PPubMed17 May 2023Cited 7×

Racial/Ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City

Shayla Nolen, Andrew J. Trinidad, Ashly E. Jordan, Traci C. Green, Ali Jalali, Sean M. Murphy, Xiao Zang, Brandon D.L. Marshall, Bruce R. Schackman

Abstract

In 2021 overdose deaths in New York City (NYC) were at their highest rate since reporting began in 2000, with fentanyl present in approximately 80% of those deaths (1). Opioid-related overdose death rates have increased significantly among non-Latino Black and Latino adults nationally and in NYC since the early 2010s. Racial/ethnic, economic, and place-based disparities in opioid overdose deaths increased as fentanyl emerged in the illicit drug market in 2016 (2-7). Naloxone, a highly effective opioid reverse agent, is available through pharmacies and community-based distribution by opioid ove

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Non‑Latino Black residents in NYC received naloxone from community programs at higher rates than non‑Latino White residents, with notable neighborhood variation for Black and Latino groups.

What’s new

i.Evaluated racial/ethnic differences in naloxone receipt from NYC opioid overdose prevention programs
ii.Applied multilevel negative binomial regression to compare receipt rates across racial/ethnic groups
iii.Conducted racial/ethnic‑specific geospatial analyses to identify within‑group neighborhood variation
iv.Aggregated quarterly neighborhood‑specific receipt rates for 42 NYC neighborhoods

How they did it

The authors used naloxone recipient data collected by 170 opioid overdose prevention programs between April 2018 and March 2019, aggregating quarterly receipt rates for 42 NYC neighborhoods. They fitted multilevel negative binomial regression models with neighborhood covariates to compare rates across four racial/ethnic groups. Separate Getis‑Ord Gi* geospatial analyses identified hot‑ and cold‑spot clusters for each group.

What they found

Median quarterly receipt rates: Black 41.8, Latino 22.0, White 13.6, Other 13.3 per 100,000 residents
Total kits distributed: 79,555 (28,034 to Black, 27,343 to Latino, 15,898 to White, 8,280 to Other)
Adjusted rate ratio for Black vs White: 2.10 (95% CI 1.54‑2.85); Latino vs White: 1.11 (non‑significant); Other vs White: 0.79 (95% CI 0.67‑0.92)
Geospatial hot spots in northern/northwestern neighborhoods; cold spots for Black and Latino residents in southern/southeastern neighborhoods

Caveats

✕Only overall overdose death rates (not race‑specific) were available as covariates
✕Quarterly aggregation over a single year may mask temporal trends
✕Multiple racial/ethnic groups were combined into a single ‘Non‑Latino Other’ category
✕Small event counts by neighborhood limited statistical power

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