Open Access

Harm Reduction Journal

, volume 20 , issue 1 , publication number 24

Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City

Maria R. Khan ^{1, 2, 3}

Lee Hoff ¹

Luther Elliott ^{2, 3, 4}

Joy D. Scheidell ^{1, 2, 3}

John R. Pamplin ^{3, 5}

Tarlise N. Townsend ^{1, 3}

Natalia M. Irvine ¹

Alex S. Bennett ^{2, 3, 6}

Hide authors affiliations Show authors affiliations: 6 affiliations

Department of Population Health, New York University Grossman School of Medicine, New York, USA |

Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, USA |

Center for Opioid Epidemiology and Policy, New York University Grossman School of Medicine, New York, USA |

⁴

Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, USA |

⁵

Columbia University Mailman School of Public Health, Department of Epidemiology, New York, USA |

⁶

Center for Anti-Racism, Social Justice, and Public Health, New York University School of Global Public Health, New York, USA |

Publication type: Journal Article

Publication date: 2023-02-25

Springer Nature

Harm Reduction Journal

scimago Q1

wos Q1

SJR: 1.409

CiteScore: 5.4

Impact factor: 4.0

ISSN: 14777517

DOI: 10.1186/s12954-023-00736-7

Copy DOI

PubMed ID: 36841763

Medicine (miscellaneous)

Public Health, Environmental and Occupational Health

Psychiatry and Mental health

Abstract

Background

Drug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm reduction including naloxone across racial/ethnic groups is warranted.

Methods

Using data from an ongoing study of people who use illicit opioids in NYC (N = 575), we quantified racial/ethnic differences in the naloxone care cascade.

Results

We observed gaps across the cascade overall in the cohort, including in naloxone training (66%), current possession (53%) daily access during using and non-using days (21%), 100% access during opioid use (20%), and complete protection (having naloxone and someone who could administer it present during 100% of opioid use events; 12%). Naloxone coverage was greater in white (training: 79%, possession: 62%, daily access: 33%, access during use: 27%, and complete protection: 13%, respectively) and Latinx (training: 67%, possession: 54%, daily access: 22%, access during use: 24%, and complete protection: 16%, respectively) versus Black (training: 59%, possession: 48%, daily access:13%, access during use: 12%, and complete protection: 8%, respectively) participants. Black participants, versus white participants, had disproportionately low odds of naloxone training (OR 0.40, 95% CI 0.22–0.72). Among participants aged 51 years or older, Black race (versus white, the referent) was strongly associated with lower levels of being trained in naloxone use (OR 0.20, 95% CI 0.07–0.63) and having 100% naloxone access during use (OR 0.34, 95% CI 0.13–0.91). Compared to white women, Black women had 0.27 times the odds of being trained in naloxone use (95% CI 0.10–0.72).

Conclusions

There is insufficient protection by naloxone during opioid use, with disproportionately low access among Black people who use drugs, and a heightened disparity among older Black people and Black women.

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Khan M. R. et al. Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City // Harm Reduction Journal. 2023. Vol. 20. No. 1. 24

GOST all authors (up to 50) Copy

Khan M. R., Hoff L., Elliott L., Scheidell J. D., Pamplin J. R., Townsend T. N., Irvine N. M., Bennett A. S. Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City // Harm Reduction Journal. 2023. Vol. 20. No. 1. 24

RIS |

Cite this

RIS Copy

TY - JOUR

DO - 10.1186/s12954-023-00736-7

UR - https://doi.org/10.1186/s12954-023-00736-7

TI - Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City

T2 - Harm Reduction Journal

AU - Khan, Maria R.

AU - Hoff, Lee

AU - Elliott, Luther

AU - Scheidell, Joy D.

AU - Pamplin, John R.

AU - Townsend, Tarlise N.

AU - Irvine, Natalia M.

AU - Bennett, Alex S.

PY - 2023

DA - 2023/02/25

PB - Springer Nature

IS - 1

VL - 20

PMID - 36841763

SN - 1477-7517

ER -

BibTex

Cite this

BibTex (up to 50 authors) Copy

@article{2023_Khan,

author = {Maria R. Khan and Lee Hoff and Luther Elliott and Joy D. Scheidell and John R. Pamplin and Tarlise N. Townsend and Natalia M. Irvine and Alex S. Bennett},

title = {Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City},

journal = {Harm Reduction Journal},

year = {2023},

volume = {20},

publisher = {Springer Nature},

month = {feb},

url = {https://doi.org/10.1186/s12954-023-00736-7},

number = {1},

pages = {24},

doi = {10.1186/s12954-023-00736-7}

}

Publisher

Springer Nature

Journal

Harm Reduction Journal

scimago Q1

wos Q1

SJR

1.409

CiteScore

5.4

Impact factor

4.0

ISSN

14777517 (Print, Electronic)