From Crisis to Care: Addressing Disparities in Substance Misuse Treatment

Team Pic

From Left: Katherine Dixon-Gordon (Psychological & Brain Sciences); Karen Kalmakis (Nursing); Linda Isbell, PhD (Psychological & Brain Sciences); William Soares (Emergency Medicine, UMass Medical School, Baystate); Elizabeth Schoenfeld (Emergency Medicine, UMass Medical School, Baystate)

In the nexus of emergency healthcare, a stark gap emerges in the treatment of substance misuse. This study ventures into the heart of emergency departments to unravel why critical screenings and referrals are often overlooked, particularly for low-income and minority populations, aiming to forge a pathway towards more equitable healthcare solutions.

With multiple, significant, and worsening addiction epidemics sweeping the country, substance misuse represents a significant portion of emergency department (ED) visits and is thus a critical area for intervention. Despite the proven efficacy of brief screenings and treatment referrals in treating substance misuse at the ED, such practices are inconsistently applied: shockingly, less than half of ED staff engage in these potentially life-altering interventions.

The ED stands as a crucial, often singular, healthcare touchpoint for populations marred by socio-economic disparities. Obligated to provide care to all, EDs find themselves disproportionately attending to low-income, underinsured patients. Among these, substance misuse emerges more frequently, further complicating the healthcare delivery landscape. Compounding this issue, minority groups face additional barriers, finding themselves distanced from necessary substance use treatments due to systemic hurdles.

This disparity stems from a confluence of factors, including prevailing negative attitudes toward substance use disorders, a lack of specialized training among ED personnel, and a shortage of resources. These elements collectively contribute to a healthcare delivery gap, leaving a vulnerable population in dire need of support.

The ambition of this study is twofold: to pinpoint the healthcare provision disparities faced by substance users in the ED and to dissect the impact of provider perceptions, training, and available resources on these disparities. By addressing these critical dimensions, the research aims to understand the causes of healthcare inequity within emergency settings.

At its core, the long-term vision of this research is to aid in dismantling the barriers hindering effective substance misuse interventions in the ED, paving the way for a more inclusive and responsive healthcare system. The findings from this preliminary investigation will be used to develop a comprehensive grant application to the Agency for Healthcare Research and Quality (AHRQ), advancing a pivotal step towards wider systemic change.