National Institute on Drug Abuse Clinical Trial Network: New England Consortium Node

项目摘要 近年来，黑人和拉丁裔人群中阿片类药物过量死亡人数显著增加。 成瘾治疗，包括治疗阿片类药物使用障碍（MOUD）的药物，如丁丙诺啡， 减少致命的阿片类药物过量。然而，黑人和拉丁美洲人在获得 MOUD和成瘾治疗。急诊科（艾德）代表了一种新兴的设置， MOUD，并为接受未经治疗的阿片类药物治疗的黑人和拉丁美洲人提供持续成瘾治疗的联系 使用障碍（OUD）。然而，很少有人知道黑人和拉丁美洲人的障碍和促进因素， 在艾德就诊后，此外，人们对 阿片类药物过量、多种物质使用、重度抑郁症和污名的艾德表现差异 在这些人群中。填补这些知识空白很重要，因为阿片类药物过量， 滥用、重度抑郁症和污名化都与更糟糕的治疗结果有关。此外，本发明还 引出障碍和促进者可以为未来基于ED的干预提供信息，以增强成瘾的参与 黑人和拉丁美洲人未经治疗的OUD。本提案的目的是评估 在获得成瘾治疗方面的差距，并引出基于ED的干预措施的潜在目标， 在黑人和拉丁裔人口中参与成瘾治疗。具体目标是：1）开展 一项定性研究，重点是在青少年中从事成瘾治疗的障碍和促进因素的模式， 接受ED启动丁丙诺啡治疗的黑人、拉丁裔和非拉丁裔白色患者，转诊为 在艾德外继续OUD治疗，以及2）评价黑人、拉丁美洲人和非 拉丁裔白色艾德患者中未接受治疗的OUD患者，既往确定的因素是治疗效果较差的预测因素 结果，包括阿片类药物过量，多种物质的使用，重度抑郁症，和耻辱，使用 CTN 0099中收集的数据的补充分析。为了实现这一点，我们将进行两个半结构化 对黑人、拉丁美洲人和非拉丁美洲白色参与者进行了单独访谈，这些参与者在他们完成了CTN 0099之后参加了CTN 0099。 根据CTN 0099中收集的数据完成了最终30天评估和补充分析。研究 研究结果将为开发基于ED的干预措施提供信息， 黑人和拉丁裔人群在艾德就诊后接受治疗。

PROJECT SUMMARY In recent years there has been a marked surge in opioid overdose deaths across Black and Latino populations. Addiction treatment, which includes medications for opioid use disorder (MOUD) such as buprenorphine, decreases fatal opioid overdoses. Yet Black and Latino individuals face substantial disparities in access to MOUD and addiction treatment. The emergency department (ED) represents an emerging setting to initiate MOUD and provide linkage to ongoing addiction treatment to Black and Latino individuals with untreated opioid use disorder (OUD). However, little is known about the barriers and facilitators that Black and Latino individuals encounter to engage in addiction treatment subsequent to an ED visit. Moreover, less is known about the differences in ED presentation for opioid overdose, polysubstance use, major depressive disorder, and stigma within these populations. Filling these knowledge gaps are important because opioid overdose, polysubstance use, major depressive disorder, and stigma have each been linked to worse treatment outcomes. Further, eliciting barriers and facilitators can inform future ED-based interventions to enhance engagement in addiction treatment among Black and Latino individuals with untreated OUD. The goal of this proposal is to evaluate disparities in access to addiction treatment and elicit potential targets for ED-based interventions that enhance engagement in addiction treatment among Black and Latino populations. The specific aims are to: 1) conduct a qualitative study focusing on patterns of barriers and facilitators to engaging in addiction treatment among Black, Latino, and non-Latino White patients receiving ED-initiated buprenorphine treatment with a referral for continuation of OUD treatment outside of the ED and 2) evaluate differences among Black, Latino, and non- Latino White ED patients with untreated OUD on factors previously identified as predictors of worse treatment outcome, including opioid overdose, polysubstance use, major depressive disorder, and stigma, using supplemental analyses of data collected in CTN 0099. To accomplish this, we will conduct both semi-structured individual interviews of Black, Latino, and non-Latino White participants enrolled in CTN 0099 after they have completed their final 30-day assessments and supplemental analyses from data collected in CTN 0099. Study findings will inform the development of an ED-based intervention that enhances engagement in addiction treatment among Black and Latino populations subsequent to ED visit.