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Study Suggests People of Color Face Inequitable Naloxone Access

People who inject drugs who identified as Black or Latinx were less likely to be engaged in the naloxone delivery cascade, according to the study


RESEARCH TRIANGLE PARK, N.C. — A new study from RTI International, a nonprofit research institute, adds to a body of evidence that people of color and those experiencing homelessness are subjected to inequitable access to naloxone, an opioid overdose reversal medication.


The study of 536 people who inject drugs (PWID) was conducted in Los Angeles and San Francisco from 2017 to 2018 and assessed the naloxone engagement and re-engagement cascade, which provides a lens into where drop-offs occur in naloxone delivery and where disparities exist at various points in the cascade. Overall, 49% of participants received naloxone in the past six months and 35% currently owned the medication. Of the people who had recently received naloxone, 74% had used it or lost it and 67% reported getting refills.

With their analysis, the research team found that PWID who identified as Latinx or Black were less likely to have recently received naloxone when compared to their White counterparts. However, of those who had received naloxone, Latinx or Black PWID received refills similarly to their White counterparts.

“To identify disparities in naloxone access, it’s important to examine the ‘delivery cascade’ to help us understand where we are missing people along the pathway of engaging and re-engaging in naloxone delivery,” said Barrot Lambdin, Ph.D., a senior implementation scientist at RTI. “This study offers evidence that people of color and those experiencing homelessness face inequitable access in the early stages of the cascade. Once engaged in naloxone delivery, people re-engage similarly. As a public health community, this is an urgent priority. We must develop new approaches to equitably engage people in naloxone delivery and ensure the benefits of this lifesaving medication are extended to all.”

Most study participants said they accessed naloxone via community-based organizations, such as syringe service programs.

View the full study.