Shayla Nolen1, Xiao Zang1, Avik Chatterjee2, Czarina N Behrends3, Traci C Green4,5,6, Aranshi Kumar1, Benjamin P Linas7,8, Jake R Morgan9, Sean M Murphy3, Alexander Y Walley2, Shapei Yan2, Bruce R Schackman3, Brandon D L Marshall1. 1. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. 2. Grayken Center for Addiction and Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA. 3. Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA. 4. Warren Alpert School of Medicine of Brown University, Providence, RI, USA. 5. The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA. 6. Center of Biomedical Research Excellence on Opioids and Overdose, Rhode Island Hospital, Providence, RI, USA. 7. Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA. 8. Boston University School of Medicine, Boston, MA, USA. 9. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND AND AIMS: Opioid-related overdose death rates continue to rise in the United States, especially in racial/ethnic minority communities. Our objective was to determine if US municipalities with high percentages of non-white residents have equitable access to the overdose antidote naloxone distributed by community-based organizations. METHODS: We used community-based naloxone data from the Massachusetts Department of Public Health and the Rhode Island non-pharmacy naloxone distribution program for 2016-18. We obtained publicly available opioid-related overdose death data from Massachusetts and the Office of the State Medical Examiners in Rhode Island. We defined the naloxone coverage ratio as the number of community-based naloxone kits received by a resident in a municipality divided by the number of opioid-related overdose deaths among residents, updated annually. We used a Poisson regression with generalized estimating equations to analyze the relationship between the municipal racial/ethnic composition and naloxone coverage ratio. To account for the potential non-linear relationship between naloxone coverage ratio and race/ethnicity we created B-splines for the percentage of non-white residents; and for a secondary analysis examining the percentage of African American/black and Hispanic residents. The models were adjusted for the percentage of residents in poverty, urbanicity, state and population size. RESULTS: Between 2016 and 2018, the annual naloxone coverage ratios range was 0-135. There was no difference in naloxone coverage ratios among municipalities with varying percentages of non-white residents in our multivariable analysis. In the secondary analysis, municipalities with higher percentages of African American/black residents had higher naloxone coverage ratios, independent of other factors. Naloxone coverage did not differ by percentage of Hispanic residents. CONCLUSIONS: There appear to be no municipal-level racial/ethnic inequities in naloxone distribution in Rhode Island and Massachusetts, USA.
BACKGROUND AND AIMS: Opioid-related overdose death rates continue to rise in the United States, especially in racial/ethnic minority communities. Our objective was to determine if US municipalities with high percentages of non-white residents have equitable access to the overdose antidote naloxone distributed by community-based organizations. METHODS: We used community-based naloxone data from the Massachusetts Department of Public Health and the Rhode Island non-pharmacy naloxone distribution program for 2016-18. We obtained publicly available opioid-related overdose death data from Massachusetts and the Office of the State Medical Examiners in Rhode Island. We defined the naloxone coverage ratio as the number of community-based naloxone kits received by a resident in a municipality divided by the number of opioid-related overdose deaths among residents, updated annually. We used a Poisson regression with generalized estimating equations to analyze the relationship between the municipal racial/ethnic composition and naloxone coverage ratio. To account for the potential non-linear relationship between naloxone coverage ratio and race/ethnicity we created B-splines for the percentage of non-white residents; and for a secondary analysis examining the percentage of African American/black and Hispanic residents. The models were adjusted for the percentage of residents in poverty, urbanicity, state and population size. RESULTS: Between 2016 and 2018, the annual naloxone coverage ratios range was 0-135. There was no difference in naloxone coverage ratios among municipalities with varying percentages of non-white residents in our multivariable analysis. In the secondary analysis, municipalities with higher percentages of African American/black residents had higher naloxone coverage ratios, independent of other factors. Naloxone coverage did not differ by percentage of Hispanic residents. CONCLUSIONS: There appear to be no municipal-level racial/ethnic inequities in naloxone distribution in Rhode Island and Massachusetts, USA.
Authors: Xiao Zang; Alexandria Macmadu; Maxwell S Krieger; Czarina N Behrends; Traci C Green; Jake R Morgan; Sean M Murphy; Shayla Nolen; Alexander Y Walley; Bruce R Schackman; Brandon Dl Marshall Journal: Int J Drug Policy Date: 2021-09-03
Authors: Barrot H Lambdin; Corey S Davis; Eliza Wheeler; Stephen Tueller; Alex H Kral Journal: Drug Alcohol Depend Date: 2018-05-15 Impact factor: 4.492
Authors: Jamie K Lim; Leah S Forman; Sarah Ruiz; Ziming Xuan; Barry P Callis; Kevin Cranston; Alexander Y Walley Journal: Drug Alcohol Depend Date: 2019-08-30 Impact factor: 4.492