Racial disparities in linkage to care among patients with substance use disorders

Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department

“…The lack of association in the present study may be due to our smaller sample size relative and differences in sampling design (e.g., clinical data extracted from a single ED located in Maryland vs. nationally representative sampling frames) ( Amaducci et al, 2020 ; Martin et al, 2021 ). Prior data observing racial disparities among Black patients referred to treatment by peer specialists was similar to the present study in terms of overall sample size, but the present study had a somewhat higher percentage of Black patients (32% vs. 21%) and the characteristics of the sample (e.g., geographic region) or intervention strategy may differ in ways that are not captured by the present analysis ( Webb et al, 2021 ). We are not able to examine outcomes as a function of individual peer specialist or specialist-patient concordance with respect to racial and gender identity, however, we note that the peer specialist staff at JHBMC was diverse with respect to race and gender.…”

“…Although we included sex and race as factors in the analyses, we did not observe statistically significant differences in linkage to treatment as a function of these variables. As previously noted, sex and racial disparities in treatment receipt and referral have been documented in the emergency department referral to treatment setting and in national databases ( Amaducci et al, 2020 ; Martin et al, 2021 ; Webb et al, 2021 ). The lack of association in the present study may be due to our smaller sample size relative and differences in sampling design (e.g., clinical data extracted from a single ED located in Maryland vs. nationally representative sampling frames) ( Amaducci et al, 2020 ; Martin et al, 2021 ).…”

“…In response, EDs have developed programs to screen patients for alcohol and drug use, provide brief intervention, and initiate referral to substance use treatment based on strategies originally developed for alcohol use disorder ( Barata et al, 2017 ; Hawk & D’Onofrio, 2018 ; Kaczorowski et al, 2020 ; Kaner et al, 2018 ; Landy et al, 2016 ; Monico et al, 2020 ; Siegel et al, 2021 ; Webb et al, 2021 ). Brief intervention provides awareness about harmful substance use risks with a focus on changing behavior ( Substance Abuse and Mental Health Services Administration, 2022 ).…”

“…Little is known about the factors that are related to treatment attendance following brief intervention in the ED, but prior data suggests having insurance, older age, and readiness to change may be important ( Blow et al, 2010 ). Racial disparity has also been observed, such that Black patients are less likely to be linked to treatment from the ED relative to White patients ( Webb et al, 2021 ). Similarly, gender disparity has been observed, as women are less likely to be linked to treatment from the ED compared to men ( Amaducci et al, 2020 ).…”

Implications of missingness in self‐reported data for estimating racial and ethnic disparities in Medicaid quality measures

“…41 Accurate disparities measurement may identify targeted interventions, such as the use of peer support specialists in substance use treatment or training that addresses interpersonal racism within a specific community. 42,43 This study has several limitations. First, BISG is not recommended for inference about American Indian/Alaska Native or multiracial populations, 16 which prevented us from examining disparities in these important groups.…”