Homelessness and Treatment Outcomes Among Black Adults With Opioid Use Disorder: A Secondary Analysis of X:BOT.

Autor:	Justen M; From the Yale School of Medicine, New Haven, CT (MJ); Department of Biostatistics, Brown University, Providence, RI (JS); New York Psychiatric Institute, New York, NY (JS); Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY (MP); Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY (T-HC); New York State Psychiatric Institute, New York, NY (MG, OO, EVN); Columbia Irving Medical Center, New York, NY (MG, EVN); Department of Psychiatry, Yale School of Medicine, New Haven, CT (TGR, AH); VA New England Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT (TGR); NYU Grossman School of Medicine, New York, NY (JR); Department of Emergency Medicine, Yale School of Medicine, New Haven, CT (KH); Yale School of Public Health, New Haven, CT (KH, EJE); Program in Addiction Medicine, Yale School of Medicine, New Haven, CT (KH, EJE); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (EJE)., Scodes J, Pavlicova M, Choo TH, Gopaldas M, Haeny A, Opara O, Rhee TG, Rotrosen J, Nunes EV Jr, Hawk K, Edelman EJ
Jazyk:	angličtina
Zdroj:	Journal of addiction medicine [J Addict Med] 2023 Jul-Aug 01; Vol. 17 (4), pp. 463-467. Date of Electronic Publication: 2023 Jan 05.
DOI:	10.1097/ADM.0000000000001125
Abstrakt:	Objective: We sought to identify the sociodemographic and clinical characteristics associated with homelessnesss, and explore the relationship between homelessnesss and treatment outcomes among Black individuals. Methods: This is a secondary analysis of the subgroup of Black participants (n = 73) enrolled in "X:BOT," a 24-week multisite randomized clinical trial comparing the effectiveness of extended-release naltrexone versus sublingual buprenorphine-naloxone (n = 570). Outcomes included medication initiation, return to extramedical use of opioids assessed by both self-report and urine toxicology, and engagement in medications for opioid use disorder (MOUD) treatment at 28 weeks postrandomization. Descriptive statistics were performed. Results: Black participants were mostly unmarried and male, and about a third were aged 21-30 years. Among people experiencing homelessnesss, more were uninsured (45.5% [10/22] vs 19.6% [10/51]), unemployed (77.3% [17/22] vs 64.7% [33/51]), and reported alcohol (40.9% [9/22] vs 23.5% [12/51]) and sedative use (54.5% [12/22] vs 17.6% [9/51]) within the previous 30 days. Compared with housed Black individuals, a slightly higher proportion of Black individuals experiencing homelessnesss successfully initiated study medication (81.1% [18/22] vs 72.6% [37/51]); similar proportions returned to opioid use during the trial (68.2% [15/22] vs 68.6% [35/51]) and were engaged in MOUD at 28 weeks after trial entry (72.2% [13/18] vs 69.7% [23/33]) among participants located for follow-up. Conclusions: These descriptive results among Black patients participating in a trial of MOUD suggest that efficacious MOUD is possible despite homelessnesss with additional clinical supports such as those provided by a clinical trial. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 American Society of Addiction Medicine.)
Databáze:	MEDLINE
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