Evaluating equity in community-based naloxone access among racial/ethnic groups in Massachusetts

Details

• Alternative Title:
  Drug Alcohol Depend
• Personal Author:
  Nolen, Shayla ; Zang, Xiao ; Chatterjee, Avik ; Behrends, Czarina N. ; Green, Traci C. ; Linas, Benjamin P. ; Morgan, Jake R. ; Murphy, Sean M. ; Walley, Alexander Y. ; Schackman, Bruce R. ; Marshall, Brandon D.L.
• Description:
  Background:
  
  Racial/ethnic minorities have experienced disproportionate opioid-related overdose death rates in recent years. In this context, we examined inequities in community-based naloxone access across racial/ethnic groups in Massachusetts.
  
  Methods:
  
  We used data from: the Massachusetts Department of Public Health on community-based overdose education and naloxone distribution (OEND) programs; the Massachusetts Office of the Chief Medical Examiner on opioid-related overdose deaths, and; the United States Census American Community Survey for regional demographic/socioeconomic details to estimate community populations by race/ethnicity and racial segregation between African American/Black and white residents. Race/ethnicity groups included in the analysis were African American/Black (non-Hispanic), Hispanic, white (non-Hispanic), and “other” (non-Hispanic). We evaluated racial/ethnic differences in naloxone distribution across regions in Massachusetts and neighborhoods in Boston descriptively and spatially, plotting the race/ethnicity-specific number of kits per opioid-related overdose death per jurisdiction. Lastly, we constructed generalized estimating equations models with a negative binomial distribution to compare the race/ethnicity-specific naloxone distribution rate by OEND programs.
  
  Results:
  
  From 2016–2019, the median annual rate of naloxone kits received from OEND programs in Massachusetts per racial/ethnicity group ranged between 160–447 per 100,000. In a multivariable analysis, we found that the naloxone distribution rates for racial/ethnic minorities were lower than the rate for white residents. We also found naloxone was more likely to be distributed in racially segregated communities than non-segregated communities.
  
  Conclusion:
  
  We identified racial/ethnic inequities in naloxone receipt by individuals in Massachusetts. Additional resources focused on designing and implementing OEND programs for racial/ethnic minorities are warranted to ensure equitable access to naloxone.
  
  
• Subjects:
  Analgesics, Opioid Drug Overdose Humans Massachusetts Naloxone Opiate Overdose Racial Groups United States United States Department Of Veterans Affairs
• Keywords:
  Naloxone Distribution OEND Opioids Overdose Racial Inequity
• Source:
  Drug Alcohol Depend. 241:109668
• Pubmed ID:
  36309001
• Pubmed Central ID:
  PMC9833886
• Document Type:
  Journal Article
• Funding:
  P30 DA040500/DA/NIDA NIH HHSUnited States/ ; R01 CE002999/CE/NCIPC CDC HHSUnited States/ ; R01CE002999/ACL/ACL HHSUnited States/ ; U01 DA047408/DA/NIDA NIH HHSUnited States/
• Volume:
  241
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:7f8de6c6ba7cdf73ba79e8ab226e666fc1192f02175dbef83b73dcef96963fa80cda02ef620801245ee9a50406139feca0131316a8bba1cb17879e3bfb0c7884
• Download URL:
  https://stacks.cdc.gov/view/cdc/123525/cdc_123525_DS1.pdf
• File Type:
  [PDF - 572.02 KB ]