Who feels safe calling 911: are prior experiences of anti-Black racial discrimination associated with hesitancy seeking emergency medical services in the event of accidental drug overdose? - a study protocol

Ann Med. 2025 Dec;57(1):2439540. doi: 10.1080/07853890.2024.2439540. Epub 2024 Dec 19.

Abstract

Background: Racial discrimination is associated with health disparities among Black Americans, a group that has experienced an increase in rates of fatal drug overdose. Prior research has found that racial discrimination in the medical setting may be a barrier to addiction treatment. Nevertheless, it is unknown how experiences of racial discrimination might impact engagement with emergency medical services for accidental drug overdose. This study will psychometrically assess a new measure of hesitancy in seeking emergency medical services for accidental drug overdose and examine prior experiences of racial discrimination and group-based medical mistrust as potential corollaries of this hesitancy.

Method: Cross-sectional survey of 200 Black adults seeking treatment for substance-use-related medical problems (i.e. substance use disorder, overdose, infectious complications of substance use, etc.). Participants will complete a survey including sociodemographic information, the Discrimination in Medical Settings Scale, Everyday Discrimination Scale, Group-Based Medical Mistrust Scale, and an original questionnaire measuring perceptions of and prior engagement with emergency services for accidental drug overdose. Analyses will include exploratory factor analysis, Cronbach's alpha, and non-parametric partial correlations controlling for age, gender, income, and education.

Conclusions: This article describes a planned cross-sectional survey of Black patients seeking treatment for substance use related health problems. Currently, there is no validated instrument to measure hesitancy in seeking emergency medical services for accidental drug overdose or how experiences of racial discrimination might relate to such hesitancy. Results of this study may provide actionable insight into medical discrimination and the rising death toll of accidental drug overdose among Black Americans.

Keywords: Racial discrimination; healthcare disparities; medical mistrust; mortality, premature; social justice; substance use treatment; substance-related disorders.

MeSH terms

  • Adult
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • Cross-Sectional Studies
  • Drug Overdose* / ethnology
  • Drug Overdose* / psychology
  • Drug Overdose* / therapy
  • Emergency Medical Services* / statistics & numerical data
  • Female
  • Healthcare Disparities / ethnology
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care* / ethnology
  • Patient Acceptance of Health Care* / psychology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Racism* / ethnology
  • Racism* / psychology
  • Substance-Related Disorders / ethnology
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy
  • Surveys and Questionnaires
  • White
  • Young Adult

Grants and funding

This study was supported by the Recognizing and Eliminating Disparities in Addiction through Culturally Informed Healthcare (REACH) program. The REACH Program is made possible by funding to the Academy of Addiction Psychiatry (AAAP) from the Substance Abuse and Mental Health Services Administration (SAMHSA) grant no. 1H79TI08135801. The views expressed in this publication do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government. The funder had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.