Racial/ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City.

Author: Shayla Nolen, Andrew Trinidad, Ashly Jordan, Traci Green, Ali Jalali, Sean Murphy, Xiao Zang, Brandon Marshall, Bruce Schackman

Theme: Epidemiology & Public Health Research Year: 2023

Objectives: We evaluated racial/ethnic differences in the receipt of naloxone distributed by opioid overdose prevention programs (OOPPs) in New York City (NYC).

Methods: We used naloxone recipient racial/ethnic data collected by OOPPs from April 2018 to March 2019. We aggregated quarterly neighborhood-specific rates of naloxone receipt and other covariates to 42 NYC neighborhoods. Disparities were evaluated using a multilevel negative binomial regression model in which we conducted bivariable and multivariable analyses to assess the relationship between neighborhood-specific naloxone receipt rates and race/ethnicity. Race/ethnicity was stratified into four mutually exclusive racial/ethnic groups: Latino, non-Latino Black, non-Latino White and non-Latino Other. We also conducted racial/ethnic-specific geospatial analyses to assess whether there was within-group geographic variation in naloxone receipt rates for each racial/ethnic group.

Results: In the 42 NYC neighborhoods, non-Latino Black residents had the highest median quarterly naloxone receipt rate of 41.8 per 100,000 residents, followed by Latino residents (22.0 per 100,000), non-Latino White (13.6 per 100,000) and non-Latino Other residents (13.3 per 100,000). In our multivariable analysis, compared with non-Latino White residents, non-Latino Black residents had a significantly higher receipt rate (aRR=2.10 [95% CI=1.54-2.85]) and Latino residents had a non-significantly higher rate (aRR=1.11, (95%CI=0.85-1.43). However, non-Latino Other residents had a significantly lower (aRR=0.79, [95%CI=0.67-0.92]) naloxone receipt rate than their non-Latino White counterparts. In the race/ethnicity-specific geospatial analyses, both Latino and non-Latino Black residents had the most within-group geographic variation in naloxone receipt rates compared to non-Latino White and Other residents.

Conclusion: This study found significant racial/ethnic differences in naloxone receipt from NYC OOPPs. We observed substantial variation in naloxone receipt for non-Latino Black and Latino residents across neighborhoods, indicating relatively poorer access in some neighborhoods and opportunities for new approaches to address geographic and structural barriers in these locations.

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