Racial and economic inequities restrict access to medications for opioid use disorder (MOUD) and persist at the point of dispensing in community pharmacies, according to a study published in the journal Drug and Alcohol Dependence Reports.1 The authors said the findings support the need for policy interventions that advance pharmacoequity.
The opioid epidemic continues to have a significant impact in the United States, with CDC data showing there were 81,083 deaths involving opioids in 2023.2 The public health crisis has also not impacted everyone equally, with death rates seen to be rising fastest in Black and Hispanic communities.3 MOUD access is known to be impacted by racial and ethnic inequities, but there has been a lack of data on if these persist at the point of dispensing.
READ MORE: FDA Approves Nalmefene Injection for Opioid Overdose
“While there have been notable policy changes over the past decade that have improved access to meds used for opioid use disorder and made headway against racial disparities, those efforts haven’t taken into consideration the issue of whether patients can actually get their prescription filled,” Dan Hartung, co-author on the study, said in a release.3
A team of investigators from Oregon State University and Johns Hopkins University conducted a study to assess associations between county-level proxies of racism and classism with restricted buprenorphine dispensing in community pharmacies. Data was gathered from a previous study that quantified the frequency of barriers encountered by patients seeking to fill buprenorphine prescriptions from pharmacies in the US.4
The new study included 858 pharmacies in 473 counties who answered a phone call that was scripted to mimic a patient enquiring about filling a buprenorphine prescription. The answers the pharmacies gave were categorized into 3 different groups: can dispense, cannot dispense, or unwilling to disclose buprenorphine availability over the telephone.
Of the pharmacies included, investigators found that 675 dispensed buprenorphine and 183 restricted dispensing. Pharmacies in the most ethnically segregated and economically deprived counties had 2.66 times the odds of restricting buprenorphine dispensing. Pharmacies in counties with high racialized economic segregation also had higher odds of restricting the medication. Although there were similar associations observed for economic segregation, there were no associations for ethnic or racial segregation alone.
Study limitations include that the study may not have included some counties with high overdose burdens in more recent years, that there was a lack of rural pharmacy representation, that people not living in houses were excluded, and that the measure of restricted dispensing does not capture delays due to stocking challenges or depleted inventory. The authors noted that these limitations likely caused an underestimate on the effects of racialized economic segregation.
“These pharmacy dispensing barriers have the potential to exacerbate inequities in access to treatment,” Kyle Moon, lead author on the study, said in a release.3 “And it shows that future policy interventions aimed at improving health care equity need to target dispensing capacity to augment the ones already put in place that make it easier for providers to prescribe buprenorphine.”
READ MORE: Substance Use Disorder Resource Center
Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.
References
1. Moon KJ, Linton SL, Kazerouni NJ, et al. Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies. Drug Alcohol Depend Rep. 2024 Jul 14;12:100255. doi: 10.1016/j.dadr.2024.100255. PMID: 39108610; PMCID: PMC11301394.
4. Kazerouni NJ, Irwin AN, Levander XA, et al. Pharmacy-related buprenorphine access barriers: An audit of pharmacies in counties with a high opioid overdose burden. Drug Alcohol Depend. 2021 Jul 1;224:108729. doi: 10.1016/j.drugalcdep.2021.108729. Epub 2021 Apr 24. PMID: 33932744.
Social, Economic Barriers Impact Access to Opioid Use Disorder Medications
Community pharmacies in counties with high racialized economic segregation had higher odds of restricting buprenorphine.
Racial and economic inequities restrict access to medications for opioid use disorder (MOUD) and persist at the point of dispensing in community pharmacies, according to a study published in the journal Drug and Alcohol Dependence Reports.1 The authors said the findings support the need for policy interventions that advance pharmacoequity.
Social, Economic Barriers Impact Access to Opioid Use Disorder Medications / Simone - stock.adobe.com
The opioid epidemic continues to have a significant impact in the United States, with CDC data showing there were 81,083 deaths involving opioids in 2023.2 The public health crisis has also not impacted everyone equally, with death rates seen to be rising fastest in Black and Hispanic communities.3 MOUD access is known to be impacted by racial and ethnic inequities, but there has been a lack of data on if these persist at the point of dispensing.
READ MORE: FDA Approves Nalmefene Injection for Opioid Overdose
“While there have been notable policy changes over the past decade that have improved access to meds used for opioid use disorder and made headway against racial disparities, those efforts haven’t taken into consideration the issue of whether patients can actually get their prescription filled,” Dan Hartung, co-author on the study, said in a release.3
A team of investigators from Oregon State University and Johns Hopkins University conducted a study to assess associations between county-level proxies of racism and classism with restricted buprenorphine dispensing in community pharmacies. Data was gathered from a previous study that quantified the frequency of barriers encountered by patients seeking to fill buprenorphine prescriptions from pharmacies in the US.4
The new study included 858 pharmacies in 473 counties who answered a phone call that was scripted to mimic a patient enquiring about filling a buprenorphine prescription. The answers the pharmacies gave were categorized into 3 different groups: can dispense, cannot dispense, or unwilling to disclose buprenorphine availability over the telephone.
Of the pharmacies included, investigators found that 675 dispensed buprenorphine and 183 restricted dispensing. Pharmacies in the most ethnically segregated and economically deprived counties had 2.66 times the odds of restricting buprenorphine dispensing. Pharmacies in counties with high racialized economic segregation also had higher odds of restricting the medication. Although there were similar associations observed for economic segregation, there were no associations for ethnic or racial segregation alone.
Study limitations include that the study may not have included some counties with high overdose burdens in more recent years, that there was a lack of rural pharmacy representation, that people not living in houses were excluded, and that the measure of restricted dispensing does not capture delays due to stocking challenges or depleted inventory. The authors noted that these limitations likely caused an underestimate on the effects of racialized economic segregation.
“These pharmacy dispensing barriers have the potential to exacerbate inequities in access to treatment,” Kyle Moon, lead author on the study, said in a release.3 “And it shows that future policy interventions aimed at improving health care equity need to target dispensing capacity to augment the ones already put in place that make it easier for providers to prescribe buprenorphine.”
READ MORE: Substance Use Disorder Resource Center
Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.
References
1. Moon KJ, Linton SL, Kazerouni NJ, et al. Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies. Drug Alcohol Depend Rep. 2024 Jul 14;12:100255. doi: 10.1016/j.dadr.2024.100255. PMID: 39108610; PMCID: PMC11301394.
2. U.S. Overdose Deaths Decrease in 2023, First Time Since 2018. News Release. CDC. May 15, 2024. Accessed August 15, 2024. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
3. Racial, economic barriers hinder access to medicine for treating opioid use disorder. News Release. Oregon State University. August 15, 2024. Accessed August 15, 2024. https://today.oregonstate.edu/news/racial-economic-barriers-hinder-access-medicine-treating-opioid-use-disorder
4. Kazerouni NJ, Irwin AN, Levander XA, et al. Pharmacy-related buprenorphine access barriers: An audit of pharmacies in counties with a high opioid overdose burden. Drug Alcohol Depend. 2021 Jul 1;224:108729. doi: 10.1016/j.drugalcdep.2021.108729. Epub 2021 Apr 24. PMID: 33932744.
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