OBJECTIVES:

Access to medications for opioid use disorder (MOUD) among racial and ethnic minorities is a growing concern. Thus, the objective is to provide a systematic review of the literature regarding racial/ethnic disparities in receiving MOUD.

METHODS:

The databases of Medline, Science Direct, Embase, CINAHL, PsycInfo and Google Scholar were systematically searched targeting published papers from 2001-2022 using the search term (inequality or inequity or race or ethnic and/or disparity or sex) and” ((buprenorphine or naltrexone or methadone or opioid) not prescri* not overdose). Studies concerning children under 12 years of age, residential treatment patients, and pregnant women were excluded. The papers that only focused on pain treatment, rural vs. urban comparisons or perceived discrimination were also excluded. The meta-analysis was conducted in study subgroups.

RESULTS:

Eighteen studies were included in this review of two categories. The first category included ten studies comparing receiving MOUD between different races/ethnicities at the individual level. The meta-analysis of Adjusted ORs (AORs) comparing Black/African Americans, Hispanics, Native Americans, Asians, Hawaiians, and mixed-race with Whites were AOR=0.58 (95% CI: 0.35-0.81), AOR=0.85 (95% CI: 0.76-0.95), AOR=0.89 (95% CI: 0.73-1.04), AOR=0.85 (95% CI: 0.72-0.99), AOR=0.32 (95% CI: 0.00-0.95), and AOR=0.98 (95% CI: 0.83-1.12), respectively. The second category of articles compared buprenorphine and methadone treatment odds among ethnic or racial minorities and Whites at individual and ecological levels. The findings suggested that methadone is the predominant medication for minorities, while Whites and high-income communities with OUD access buprenorphine.

CONCLUSIONS:

Racial/ethnic, and socioeconomic disparities exist in receiving MOUD in the US. Racial/ethnic minorities receive significantly less medications for OUD compared to Whites. Buprenorphine is more accessible for whites and those in high-income communities. It is necessary to identify means to reduce disparities and design effective interventions and policies to close gaps in access to MOUD.