Racial Differences in Medications for Opioid Use Disorder Initiation in a Carceral Setting

Area of Science:

• Public Health
• Health Disparities
• Addiction Medicine

Background:

• The opioid overdose crisis disproportionately impacts marginalized communities, including people of color.
• Opioid use disorder and mass incarceration create a syndemic that worsens racial health disparities.
• Limited research exists on racial differences in medication for opioid use disorder (MOUD) uptake within carceral settings.

Purpose of the Study:

• To investigate racial differences in MOUD preferences among incarcerated individuals.
• To examine the influence of race on the choice between buprenorphine and methadone for opioid use disorder treatment.

Main Methods:

• A retrospective cohort study analyzed electronic medical records from the Rhode Island Department of Corrections (2017-2022).
• 3533 unique incarceration events were included, categorizing participants by race (White vs. non-White) and MOUD status (initiation vs. continuation).
• Logistic regression models were employed to assess MOUD-type preferences.

Main Results:

• No direct racial disparities in overall MOUD type preference were found.
• An interaction between race and MOUD initiation status significantly affected MOUD-type preference.
• Non-White individuals initiating MOUD during incarceration were more likely to prefer buprenorphine than White individuals.

Conclusions:

• Race influences MOUD selection, particularly for individuals initiating treatment during incarceration.
• Understanding these race-based interaction effects is crucial for equitable healthcare delivery in correctional facilities.
• Further research across diverse settings is needed to generalize findings and inform policy.