How the Pandemic Limited Access to Opioid Addiction Treatment for Racial and Ethnic Minority Groups

Writing in the medical journal JAMA Network Open, researchers said their findings give further weight to the conclusion that minority groups were more negatively impacted by the COVID-19 pandemic and face more barriers to health care in general.

“Drops in prescribing medication to treat opioid addiction at the onset of the pandemic were significant for Black, Hispanic and Asian patients, but not for white patients,” said Jennifer Miles, an author of the study and a postdoctoral associate in the School of Social Work.

The researchers examined Symphony Health, a national prescription database with race, ethnicity and insurance status for 280 million patients and 1.8 million prescribers. Using this database, the researchers analyzed prescriptions filled by retail, mail order and specialty pharmacies from May 2019 to June 2021 to compare treatment for opioid addiction before and after the start of the pandemic in the U.S.

“We focused on buprenorphine and naltrexone medications, which can be prescribed for use at home,” Miles said. “We studied the numbers of patients prescribed each medication and the length of buprenorphine prescriptions since extended-release naltrexone is effective for about a month.”

Researchers found that, for all racial and ethnic groups, pandemic-related decreases in opioid addiction medication put an end to increasing use before the pandemic. However, declines in prescriptions at the onset of the pandemic were especially pronounced for Black, Hispanic, and Asian patients, in contrast with white patients.

The researchers said the findings provide important information for addressing disparities in public health and grappling with a nationwide opioid epidemic.

“Greater treatment disruptions for racial and ethnic minority groups are particularly concerning in the context of opioid overdoses, since access to medication is critical to reduce risk of death,” said Hillary Samples, an author of the study and assistant professor of health systems and policy at the Rutgers School of Public Health. “And recent evidence has shown that overdose fatality rates are increasing faster in minority groups.”

For patients seeking treatment with buprenorphine, the most common opioid addiction medication, researchers found that white patients with private insurance had significant increases in prescription fills at the onset of the pandemic. However, Black patients with private insurance did not.

However, there also were some positive trends, researchers noted. For one, patients with access to medication received longer-running prescriptions at the onset of the pandemic.

“This was potentially important to keep patients connected to treatment while reducing the risk of COVID infection with frequent in-person visits,” Samples said.

In addition, Medicaid patients did not experience the same treatment disruptions as those with other types of coverage or those who pay directly for their care. Since Medicaid has a key role in access to addiction treatment, the researchers noted, this finding suggests programs were effective in protecting against pandemic-related disruptions.

Other Rutgers researchers involved in the study include Stephen Crystal, the Board of Governors Professor in the Institute for Health, Health Care Policy and Aging Research and the School of Social Work.