Workforce considerations for improving racial equity in substance use disorder treatment

Type: Poster Presentation
Date: November 2022


Ranjani Paradise, Jeff Desmarais, Jaylen Clarke, Andres Hoyos-Cespedes, Alykhan Nurani, Shannon E. O’Malley, Angela R. Bazzi, Simeon Kimmel, Sunday Taylor, and Dan Dooley. “Workforce considerations for improving racial equity in substance use disorder treatment.” Presented at the 2022 APHA Annual Meeting and Expo (poster). Boston, MA.


Background: There are growing racial disparities in opioid overdose mortality nationally and in Massachusetts, and research has identified racial/ethnic disparities in receipt of treatment following opioid overdoses in Boston. The capacity and characteristics of the workforce providing care to people who have survived or are at elevated risk of overdose likely impacts access to and engagement in addition treatment for this population.

Methods: Between September 2020-September 2021, we interviewed 59 recent opioid overdose survivors in Boston, 70% of whom were Black or Latinx, and 28 key informants (KIs) with professional or community roles related to overdose response, harm reduction, and treatment.

Results: Overdose survivors described positive and negative interactions they have had with the medical care and addiction treatment workforce, and how those interactions influenced their treatment- and support-seeking. Participants emphasized a desire for staff with shared lived experience (e.g., “[Programs should hire] people that are recovering […] you can read a book on [addiction] all you want, but you still never walked in those shoes.”). KIs highlighted the importance of compassion, trust, and relationship-building for facilitating engagement in services. KIs recommended developing a more robust outreach workforce and hiring more staff who reflect the communities served, but also described systems-level barriers to hiring, supporting, and retaining a diverse workforce.

Implications: Findings can help guide staffing models, hiring processes, and training interventions, and also highlight opportunities for policy and system-level changes that could help build a stronger and more diverse workforce to improve racial equity in addiction treatment and services.

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