新的见解。虽然在 MOUD 类型方面没有观察到直接的种族差异,但分析发现了一个显著的交互效应:种族影响了 MOUD 启动状态与监禁期间所选 MOUD 治疗之间的关系。具体而言,数据表明,选择丁丙诺啡的可能性因种族背景以及治疗是在监禁期间还是在社区开始而有显著差异。需要在不同的地理环境中开展进一步的研究,以了解更广泛的影响,帮助指导在监狱中提供公平的医疗保健服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Racial Differences in Medications for Opioid Use Disorder Initiation in a Carceral Setting.

Background: The opioid overdose crisis significantly affects marginalized communities, with people of color experiencing higher rates of overdose and barriers to treatment. The syndemic of opioid use disorder and mass incarceration exacerbates racial health disparities. Some carceral facilities offer medication for addiction treatment, though no significant research explores differences in type of treatment uptake by race in these settings. This study focuses on the racial differences in medications for opioid use disorder (MOUD) preferences among incarcerated individuals.

Methods: A retrospective cohort study was conducted at the Rhode Island Department of Corrections (RIDOC), examining MOUD-type preferences (buprenorphine or methadone) among incarcerated individuals. The study utilized RIDOC electronic medical records from January 1, 2017 to December 31, 2022, involving 3533 unique incarceration events. Participants were categorized by race (White vs non-White) and MOUD status (new initiation vs community continuation), with logistic regression models.

Results: The study found no direct racial disparity in preferences for MOUD type. However, an interaction between race and MOUD initiation status significantly influenced MOUD-type preference. Among those initiating MOUD during incarceration, non-White individuals were more likely to choose buprenorphine compared to their White counterparts.

Conclusions: This research provides new insights into the intersection of race, incarceration, and MOUD preferences. While direct racial disparities in MOUD type were not observed, the analysis uncovered a notable interaction effect: race influences the relationship between MOUD initiation status and the selected MOUD treatment during incarceration. Specifically, data demonstrate that the likelihood of choosing buprenorphine varies significantly based on both racial background and whether the treatment was initiated during incarceration or in the community. Further research is needed in different geographic settings to understand the broader implications to help guide equitable healthcare delivery in jails and prisons.

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