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Buprenorphine treatment varies based on race/ethnicity, income

Pooja Lagisetty

A research letter published in JAMA Psychiatry suggested that buprenorphine treatment was concentrated among white persons and those with private insurance or who used self-pay.

“Recent data shows that opioid related overdoses are climbing across races, including black Americans. However, prior studies on a city level have shown that treatment may be segregated by race and income,” Pooja A. Lagisetty, MD, from the department of medicine, University of Michigan School of Medicine, and the VA Ann Arbor Healthcare System, told Healio Psychiatry.

Using national survey data, Lagisetty and colleagues examined the changes in receipt of buprenorphine prescription since 2004 as well as whether receipt of such prescriptions varied by race/ethnicity and payment in U.S. office-based settings from 2004 to 2015. They grouped the sample into 4-year periods and tested the link between race/ethnicity and receiving a buprenorphine prescription during the 2012-2015 period after adjusting for age, sex and payment method.

The researchers found that white Americans had 35 times as many visits related to buprenorphine compared with to black Americans and that these visits were mainly paid for using cash and private insurance, according to Lagisetty.

Between 2004 and 2015, the proportion of buprenorphine visits in the United Stated increased from 0.04% to 0.36% of all ambulatory visits, which represented 13.4 million visits between 2012 and 2015, according to the results.

Analysis revealed far more buprenorphine visits among white patients (12.7 million; 95% CI, 8.6 million-16.8 million) than among those of other races/ethnicities (363,000; 95% CI, 134,000-594,000) from 2012 to 2015. After adjustment, the researchers found that black patients were less likely to receive buprenorphine prescription at their visits (adjusted OR = 0.23; 95% CI, 0.13-0.44).

The most common payment methods were self-pay and private insurance over the study period, with the number of buprenorphine visits by self-pay patients skyrocketing from 585,568 visits in 2004 to 2007 (95% CI, 0-1.3 million) to 5.3 million visits in 2012 to 2015 (95% CI, 2.5 million-8.5 million), according to the findings.

“Addiction affects everyone irrespective of your race or financial status. Treatment also cannot discriminate,” Lagisetty said. “I hope this study leads to more work on the reasons behind these divides in treatment and also a more coordinated policy approach to making sure all people needing treatment have equal access.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.