Knowledge, experiences, and perceptions of medications for opioid use disorder among Black Kentuckians

Abstract

Background

Opioid overdoses have continued to increase at higher rates among Black Americans compared to people from other racial groups. Despite demonstrated effectiveness of MOUD in reducing risk of opioid overdose, Black Americans face decreased access to and uptake of MOUD. The current study aimed to examine the knowledge, perceptions, and experiences with MOUD among a sample of Black adults who use prescription opioids nonmedically in order to inform tailored efforts to improve MOUD uptake.

Methods

Data were derived from a larger study assessing cultural and structural influences on drug use and drug treatment among people who use prescription opioids nonmedically. Semi-structured qualitative interviews were conducted with 34 Black men and women across four generational cohorts: born 1955–1969; 1970–1979; 1980–1994; and 1995–2001. Participant responses were analyzed using thematic analysis.

Results

Nearly half of participants (44.1%) reported no knowledge or experience with MOUD. Among participants who had any knowledge about MOUD, four major themes regarding their perceptions emerged: MOUD Helps with Recovery; Not Needed for Level of Drug Use; Side Effects and Withdrawal; Equivalence with Illicit Drug Use. The majority reported negative perceptions of MOUD (52.6%), and the youngest cohort (born 1995–2001) had a higher proportion of negative perceptions (80%) relative to other age cohorts (born 1980–1994: 50%; 1970–1979: 75%; 1955–1969: 16.6%).

Discussion

Findings indicate a significant knowledge gap and clear points of intervention for improving MOUD uptake. Interventions to improve communication of health information in ways that are culturally relevant and tailored by age group can be used in conjunction with efforts to improve MOUD access among Black individuals who use opioids nonmedically.

KEY MESSAGES

• Half of our sample of Black Americans who use opioids nonmedically had no knowledge of medications for opioid use disorder (MOUD).

• For those who knew about MOUD, most reported negative perceptions, including concerns about side effects of using MOUD and believing MOUD is equivalent to illicit drug use.

• The youngest age group endorsed the highest rates of negative perceptions relative to older age cohorts, indicating a need for intervention approaches tailored by age group.

Keywords:

• Medications for opioid use disorder
• Black Americans
• nonmedical prescription opioid use

Authors contributions

PBW and DSW conceptualized the study. PBW and BMR, analyzed the data and PBW, BMR, and JJ drafted the manuscript. DSW conceptualized the parent study and PBW, BMR, and JJ all collected data for the parent study. All authors approved the final version of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available on reasonable request from the corresponding author, BMR. The data are not publicly available due to containing information that could compromise the privacy of research participants. Further, data collection for the parent study is still in process as of February 2024, and will be available upon reasonable request at the conclusion of data collection in 2025.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse under Grant R01-DA049333; PI: Stevens-Watkins. The content is solely the responsibility of the authors and does not necessarily reflect the views of the National Institutes of Health.