Inequities in the treatment of opioid use disorder: A scoping review

Trevor Magee; Caleb Peters; Samuel M Jacobsen; Danya Nees; Bryan Dunford; Alicia Ito Ford; Matt Vassar

doi:10.1016/j.josat.2023.209082

Inequities in the treatment of opioid use disorder: A scoping review

J Subst Use Addict Treat. 2023 Sep:152:209082. doi: 10.1016/j.josat.2023.209082. Epub 2023 Jun 2.

Authors

Trevor Magee¹, Caleb Peters², Samuel M Jacobsen², Danya Nees², Bryan Dunford², Alicia Ito Ford³, Matt Vassar³

Affiliations

¹ Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States. Electronic address: trevor.magee@okstate.edu.
² Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.
³ Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States.

PMID: 37271346
DOI: 10.1016/j.josat.2023.209082

Abstract

Background: Given the lack of access to evidenced-based OUD treatment and the corresponding overdose crisis, researchers must evaluate and report health care inequities involving the treatment of OUD. Additionally, clinicians should be aware of these inequities in the treatment of patients.

Methods: We carried out a scoping review of the literature regarding health inequities in treatment for OUD in July 2022. The study team retrieved articles published between 2016 and 2021 from MEDLINE and Ovid Embase. After authors received training, screening and data extraction were performed in masked, duplicate fashion. The team screened a total of 3673 titles and abstracts, followed by 172 articles for full-text review. The inequities that we examined were race/ethnicity, sex or gender, income, under-resourced/rural, occupational status, education level, and LGBTQ+. We used Stata 17.0 (StataCorp, LLC, College Station, TX) to summarize data and statistics of the studies within our sample.

Results: A total of 44 studies evaluating inequities in OUD treatment met inclusion criteria. The most common inequity that studies examined was race/ethnicity (34/44 [77.27 %] studies), followed by under-resourced/rural (19/44 [43.18 %] studies), and sex or gender (18/44 [40.91 %] studies). LGBTQ+ (0/44 [0.0 %] studies) was not reported in the included studies. Our results indicate that many historically marginalized populations experience inequities related to access and outcomes in OUD treatment. The included studies in our scoping review occasionally demonstrated inconsistent findings.

Conclusions: Gaps exist within the literature on health inequities in treatment for OUD. The most examined inequities were race/ethnicity, under-resourced/rural and sex or gender, while studies did not examine LGBTQ+ status. Future research should aim to advance and supplement literature investigating health inequities in OUD treatment to ensure inclusive, patient-centered care.

Keywords: Health inequities; OUD treatment; Opioid dependence; Opioid use disorder; Substance use disorder.

Publication types

Review

MeSH terms

Drug Overdose* / drug therapy
Humans
Opiate Substitution Treatment / methods
Opioid-Related Disorders* / drug therapy
Patient-Centered Care