Racialized and beneficiary inequities in medication to treat opioid use disorder receipt within the US Military Health System

• Published in: Drug and alcohol dependence 2023-12, Vol.253, p.111025-111025, Article 111025
• Main Authors: Lance Tippit, T, O'Connell, Megan A, Costantino, Ryan C, Scott-Richardson, Maya, Peters, Sidney, Pakieser, Jennifer, Tilley, Laura C, Highland, Krista B
• Format: Article
• Language: English
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2023.111025

Medication for opioid use disorder (MOUD) can be critical to managing opioid use disorder (OUD). It is unknown the extent to which US Military Health System (MHS) patients diagnosed with OUD receive MOUD. Healthcare records of MHS-enrolled active duty and retired service members (N = 13,334) with a new (index) OUD diagnosis were included between 2018 and 2021, without 90-day pre-index MOUD receipt were included. Elastic net logistic and Cox regressions evaluated care- and system-level factors associated with 1-year MOUD receipt (primary outcome) and time-to-receipt. Only 9% of patients received MOUD 1-year post-index; only 4% received MOUD within 14 days. Black patients (OR for receipt 0.38, 95% CI 0.30-0.49), Latinx patients (OR for receipt 0.44, 95% CI 0.33-0.59), and patients whose race and ethnicity was Other (OR for receipt 0.52, 95%CI 0.35, 0.77) experienced lower MOUD access (all p < 0.001). Retirees were more likely to receive MOUD relative to active duty service members (OR for receipt 1.81, 95%CI 1.52, 2.16, p