BETHESDA, MD — Rates of prescribing for medication for opioid-use disorder (MOUD) are low in the MHS and show evidence of institutional racism, according to a new study.
In addition, the research led by the Uniformed Services University and Walter Reed National Military Medical Center pointed out that active-duty servicemembers were less likely to receive the medication critical to managing opioid-use disorder (OUD) than retirees.
The report published in the journal Drug and Alcohol Dependence included healthcare records of 13,334 MHS-enrolled active-duty and retired servicemembers (with a new index) OUD diagnosis between 2018 and 2021, without 90-day pre-index MOUD receipt.1
The study results indicated that only 9% of patients received MOUD 1-year post-index, and 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),” the authors noted. “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 <0.001).”
The researchers concluded that “Institutional racism in MOUD prescribing, combined with the overall low rates of MOUD receipt after OUD diagnosis, highlight the need for evidence-based, multifaceted, and multilevel approaches to OUD care in the Military Health System. Without clear Defense Health Agency policy, including the designation of responsible entities, transparent and ongoing evaluation and responsiveness using standardized methodology, and resourced programming and public health campaigns, MOUD rates will likely remain poor and inequitable.”
- Lance Tippit T, O’Connell MA, Costantino RC, Scott-Richardson M, Peters S, Pakieser J, Tilley LC, Highland KB. Racialized and beneficiary inequities in medication to treat opioid use disorder receipt within the US Military Health System. Drug Alcohol Depend. 2023 Dec 1;253:111025. doi: 10.1016/j.drugalcdep.2023.111025. Epub 2023 Nov 10. PMID: 38006670.