Racial Disparities in Overdose Prevention among People Who Inject Drugs
Racial Disparities in Overdose Prevention among People Who Inject Drugs
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DOI：
10.1007/s11524-020-00439-5
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发表时间：
2020-06-08
影响因子：
6.6
通讯作者：
Latkin, Carl
中科院分区：
文献类型：
--
作者：
Dayton, Lauren;Tobin, Karin;Latkin, Carl
The current opioid epidemic is the largest drug use epidemic in the history of the USA for all racial and ethnic groups [1]. Fatal opioid overdose rates continue to be exceedingly high, with 2017 experiencing an 11% increase in opioid-related fatalities compared to 2016 and more than a 670% increase since the height of the heroin epidemic in 1975 [1, 2]. The rise in fatal opioid overdose since the 1970s heroin epidemic has differentially affected racial groups. In the 1970s, opioid mortality was higher among Black Americans [3, 4]. In recent years, the racial profile of opioid-related fatalities has changed and has been highest among non-Hispanic Whites, with White individuals accounting for 37,113 (78%) and Black individuals for 5513 (12%) of the 2017 opioid-related deaths [2]. These discrepant racial trends in fatal overdose can be partially attributed to the surge in prescription opioids starting in the mid-1990s, which caused a concentrated rise in mortality among Whites while opioid-related mortality among Black individuals remained stable [5]. This divergence is associated with well noted racial disparities in pain management and prescription patterns, with Black patients prescribed opioids at lower rates compared to all other racial/ethnic groups for almost every type of pain visit [5]. While overdose fatality has been highest among White Americans, in recent years, the fatal opioid death rate is increasing more rapidly among Black Americans. From 2016 to 2017, deaths increased by 11% among White and 25% among Black individuals [2]. One factor which may contribute to the recent increase in opioid fatalities among Black compared to White Americans is differential engagement with overdose prevention services including access to, training in, and use of naloxone. This hypothesis is driven by the extensive literature on racial differences in medical care, with Black Americans less likely to report access and utilization of a range of medical procedures and care compared to White Americans [6, 7].Engagement with overdose prevention, specifically naloxone, is especially critical within the current opioid epidemic, which is characterized by synthetic opioids. Naloxone is a key medication utilized in the treatment of opioid overdoses and works by reversing the depression of the central nervous and respiratory systems caused by opioids. Synthetic opioids, such as fentanyl, are more
