Cargando…

Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City

BACKGROUND: Drug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm redu...

Descripción completa

Detalles Bibliográficos
Autores principales: Khan, Maria R., Hoff, Lee, Elliott, Luther, Scheidell, Joy D., Pamplin, John R., Townsend, Tarlise N., Irvine, Natalia M., Bennett, Alex S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9959933/
https://www.ncbi.nlm.nih.gov/pubmed/36841763
http://dx.doi.org/10.1186/s12954-023-00736-7
_version_ 1784895401337290752
author Khan, Maria R.
Hoff, Lee
Elliott, Luther
Scheidell, Joy D.
Pamplin, John R.
Townsend, Tarlise N.
Irvine, Natalia M.
Bennett, Alex S.
author_facet Khan, Maria R.
Hoff, Lee
Elliott, Luther
Scheidell, Joy D.
Pamplin, John R.
Townsend, Tarlise N.
Irvine, Natalia M.
Bennett, Alex S.
author_sort Khan, Maria R.
collection PubMed
description BACKGROUND: Drug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm reduction including naloxone across racial/ethnic groups is warranted. METHODS: Using data from an ongoing study of people who use illicit opioids in NYC (N = 575), we quantified racial/ethnic differences in the naloxone care cascade. RESULTS: We observed gaps across the cascade overall in the cohort, including in naloxone training (66%), current possession (53%) daily access during using and non-using days (21%), 100% access during opioid use (20%), and complete protection (having naloxone and someone who could administer it present during 100% of opioid use events; 12%). Naloxone coverage was greater in white (training: 79%, possession: 62%, daily access: 33%, access during use: 27%, and complete protection: 13%, respectively) and Latinx (training: 67%, possession: 54%, daily access: 22%, access during use: 24%, and complete protection: 16%, respectively) versus Black (training: 59%, possession: 48%, daily access:13%, access during use: 12%, and complete protection: 8%, respectively) participants. Black participants, versus white participants, had disproportionately low odds of naloxone training (OR 0.40, 95% CI 0.22–0.72). Among participants aged 51 years or older, Black race (versus white, the referent) was strongly associated with lower levels of being trained in naloxone use (OR 0.20, 95% CI 0.07–0.63) and having 100% naloxone access during use (OR 0.34, 95% CI 0.13–0.91). Compared to white women, Black women had 0.27 times the odds of being trained in naloxone use (95% CI 0.10–0.72). CONCLUSIONS: There is insufficient protection by naloxone during opioid use, with disproportionately low access among Black people who use drugs, and a heightened disparity among older Black people and Black women.
format Online
Article
Text
id pubmed-9959933
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-99599332023-02-26 Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City Khan, Maria R. Hoff, Lee Elliott, Luther Scheidell, Joy D. Pamplin, John R. Townsend, Tarlise N. Irvine, Natalia M. Bennett, Alex S. Harm Reduct J Research BACKGROUND: Drug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm reduction including naloxone across racial/ethnic groups is warranted. METHODS: Using data from an ongoing study of people who use illicit opioids in NYC (N = 575), we quantified racial/ethnic differences in the naloxone care cascade. RESULTS: We observed gaps across the cascade overall in the cohort, including in naloxone training (66%), current possession (53%) daily access during using and non-using days (21%), 100% access during opioid use (20%), and complete protection (having naloxone and someone who could administer it present during 100% of opioid use events; 12%). Naloxone coverage was greater in white (training: 79%, possession: 62%, daily access: 33%, access during use: 27%, and complete protection: 13%, respectively) and Latinx (training: 67%, possession: 54%, daily access: 22%, access during use: 24%, and complete protection: 16%, respectively) versus Black (training: 59%, possession: 48%, daily access:13%, access during use: 12%, and complete protection: 8%, respectively) participants. Black participants, versus white participants, had disproportionately low odds of naloxone training (OR 0.40, 95% CI 0.22–0.72). Among participants aged 51 years or older, Black race (versus white, the referent) was strongly associated with lower levels of being trained in naloxone use (OR 0.20, 95% CI 0.07–0.63) and having 100% naloxone access during use (OR 0.34, 95% CI 0.13–0.91). Compared to white women, Black women had 0.27 times the odds of being trained in naloxone use (95% CI 0.10–0.72). CONCLUSIONS: There is insufficient protection by naloxone during opioid use, with disproportionately low access among Black people who use drugs, and a heightened disparity among older Black people and Black women. BioMed Central 2023-02-25 /pmc/articles/PMC9959933/ /pubmed/36841763 http://dx.doi.org/10.1186/s12954-023-00736-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Khan, Maria R.
Hoff, Lee
Elliott, Luther
Scheidell, Joy D.
Pamplin, John R.
Townsend, Tarlise N.
Irvine, Natalia M.
Bennett, Alex S.
Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title_full Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title_fullStr Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title_full_unstemmed Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title_short Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City
title_sort racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in white, latinx, and black people who use opioids in new york city
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9959933/
https://www.ncbi.nlm.nih.gov/pubmed/36841763
http://dx.doi.org/10.1186/s12954-023-00736-7
work_keys_str_mv AT khanmariar racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT hofflee racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT elliottluther racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT scheidelljoyd racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT pamplinjohnr racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT townsendtarlisen racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT irvinenataliam racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity
AT bennettalexs racialethnicdisparitiesinopioidoverdosepreventioncomparisonofthenaloxonecarecascadeinwhitelatinxandblackpeoplewhouseopioidsinnewyorkcity