Addressing Inequities in Substance Use Disorder Treatment
A national opioid epidemic has captured the country’s attention, with many experts agreeing that substance use disorder (SUD) is a top health problem in the U.S.
Despite acknowledgment of this widespread, ever-increasing public health issue, data reveals that the gap between people who need treatment and people who actually receive treatment is massive. In 2018, a mere 18% of people identified as needing SUD treatment actually received it.[1]
While this gap exists among people of all races, it’s greatest amongst minorities. For example, a startling 90% of African Americans and 92% of Latino individuals diagnosed with SUD did not receive addiction treatment.[2][3]
The Impact of Inequities
Inequities in substance use treatment have a huge impact on our society. Most notably, the lives of people from BIPOC (Black, Indigenous, and people of color) communities are being cut short due to a lack of treatment.
Between 2016 and 2020, the U.S. saw over 116,000 excess premature deaths among racial minority groups, ethnic minority groups, and Indigenous populations due to mental and behavioral health needs.[4]
It was also recently reported that drug overdose death rates are the highest among Indigenous people and Black men. In fact, death rates for Black men between the ages of 35 and 64 have tripled since 2018 due to illegal drugs laced with the high-potency opioid, fentanyl.[5]
Veterans are also much more likely (1.5 times, to be exact) to die of an opioid overdose than the general population, yet only one in three veterans receive medications to treat opioid use disorder.[6] This is partly due to a shortage of providers who have federal approval to prescribe buprenorphine, a prescription drug used to help people reduce or quit their use of opiates.
Drug-related fatalities aside, substance abuse may lead to other issues, such as violence, crime, motor vehicle crashes, and injuries, all of which impact society as a whole.
What’s Causing Inequities in SUD Treatment?
A key ingredient in the inequity equation is a lack of adequate health insurance.
Medicaid is a state-federal health care program that pays for various medical services for children and adults with limited income. It’s also the largest payer of mental health services in the U.S. Unfortunately, 12 states have not adopted the Affordable Care Act’s Medicaid expansion, which extends Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level.[7] Data shows that states with this expansion have higher rates of SUD treatment.[7]
There are also improvements that could be made to Medicare, which is federal health insurance for people 65 and older and certain younger people with disabilities. According to a recent report, Medicare is drastically underserving older Americans with opioid use disorder, with only 18% of enrollees with a diagnosis receiving recommended medication treatment.[8]
Additional Barriers That Drive Inequities in SUD Treatment
In addition to inadequate health insurance, inequities in SUD treatment among BIPOC groups may also be affected by social factors. These might include geographic location, socioeconomic challenges, and the safety and public health infrastructure of communities.
Cultural barriers can also play a role, such as providers’ lack of familiarity with important cultural considerations and the stigma surrounding SUD treatment in minority communities.
How to Address Inequities in SUD Treatment?
Now for the million-dollar question: what can we do to reduce these treatment gaps? Here are the top factors and actions to consider:
Prioritizing Prevention
Studies show that racism, discrimination, stress, and trauma faced by BIPOC groups increase the risk of behavioral health conditions, such as PTSD, depression, anxiety, and substance misuse.[9]
As such, prevention starts with ensuring BIPOC groups have convenient access to mental health services, such as therapy and medication management, allowing individuals to work through their hardships in a productive, healthy way.
More Screening
As with any health condition, catching substance abuse early through screening is key to more favorable outcomes. Through its fully integrated digital platform, CHESS Health helps streamline the screening process, including SBIRT (screening, brief intervention, referral to treatment).
This may be of enormous benefit to communities with limited or no access to screening support.
Providing Culturally Relevant Information and Support
It’s essential to provide those with SUD with culturally relevant information and support during their treatment and recovery. That’s why CHESS Health has launched Conexiones, a Spanish-language edition of our Connections app. This version enables Spanish speakers to receive in-language and culturally appropriate resources and support from peers when and where they need it.
As with our original Connections app, Conxeiones provides ongoing support and relapse prevention to people recovering from SUD. This may be particularly helpful to those with limited access to in-person SUD treatment and resources due to location, stigma, finances, or other barriers.
The Bottom Line
It’s essential to recognize and acknowledge the shortcomings, policies, stigmas, and barriers that contribute to current inequities in SUD treatment. Only then can we start working towards change.
At CHESS Health, we collaborate with health plans, state and local governments, other public sector organizations, and individual providers to get our apps on to the smartphones of individuals struggling with SUD.
If you’re interested in learning more about the life-saving technology we offer and how it can help close the treatment gap, get in touch with CHESS Health today.
References
- https://pubmed.ncbi.nlm.nih.gov/32773076/
- https://www.samhsa.gov/data/sites/default/files/reports/rpt31099/2019NSDUH-AA/AfricanAmerican%202019%20NSDUH.pdf
- https://www.samhsa.gov/data/sites/default/files/reports/rpt31101/2019NSDUH-Hispanic/Hispanic%202019%20NSDUH.pdf
- https://satcherinstitute.org/wp-content/uploads/2022/09/The-Economic-Burden-of-Mental-Health-Inequities-in-the-US-Report-Final-single-pages.V6.pdf
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796547?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=092022
- https://www.gao.gov/assets/gao-20-35.pdf
- https://healthpolicy.usc.edu/evidence-base/racial-disparities-in-accessing-treatment-for-substance-use-highlights-work-to-be-done/#:~:text=According%20to%20SAMHSA%2C%20of%20individuals,%25%20of%20the%20time%2C%20respectively.
- https://oig.hhs.gov/oei/reports/OEI-02-22-00390.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461539/
