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 在过去的20年里，接触到的病毒急剧增加。尽管有证据表明阿片类药物的使用 精神障碍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 没有证据表明少数族裔种族和族裔的不同准入模式的治疗 小组与非小规模小组的比较。阿片类药物使用障碍的治疗和用药的差异 对于寻求阿片类药物使用治疗的妇女来说，获得治疗的机会可能与种族和族裔以及怀孕状况相交叉 无序。在孕期接受阿片类药物使用障碍的治疗对母婴健康至关重要 和福祉；然而，种族和族裔被边缘化的妇女获得公平待遇的问题 仍然没有得到充分的研究。延长正在进行的由NIDA资助的项目(R01DA045729)，该项目进行了 怀孕和未怀孕的“秘密购物者”试图获得 预约阿片类药物治疗计划或门诊丁丙诺啡提供者，这一健康公平 补充剂旨在确定非白人患者是否发现了获得阿片类药物预约的障碍 使用障碍治疗。此外，我们试图确定种族和谐是否是决定因素 根据秘密购物者的种族/民族与社区背景相匹配的妇女报告经历 诊所的位置。对这些障碍的潜在机制的解释将使用定性的 数据。利用来自NIDA资助的现场实验的独特数据，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 有能力a)获得治疗预约，b)等待治疗时间，c)自付治疗费用， 以及d)确定这些结果是否因怀孕状况和治疗提供者类型而异，以及2)探索 秘密购物者在寻找时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用药，包括阿片类药物治疗计划或门诊患者 丁丙诺啡提供者，注意基于种族/族裔和怀孕状况的可变性。来自于此的数据 这项研究将为未来旨在减轻阿片类药物使用障碍汇合时的健康不平等现象的研究提供信息， 怀孕，还有种族。

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.