Racial and Ethnic Disparities in Take-Home Methadone Use for Medicare Beneficiaries With Opioid Use Disorder

In 2020, as a response to the significant increase in opioid overdose deaths over the past decade, Medicare initiated coverage of methadone treatment for opioid use disorder (OUD), including take-home dosing. The Substance Abuse and Mental Health Services Administration (SAMHSA) also increased flexibility regarding take-home methadone. This policy has been associated with increased treatment engagement and improved patient satisfaction.  

However, research indicates that Black and Hispanic patients are less likely to receive medication for OUD than white patients. A research letter in JAMA Network Open from Dr. Hye-Young Jung, associate professor of population health sciences, Dr. Beth McGinty, chief of the Division of Health Policy and Economics and the Livingston Farrand Professor of Population Health Sciences, Dr. Mark Unruh, associate professor of population health sciences, and Yutong Zhang, a graduate of the Weill Cornell Medicine MS in Health Policy and Economics program and PhD student at Johns Hopkins University, evaluates whether the same racial and ethnic disparities persist in take-home methadone use for Medicare beneficiaries with OUD.  

Researchers analyzed data from 9172 unique beneficiaries, with characteristics including race and ethnicity measures for Hispanic, non-Hispanic Black, and non-Hispanic white. Results indicate that Black beneficiaries were less likely to use take-home methadone than white beneficiaries during the initial nine months of the COVID-19 pandemic. Availability of take-home dosing, clinician and patient dynamics, and other factors, including racial bias, may contribute to this difference.  

“The results of our study highlight the crucial need to address racial disparities in the treatment of opioid use disorder as part of efforts to confront the nation’s opioid public health emergency,” said Dr. Jung.  

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