ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2025
Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Machine learning models to detect opioid misuse in emergency department patients at triage.The American journal of emergency medicine · 2026Article
- Community-informed design of personalized patient-facing materials to facilitate ED-initiated treatment of opioid use disorder.PEC innovation · 2026Article
- Exploring Preferences in Emergency Department Coordination of Opioid Use Disorder Treatment by Race and Ethnicity.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Machine learning models to detect opioid misuse in Emergency Department patients at triage.medRxiv : the preprint server for health sciences · 2025Article
- Racial and Ethnic Factors and Opioid Use Disorder Treatment After an Emergency Department Visit.JAMA network open · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesRacial and sex disparities are noted in the administration and prescribing of buprenorphine from emergency departments (EDs) nationally. It is unknown whether disparities persist when accounting for the specific discharge diagnosis addressed during encounters such as opioid overdose or withdrawal.
methodsWe conducted a cross-sectional analysis of opioid-related ED encounters from January 2020 through December 2023 using a national database, Epic Cosmos. We analyzed the effect of opioid encounter subtype-overdose or withdrawal-on receipt of buprenorphine using multivariable logistic regression adjusting for demographics and measured confounding variables. Encounter subtypes were defined by diagnosis codes and buprenorphine receipt was defined as administration or prescribing. We evaluated for racial, ethnic, and sex disparities within encounter subtypes for withdrawal and overdose.
resultsWe examined 1,088,033 opioid-related encounters. Adjusted odds for buprenorphine receipt were greater for encounters involving withdrawal (odds ratio [OR] 2.22, 95% CI 2.18-2.26), though reduced for overdose (OR 0.52, 95% CI 0.51-0.53) and other opioid complications (OR 0.69, 95% CI 0.64-0.70). Males were more likely to receive buprenorphine (OR 1.18, 95% CI 1.16-1.19) than females. All racial minorities excepting American Indian/Native American patients (OR 1.04, 95% CI 1.00-1.08) were less likely to receive buprenorphine than White patients (Asian OR 0.85, 95% CI 0.79-0.81; Black OR 0.80, 95% CI 0.79-0.81; Native Hawaiian/Pacific Islander OR 0.79, 95% CI 0.71-0.89). Subtype analyses indicated decreased odds for buprenorphine receipt for female patients across all subtypes. An increased odds for buprenorphine receipt among Black patients (OR 1.04, 95% CI 1.01-1.07; ref. White race) was noted in encounters involving opioid withdrawal but disparities persisted for opioid overdose.
conclusionsThe administration and prescribing of buprenorphine in the ED is heavily influenced by the presence of opioid withdrawal. Disparities disadvantage female patients and racial minorities. Some racial disparities, particularly among Black patients, are not evident when solely considering encounters involving opioid withdrawal. System-level interventions are needed to address disparities and improve the equitable uptake of ED-initiated buprenorphine.
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