Dr. Michelle Durham, Associate Director of the Global and Local Center for Mental Health Disparities at Boston University School of Medicine, recently spoke at the Governor’s Institute’s Addiction Medicine 2021 conference. We followed up with a participant’s question regarding Medication for Opioid Use Disorder (MOUD) and the African American community.
Question: What are your thoughts about low MOUD use in the black community? Is this due to access issues or stigma or something else? How do we address this?
Answer: My short answer is that it is both stigma and access. Buprenorphine is an office-based treatment typically associated with PCP and/or psychiatrist providing the Rx after an office visit. Low income or marginalized communities may not have access to a psychiatrist or they may not be able to establish care with PCP. Methadone being federally monitored with regular urine checks, daily check in for medications can be stigmatizing in and of itself and does not humanize folks or their difficulty with using substances. During the pandemic they decreased these restrictions which means it is doable and we should understand how this helped patients. Advocacy at the state and federal levels will be necessary to remove some of these policies from people accessing treatment, but then we will need providers to confront their own biases on who gets a Rx and culturally responsive care.
Dr. Durham recommended a SAMHSA resource “The Opioid Crisis: The Black/African American Population: An Urgent Issue” that addresses many of the factors at play.