Racial and Ethnic Differences in Long-Term Outcomes among Individuals with Opioid Use Disorder at Opioid Treatment Programs

Objectives: Racial and ethnic differences in long-term outcomes associated with medications for opioid use disorder (MOUD) are poorly understood.

Methods: The present analyses were based on 751 participants with opioid use disorder (OUD) who were initially recruited from opioid treatment programs located in California, Connecticut, Oregon, Pennsylvania, and Washington and participated in a randomized controlled trial and at least one follow-up interview. 9.6% (n = 72) of the participants self-identified as Non-Hispanic (NH) Black, 16.0% (n = 120) Hispanic, and 74.4% (n = 559) NH White. We tested racial and ethnic differences in psychiatric or social functioning, substance use and treatment participation.

Results: From the baseline to the end of follow-up interview, compared with NH White, Hispanic participants had a significantly greater proportion of months reporting any opioid use (45.5% vs. 32.5%, p < 0.001) and a smaller proportion of months receiving any MOUD (47.7% vs. 58.1%; p < 0.05), particularly receipt of buprenorphine treatment (8.3% vs. 14.9%; p < 0.01). At the third follow-up interview, data from the Addiction Severity Index (ASI) indicated that Hispanic participants had greater severity in employment problems (0.72 vs. 0.58; p < 0.001), while Black participants had less severity in drug problems (0.11 vs. 0.16; p < 0.05) compared to NH Whites.

Conclusions: The study found that Hispanic participants had higher rates of opioid use (heroin and prescription opioids), but few received MOUD (buprenorphine and methadone) during the follow-up period, which suggests that effective strategies are needed to increase access to MOUD among Hispanics. Additionally, addressing employment challenges might also help improve long-term outcomes for all populations with OUD.