Community-based naloxone coverage equity for the prevention of opioid overdose fatalities in racial/ethnic minority communities in Massachusetts and Rhode Island.
Analgesics, Opioid
/ therapeutic use
Drug Overdose
/ drug therapy
Ethnic and Racial Minorities
Ethnicity
Humans
Massachusetts
/ epidemiology
Minority Groups
Naloxone
/ therapeutic use
Narcotic Antagonists
/ therapeutic use
Opiate Overdose
Opioid-Related Disorders
/ drug therapy
Rhode Island
/ epidemiology
United States
accessibility
naloxone
opioids, overdose deaths
racial disparity, spatial analysis
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
27
05
2021
accepted:
04
11
2021
pubmed:
27
11
2021
medline:
6
4
2022
entrez:
26
11
2021
Statut:
ppublish
Résumé
Opioid-related overdose death rates continue to rise in the United States, especially in racial/ethnic minority communities. Our objective was to determine if US municipalities with high percentages of non-white residents have equitable access to the overdose antidote naloxone distributed by community-based organizations. We used community-based naloxone data from the Massachusetts Department of Public Health and the Rhode Island non-pharmacy naloxone distribution program for 2016-18. We obtained publicly available opioid-related overdose death data from Massachusetts and the Office of the State Medical Examiners in Rhode Island. We defined the naloxone coverage ratio as the number of community-based naloxone kits received by a resident in a municipality divided by the number of opioid-related overdose deaths among residents, updated annually. We used a Poisson regression with generalized estimating equations to analyze the relationship between the municipal racial/ethnic composition and naloxone coverage ratio. To account for the potential non-linear relationship between naloxone coverage ratio and race/ethnicity we created B-splines for the percentage of non-white residents; and for a secondary analysis examining the percentage of African American/black and Hispanic residents. The models were adjusted for the percentage of residents in poverty, urbanicity, state and population size. Between 2016 and 2018, the annual naloxone coverage ratios range was 0-135. There was no difference in naloxone coverage ratios among municipalities with varying percentages of non-white residents in our multivariable analysis. In the secondary analysis, municipalities with higher percentages of African American/black residents had higher naloxone coverage ratios, independent of other factors. Naloxone coverage did not differ by percentage of Hispanic residents. There appear to be no municipal-level racial/ethnic inequities in naloxone distribution in Rhode Island and Massachusetts, USA.
Sections du résumé
BACKGROUND AND AIMS
Opioid-related overdose death rates continue to rise in the United States, especially in racial/ethnic minority communities. Our objective was to determine if US municipalities with high percentages of non-white residents have equitable access to the overdose antidote naloxone distributed by community-based organizations.
METHODS
We used community-based naloxone data from the Massachusetts Department of Public Health and the Rhode Island non-pharmacy naloxone distribution program for 2016-18. We obtained publicly available opioid-related overdose death data from Massachusetts and the Office of the State Medical Examiners in Rhode Island. We defined the naloxone coverage ratio as the number of community-based naloxone kits received by a resident in a municipality divided by the number of opioid-related overdose deaths among residents, updated annually. We used a Poisson regression with generalized estimating equations to analyze the relationship between the municipal racial/ethnic composition and naloxone coverage ratio. To account for the potential non-linear relationship between naloxone coverage ratio and race/ethnicity we created B-splines for the percentage of non-white residents; and for a secondary analysis examining the percentage of African American/black and Hispanic residents. The models were adjusted for the percentage of residents in poverty, urbanicity, state and population size.
RESULTS
Between 2016 and 2018, the annual naloxone coverage ratios range was 0-135. There was no difference in naloxone coverage ratios among municipalities with varying percentages of non-white residents in our multivariable analysis. In the secondary analysis, municipalities with higher percentages of African American/black residents had higher naloxone coverage ratios, independent of other factors. Naloxone coverage did not differ by percentage of Hispanic residents.
CONCLUSIONS
There appear to be no municipal-level racial/ethnic inequities in naloxone distribution in Rhode Island and Massachusetts, USA.
Identifiants
pubmed: 34825427
doi: 10.1111/add.15759
pmc: PMC8983544
mid: NIHMS1763326
doi:
Substances chimiques
Analgesics, Opioid
0
Narcotic Antagonists
0
Naloxone
36B82AMQ7N
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1372-1381Subventions
Organisme : NIDA NIH HHS
ID : P30 DA040500
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM125507
Pays : United States
Organisme : ACL HHS
ID : R01CE002999
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA045745
Pays : United States
Organisme : NIDA NIH HHS
ID : U01 DA047408
Pays : United States
Informations de copyright
© 2021 Society for the Study of Addiction.
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