Exploring patient-related factors behind racial inequities in buprenorphine treatment for opioid use disorder in primary care

From 2019 to 2020, overdose death rates increased 39% among Black Americans nationally. The goal of this study is to understand patient-related etiologies behind racial inequities in buprenorphine treatment for opioid use disorder (OUD) in primary care patients. We surveyed adults with primary care providers (PCPs) in practices at an integrated healthcare system in Massachusetts where buprenorphine was prescribed. 428 adults were randomly sampled, 278 confirmed to have OUD via chart review, and 33 patients completed the survey. 36.4% (n=12) identified as LatinX, 33.3% (n=11) identified as Black, 27.3% (n=9) as white. 82% (n=27) reported having ever been prescribed buprenorphine for OUD [100% (n=9) of white respondents, 75% (n=9) of Latinx respondents, 73% (n=8) of Black respondents]. A majority (n=23) of respondents preferred to get their OUD treatment at their PCP’s office [82% (n=9) of Black respondents, 75% (n=9) of LatinX respondents, and 56% (n=5) of white respondents]. Most Black and Latinx patients preferred to get their OUD treatment at their PCP’s office although only half have ever discussed buprenorphine with their PCP. Black and Latinx patients placed more importance on having healthcare staff who are from and know about different racial/ethnic backgrounds compared to white patients. None of the respondents reported that having their PCP share or understand their racial/ethnic background would improve buprenorphine access. Respondents suggested that hiring more staff and clinicians who are Black and/or Latinx, treating people with SUD compassionately, and offering financial assistance would better meet the needs of Black and Latinx patients.