Recommendations from Black and Latinx Boston overdose survivors for how to improve quality of life and racial equity in substance use disorder treatment

Type: Oral Presentation
Date: March 2024

Citation

S O’Malley, J Desmarais, R Paradise, J Clarke, A Hoyos-Cespedes, A Nurani, AR Bazzi, S Kimmel, S Taylor, D Dooley, “Recommendations from Black and Latinx Boston overdose survivors for how to improve quality of life and racial equity in substance use disorder treatment”, Grayken Center for Addiction Together for Hope: Boston Addiction Conference 2024 (oral presentation)

Abstract

Background: In Massachusetts, the opioid-related overdose death rate reached an all-time high in 2022, and there are significant and growing racial disparities. Furthermore, there is a substantial treatment gap for people with substance use disorders nationally, and local research has identified racial/ethnic inequities in receipt of treatment following opioid overdoses in Boston. To better understand how to support people who use drugs and address racial inequities in the treatment system, it is critical to engage with overdose survivors, especially those who identify as Black and Latinx, to learn what resources, and system reforms are needed to improve their lives and reduce these inequities. 

Objective: Uplift specific recommendations made by Black and Latinx overdose survivors living in Boston for improving racial equity in access to substance use disorder treatment.

Methods: In 2021, we conducted semi-structured interviews with 59 recent opioid overdose survivors living in Boston, 18 (31%) identified as non-Hispanic Black and 23 (39%) as Hispanic or Latino/a/x. We asked survivors to give recommendations for improving access to substance use disorder treatment in general, as well as recommendations to improve racial equity. Interview transcripts were analyzed using a Framework Analysis approach, and subgroup analysis was conducted for Black and Latinx participants (n= 41).  

Results: Black and Latinx overdose survivors provided recommendations to reform and expand current systems to be more responsive to their complex needs. Participants recommended increasing the number of staff who share lived experiences, improving outreach, reducing stigma, providing more person-centered care, and developing more responsive program policies. Survivors called for expansion of the harm reduction and treatment systems to increase capacity, and some emphasized the importance of access to safe use sites. Many participants also discussed the need for more resources to address the social determinants of health; focusing on housing, pathways to meaningful employment, and access to necessities such as food and bathrooms. When reflecting on how to improve racial equity, Black and Latinx participants reinforced a need for more staff with shared lived experiences with clients and suggested specific modifications to program processes to improve equitable access. 

Conclusion:  Forty-one Black and Latinx overdose survivors in Boston provided specific recommendations for how the substance use disorder treatment and social services systems can improve access and equity for marginalized people. These recommendations can inform the development of programs and policies that better meet the needs of communities disproportionately impacted by racism and the current overdose crisis in Boston.