Improving Access to Treatment for Women with Opioid Use Disorder

阿片类药物使用、孕妇阿片类药物使用障碍的诊断以及宫内阿片类药物的并发症 在过去二十年中，接触率急剧上升。尽管有证据表明阿片类药物的使用 对于预防阿片类药物使用障碍的不良后果非常有效，大多数患者需要 少数民族的种族和族裔在获得治疗方面存在差别， 与非少数群体相比。阿片类药物使用障碍治疗和药物治疗的差异 对于因使用阿片类药物而寻求治疗的妇女来说，获得治疗可能与种族和民族以及妊娠状况有关 disorder.在怀孕期间接受阿片类药物使用障碍的治疗对母婴健康至关重要 然而，在种族和族裔上属于少数群体的妇女获得平等待遇的问题 仍在研究中。扩展正在进行的NIDA资助的项目（R 01 DA 045729），该项目进行了 怀孕和非怀孕的“秘密购物者”试图获得 在阿片类药物治疗计划或门诊丁丙诺啡提供者的预约，这种健康公平 补充旨在确定非白人患者是否确定了获得阿片类药物预约的障碍 使用紊乱治疗。此外，我们试图确定种族一致性是否是一个决定性因素， 根据秘密购物者的种族/民族与社区环境的匹配， 诊所位置这些障碍的潜在机制的解释将采用定性分析的方法进行探讨。 数据利用NIDA资助的实地实验的独特数据，这项研究将1）确定种族 秘密购物者和诊所周围社区之间的一致性影响了他们的 能够a）预约治疗，B）等待治疗的时间，c）自付治疗费用， 和d）确定这些结果是否因妊娠状态和治疗提供者类型而异，以及2）探索 秘密购物者对种族歧视遭遇和经历的定性描述， 阿片类药物治疗计划的治疗和药物，无论是阿片类药物治疗计划还是门诊 丁丙诺啡提供者，注意基于种族/民族和怀孕状况的差异。数据从该 这项研究将为未来的研究提供信息，这些研究旨在减轻阿片类药物使用障碍的健康不公平现象， 怀孕和种族

Opioid use, diagnoses of opioid use disorder among pregnant women, and complications from in utero opioid exposure increased dramatically over the past two decades. Despite evidence that medications for opioid use disorder are highly effective for preventing adverse outcomes from opioid use disorder, most patients needing treatment do not receive it with evidence of differential patterns of access for minoritized racial and ethnic groups compared to non-minoritized groups. Disparities in opioid use disorder treatment and medication access may intersect with race and ethnicity and pregnancy status for women seeking treatment for opioid use disorder. Receiving treatment for opioid use disorder during pregnancy is crucial for maternal and infant health and wellbeing; however, issues of equitable treatment access for racial and ethnically minoritized women remains understudied. Extending the ongoing NIDA-funded project (R01DA045729), which conducted a randomized field experiment of pregnant and non-pregnant “secret shoppers” attempting to obtain appointments at opioid treatment programs or with outpatient buprenorphine providers, this health equity supplement seeks to determine if non-white patients identified barriers to obtaining an appointment for opioid use disorder treatment. In addition, we seek to determine if racial concordance was a determining factor in women’s reported experiences based on secret shoppers’ race/ethnicity matching with community setting of clinic locations. Explanations of underlying mechanisms of these barriers will be explored using qualitative data. Leveraging the unique data from the NIDA-funded field experiment, this study will 1) determine if racial concordance between secret shoppers and the communities that surround clinic locations influenced their ability to a) obtain an appointment for treatment, b) wait time for treatment, c) out of pocket costs for treatment, and d) determine if these outcomes varied by pregnancy status and treatment provider type, and 2) explore secret shoppers’ qualitative descriptions of racial discriminatory encounters and experiences when seeking treatment and medication at opioid treatment program, either with opioid treatment programs or outpatient buprenorphine providers, attending to variability based on race/ethnicity and pregnancy status. Data from this study will inform future studies aimed at mitigating health inequities at the confluence of opioid use disorder, pregnancy, and race.