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Erschienen in: Current Pain and Headache Reports 2/2022

18.02.2022 | Acute Pain Medicine (R Urman, Section Editor)

Opioid Use Disorder and Racial/Ethnic Health Disparities: Prevention and Management

verfasst von: Neha Siddiqui, Richard D. Urman

Erschienen in: Current Pain and Headache Reports | Ausgabe 2/2022

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Abstract

Purpose of Review

This review aims to summarize risks and disparities associated with the prevalence and treatment of opioid use disorder in the perioperative and long-term setting, as well as evidence-based treatment and prevention targeted toward specific vulnerable populations.

Recent Finding

There are significant demographic disparities in pain management and development and management of OUD in the chronic and surgical setting. While White patients traditionally receive more pain management, they are also at higher risk of developing OUD. Hispanic and Latin populations have the largest proportion of youth with OUD and often lack culturally appropriate translation services that allow for effective treatment. Native Americans have the second highest rate of OUD and often receive care in communities and healthcare settings that lack funding and resources to combat OUD. African Americans tend to suffer from the criminalization of OUD and are less able to seek treatment due to this, and furthermore, often lack community services that would benefit them. Additional vulnerable populations include homeless individuals that lack access to healthcare or health insurance. In addition, incarcerated individuals often lack access to naloxone and suffer from high rates of fatal overdose soon after being released to the community. People in rural settings lack needle-exchange programs and community-based interventions/support groups.

Summary

Patients in the perioperative setting lack standard screening and pain management protocols. Interventions targeted toward each appropriate group can help decrease the rate of OUD and improve its treatment, and overarching interventions such as protocols, targeted funding, education and regulation can combat OUD for all populations.
Literatur
1.
Zurück zum Zitat Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Copyright 2013. American Psychiatric Association. Accessed October 30, 2021. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Copyright 2013. American Psychiatric Association. Accessed October 30, 2021.
3.
8.
Zurück zum Zitat •• National Vital Statistics System (NVSS) - Mortality Data. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/nvss/deaths.htm. Published July 26, 2021. Accessed August 16, 2021. NVSS contains national mortality data on mortality, other public health challenges, life expectancy, and provides information to compare death trends across countries. •• National Vital Statistics System (NVSS) - Mortality Data. Centers for Disease Control and Prevention. https://​www.​cdc.​gov/​nchs/​nvss/​deaths.​htm. Published July 26, 2021. Accessed August 16, 2021. NVSS contains national mortality data on mortality, other public health challenges, life expectancy, and provides information to compare death trends across countries.
9.
Zurück zum Zitat Krawczyk N, Garrett B, Ahmad NJ, Patel E, Solomon K, Stuart EA, Saloner B. Medications for opioid use disorder among American Indians and Alaska natives: Availability and use across a national sample. Drug Alcohol Depend. 2021;220:108512. https://doi.org/10.1016/j.drugalcdep.2021.108512. (Epub 2021 Jan 19. PMID: 33508692). Krawczyk N, Garrett B, Ahmad NJ, Patel E, Solomon K, Stuart EA, Saloner B. Medications for opioid use disorder among American Indians and Alaska natives: Availability and use across a national sample. Drug Alcohol Depend. 2021;220:108512. https://​doi.​org/​10.​1016/​j.​drugalcdep.​2021.​108512. (Epub 2021 Jan 19. PMID: 33508692).
11.
Zurück zum Zitat Centers for Disease Control and Prevention (CDC). Annual surveillance report of drug-related risks and outcomes —United States. [internet]. Atlanta, GA: CDC National Center for Injury Prevention and Control. 2017. [cited 2019 Dec 12]. Available from: https://stacks.cdc.gov/view/cdc/47832 Centers for Disease Control and Prevention (CDC). Annual surveillance report of drug-related risks and outcomes —United States. [internet]. Atlanta, GA: CDC National Center for Injury Prevention and Control. 2017. [cited 2019 Dec 12]. Available from: https://​stacks.​cdc.​gov/​view/​cdc/​47832
13.
Zurück zum Zitat Craven P, Cinar O, Fosnocht D, Carey J, Carey
A, Rogers L, et al. Prospective, 10-year evaluation of
the impact of Hispanic ethnicity on pain management practices in the ED. Am J Emerg Med [Internet]. 2014 [cited 2020 May 28];32(9):1055–9. Available from: https://doi.org/10.1016/j.ajem.2014.06.026 Craven P, Cinar O, Fosnocht D, Carey J, Carey
A, Rogers L, et al. Prospective, 10-year evaluation of
the impact of Hispanic ethnicity on pain management practices in the ED. Am J Emerg Med [Internet]. 2014 [cited 2020 May 28];32(9):1055–9. Available from: https://​doi.​org/​10.​1016/​j.​ajem.​2014.​06.​026
14.
Zurück zum Zitat Harrison JM, Lagisetty P, Sites BD, Guo C, Davis MA. Trends in prescription pain medication use by race/ethnicity among US adults with noncancer pain, 2000– 2015. Am J Public Health [Internet]. 2018 [cited 2020 May 28];108(6):788–90. Available from: https://doi.org/10.2105/AJPH.2018.304349 Harrison JM, Lagisetty P, Sites BD, Guo C, Davis MA. Trends in prescription pain medication use by race/ethnicity among US adults with noncancer pain, 2000– 2015. Am J Public Health [Internet]. 2018 [cited 2020 May 28];108(6):788–90. Available from: https://​doi.​org/​10.​2105/​AJPH.​2018.​304349
16.
19.
Zurück zum Zitat • Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18–5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/. Accessed November 10, 2021. This source outlines results from 2017 National Survey on Drug Use and Health, and has information on key correlates with substance use and how it coincides with mental health. • Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18–5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://​www.​samhsa.​gov/​data/​. Accessed November 10, 2021. This source outlines results from 2017 National Survey on Drug Use and Health, and has information on key correlates with substance use and how it coincides with mental health.
20.
Zurück zum Zitat Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999–2018 on CDC WONDER Online Database, released in 2020. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999–2018 on CDC WONDER Online Database, released in 2020.
21.
Zurück zum Zitat •• WL Swann S Kim SY Kim TL Schreiber 2021 Jan Urban-Rural Disparities in Opioid Use Disorder Prevention and Response Activities: A Cross-Sectional Analysis J Rural Health 37 1 16 22 https://doi.org/10.1111/jrh.12491 Epub 2020 Jul 8 PMID: 32639664. This study compares policy and programmatic activities designed to address the opioid crisis in metropolitan and nonmetropolitan areas, as well as barriers to implementing interventions. •• WL Swann S Kim SY Kim TL Schreiber 2021 Jan Urban-Rural Disparities in Opioid Use Disorder Prevention and Response Activities: A Cross-Sectional Analysis J Rural Health 37 1 16 22 https://​doi.​org/​10.​1111/​jrh.​12491 Epub 2020 Jul 8 PMID: 32639664. This study compares policy and programmatic activities designed to address the opioid crisis in metropolitan and nonmetropolitan areas, as well as barriers to implementing interventions.
22.
Zurück zum Zitat Weiss AJ, Elixhauser A, Barrett ML, et al. Opioid-related inpatient stays and emer- gency department visits by state, 2009–2014: statistical brief #219. In: Healthcare cost and utilization project (HCUP) statistical briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016. Weiss AJ, Elixhauser A, Barrett ML, et al. Opioid-related inpatient stays and emer- gency department visits by state, 2009–2014: statistical brief #219. In: Healthcare cost and utilization project (HCUP) statistical briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.
23.
Zurück zum Zitat Holt SR, Ramos J, Harma MA, et al. Prevalence of unhealthy substance use on teaching and hospitalist medical services: implications for education. Am J Addict. 2012;21(2):111–9.CrossRef Holt SR, Ramos J, Harma MA, et al. Prevalence of unhealthy substance use on teaching and hospitalist medical services: implications for education. Am J Addict. 2012;21(2):111–9.CrossRef
24.
Zurück zum Zitat McNeely J, Gourevitch MN, Paone D, et al. Estimating the prevalence of illicit opioid use in New York City using multiple data sources. BMC Public Health. 2012;12:443.CrossRef McNeely J, Gourevitch MN, Paone D, et al. Estimating the prevalence of illicit opioid use in New York City using multiple data sources. BMC Public Health. 2012;12:443.CrossRef
25.
Zurück zum Zitat Compton P, Charuvastra VC, Ling W. Pain intolerance in opioid-maintained former opiate addicts: effect of long-acting maintenance agent. Drug Alcohol Depend. 2001;63:139–46.CrossRef Compton P, Charuvastra VC, Ling W. Pain intolerance in opioid-maintained former opiate addicts: effect of long-acting maintenance agent. Drug Alcohol Depend. 2001;63:139–46.CrossRef
26.
Zurück zum Zitat Wachholtz A, Gonzalez G. Co-morbid pain and opioid addiction: long term effect of opioid maintenance on acute pain. Drug Alcohol Depend. 2014;145:143–9.CrossRef Wachholtz A, Gonzalez G. Co-morbid pain and opioid addiction: long term effect of opioid maintenance on acute pain. Drug Alcohol Depend. 2014;145:143–9.CrossRef
27.
Zurück zum Zitat Shanahan CW, Beers D, Alford DP, et al. A transitional opioid program to engage hospitalized drug users. J Gen Intern Med. 2010;25(8):803–8.CrossRef Shanahan CW, Beers D, Alford DP, et al. A transitional opioid program to engage hospitalized drug users. J Gen Intern Med. 2010;25(8):803–8.CrossRef
29.
Zurück zum Zitat Burns S, Urman R, Pian R, Coppes OJM. Reducing new persistent opioid use after surgery: A review of interventions. Curr Pain Headache Rep. 2021 Mar 24;25(5):27. https://doi.org/10.1007/s11916-021-00943-6. Erratum in: Curr Pain Headache Rep. 2021 Nov 5;25(10):68. PMID: 33760983. Burns S, Urman R, Pian R, Coppes OJM. Reducing new persistent opioid use after surgery: A review of interventions. Curr Pain Headache Rep. 2021 Mar 24;25(5):27. https://​doi.​org/​10.​1007/​s11916-021-00943-6. Erratum in: Curr Pain Headache Rep. 2021 Nov 5;25(10):68. PMID: 33760983.
30.
32.
Zurück zum Zitat •• MS Patzkowski JC Patzkowski 2019 Perioperative pain management and avoidance of LONG-TERM opioid use Sports Med Arthrosc Rev. 2019;27(3):112–118. https://doi.org/10.1097/jsa.0000000000000244. This article addresses perioperative pain management strategies to decrease opioid. Suggested interventions include preoperative counseling, multimodal analgesia, regional anesthetic approaches, limiting the use of tourniquets, and preoperative assessment of behavioral health. •• MS Patzkowski JC Patzkowski 2019 Perioperative pain management and avoidance of LONG-TERM opioid use Sports Med Arthrosc Rev. 2019;27(3):112–118. https://​doi.​org/​10.​1097/​jsa.​0000000000000244​. This article addresses perioperative pain management strategies to decrease opioid. Suggested interventions include preoperative counseling, multimodal analgesia, regional anesthetic approaches, limiting the use of tourniquets, and preoperative assessment of behavioral health.
33.
Zurück zum Zitat Sullivan MA, Bisaga A, Pavlicova M, Carpenter KM, Choi CJ, Mishlen K, Levin FR, Mariani JJ, Nunes EV. A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder. Am J Psychiatry. 20191;176(2):129–137. https://doi.org/10.1176/appi.ajp.2018.17070732. (Epub 2018 Oct 19. PMID: 30336703; PMCID: PMC6358483). Sullivan MA, Bisaga A, Pavlicova M, Carpenter KM, Choi CJ, Mishlen K, Levin FR, Mariani JJ, Nunes EV. A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder. Am J Psychiatry. 20191;176(2):129–137. https://​doi.​org/​10.​1176/​appi.​ajp.​2018.​17070732. (Epub 2018 Oct 19. PMID: 30336703; PMCID: PMC6358483).
34.
Zurück zum Zitat Lee JD, Nunes EV Jr, Novo P, Bachrach K, Bailey GL, Bhatt S, Farkas S, Fishman M, Gauthier P, Hodgkins CC, King J, Lindblad R, Liu D, Matthews AG, May J, Peavy KM, Ross S, Salazar D, Schkolnik P, Shmueli-Blumberg D, Stablein D, Subramaniam G, Rotrosen J. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet. 2018;391(10118):309–318. https://doi.org/10.1016/S0140-6736(17)32812-X (Epub 2017 Nov 14. PMID: 29150198; PMCID: PMC5806119). Lee JD, Nunes EV Jr, Novo P, Bachrach K, Bailey GL, Bhatt S, Farkas S, Fishman M, Gauthier P, Hodgkins CC, King J, Lindblad R, Liu D, Matthews AG, May J, Peavy KM, Ross S, Salazar D, Schkolnik P, Shmueli-Blumberg D, Stablein D, Subramaniam G, Rotrosen J. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet. 2018;391(10118):309–318.  https://​doi.​org/​10.​1016/​S0140-6736(17)32812-X (Epub 2017 Nov 14. PMID: 29150198; PMCID: PMC5806119).
35.
Zurück zum Zitat Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272–279. https://doi.org/10.1177/1078390318820124 (Epub 2018 Dec 20. PMID: 30569814). Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272–279. https://​doi.​org/​10.​1177/​1078390318820124​ (Epub 2018 Dec 20. PMID: 30569814).
39.
Zurück zum Zitat •• Shanthanna H, Ladha KS, Kehle H, Joshi FP. Perioperative Opioid Administration Anesthesiology; 2021;4:645-659. https://doi.org/10.1097/ALN.0000000000003572 (PMID: 32991672). This article discusses opioid-sparing and opioid-free approaches to managing pain in the surgical patient, as well as patient- and procedure-specific approaches to pain management in the perioperative setting. •• Shanthanna H, Ladha KS, Kehle H, Joshi FP. Perioperative Opioid Administration Anesthesiology; 2021;4:645-659. https://​doi.​org/​10.​1097/​ALN.​0000000000003572​ (PMID: 32991672). This article discusses opioid-sparing and opioid-free approaches to managing pain in the surgical patient, as well as patient- and procedure-specific approaches to pain management in the perioperative setting.
42.
Zurück zum Zitat Naeger S, Mutter R, Ali MM, et al. Post-discharge treatment engagement among patients with an opioid-use disorder. J Subst Abuse Treat. 2016;69:64–71.CrossRef Naeger S, Mutter R, Ali MM, et al. Post-discharge treatment engagement among patients with an opioid-use disorder. J Subst Abuse Treat. 2016;69:64–71.CrossRef
44.
Zurück zum Zitat Shanahan CW, Beers D, Alford DP, et al. A transitional opioid program to engage hospitalized drug users. J Gen Intern Med 2010;25(8):803–8. Shanahan CW, Beers D, Alford DP, et al. A transitional opioid program to engage hospitalized drug users. J Gen Intern Med 2010;25(8):803–8.
45.
Zurück zum Zitat Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2018. (Treatment Improvement Protocol (TIP) Series, No. 63.) Part 2, Addressing Opioid Use Disorder in General Medical Settings. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535277/ Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2018. (Treatment Improvement Protocol (TIP) Series, No. 63.) Part 2, Addressing Opioid Use Disorder in General Medical Settings. Available from: https://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK535277/​
47.
Zurück zum Zitat Nafiu OO, Chimbira WT, Stewart M, Gibbons K, Porter LK, Reynolds PI. Racial differences in the pain management of children recovering from anesthesia. Paediatr Anaesth. 2017;27(7):760–767. https://doi.org/10.1111/pan.13163 (Epub 2017 May 15. PMID: 28504322; PMCID: PMC5474946). Nafiu OO, Chimbira WT, Stewart M, Gibbons K, Porter LK, Reynolds PI. Racial differences in the pain management of children recovering from anesthesia. Paediatr Anaesth. 2017;27(7):760–767. https://​doi.​org/​10.​1111/​pan.​13163 (Epub 2017 May 15. PMID: 28504322; PMCID: PMC5474946).
48.
Zurück zum Zitat Sadhasivam S, Chidambaran V, Ngamprasertwong P, Esslinger HR, Prows C, Zhang X, Martin LJ, McAuliffe J. Race and unequal burden of perioperative pain and opioid related adverse effects in children. Pediatrics. 2012;129(5):832–8. https://doi.org/10.1542/peds.2011-2607 (Epub 2012 Apr 23. PMID: 22529273; PMCID: PMC3340593). Sadhasivam S, Chidambaran V, Ngamprasertwong P, Esslinger HR, Prows C, Zhang X, Martin LJ, McAuliffe J. Race and unequal burden of perioperative pain and opioid related adverse effects in children. Pediatrics. 2012;129(5):832–8. https://​doi.​org/​10.​1542/​peds.​2011-2607 (Epub 2012 Apr 23. PMID: 22529273; PMCID: PMC3340593).
49.
Zurück zum Zitat Edwards RR, Moric M, Husfeldt B, Buvanendran A, Ivankovich O. Ethnic similarities and differences in the chronic pain experience: a comparison of African American, Hispanic, and white patients. Pain Med. 2005;6(1):88–98.CrossRef Edwards RR, Moric M, Husfeldt B, Buvanendran A, Ivankovich O. Ethnic similarities and differences in the chronic pain experience: a comparison of African American, Hispanic, and white patients. Pain Med. 2005;6(1):88–98.CrossRef
53.
Zurück zum Zitat Beletsky A, Burton BN, Finneran Iv JJ, Alexander BS, Macias A, Gabriel RA. Association of race and ethnicity in the receipt of regional anesthesia following mastectomy. Reg Anesth Pain Med. 2021;46(2):118-123. https://doi.org/10.1136/rapm-2020-101818 (Epub 2020 Nov 10. PMID: 33172904). Beletsky A, Burton BN, Finneran Iv JJ, Alexander BS, Macias A, Gabriel RA. Association of race and ethnicity in the receipt of regional anesthesia following mastectomy. Reg Anesth Pain Med. 2021;46(2):118-123. https://​doi.​org/​10.​1136/​rapm-2020-101818 (Epub 2020 Nov 10. PMID: 33172904).
54.
Zurück zum Zitat 2019 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States Surveillance Special Report. In: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019. 2019 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States Surveillance Special Report. In: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.
55.
Zurück zum Zitat Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. In: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2017. Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. In: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2017.
59.
Zurück zum Zitat Preuss CV, Kalava A, King KC. Prescription of Controlled Substances: Benefits and Risks. 2021 Jun 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (PMID: 30726003). Preuss CV, Kalava A, King KC. Prescription of Controlled Substances: Benefits and Risks. 2021 Jun 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (PMID: 30726003).
61.
Zurück zum Zitat Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272–279. doi: https://doi.org/10.1177/1078390318820124. (Epub 2018 Dec 20. PMID: 30569814). Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272–279. doi: https://​doi.​org/​10.​1177/​1078390318820124​. (Epub 2018 Dec 20. PMID: 30569814).
66.
Zurück zum Zitat Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272-279. https://doi.org/10.1177/1078390318820124. (Epub 2018 Dec 20. PMID: 30569814). Zavod A, Akerman SC, Snow MM, Tierney M, Sullivan MA. Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder. J Am Psychiatr Nurses Assoc. 2019;25(4):272-279. https://​doi.​org/​10.​1177/​1078390318820124​. (Epub 2018 Dec 20. PMID: 30569814).
68.
Zurück zum Zitat Crocker A, Bloodworth L, Ballou J, Liles AM, Fleming L. First Responder knowledge, perception and confidence in administering naloxone: Impact of a pharmacist-provided educational program in rural Mississippi. J Am Pharm Assoc. 2019;59(4S):S117-S121.e2. https://doi.org/10.1016/j.japh.2019.04.011 (Epub 2019 May 17. PMID: 31109810). Crocker A, Bloodworth L, Ballou J, Liles AM, Fleming L. First Responder knowledge, perception and confidence in administering naloxone: Impact of a pharmacist-provided educational program in rural Mississippi. J Am Pharm Assoc. 2019;59(4S):S117-S121.e2. https://​doi.​org/​10.​1016/​j.​japh.​2019.​04.​011 (Epub 2019 May 17. PMID: 31109810).
Metadaten
Titel
Opioid Use Disorder and Racial/Ethnic Health Disparities: Prevention and Management
verfasst von
Neha Siddiqui
Richard D. Urman
Publikationsdatum
18.02.2022
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 2/2022
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-022-01010-4

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