Racial Disparities in Linkage to Care among Patients with Substance Use Disorders

Caleb P. Webb
Martin Huecker
Jacob Shreffler
Bennett S. McKinley
Ahsan M. Khan
Isaac Shaw
Peer-Reviewed Article
June 2022


Peer support specialists can link patients with substance use disorders (SUD) to treatment, but this study showed disparate outcomes for how one program impacted access to care for Black and white patients.


Most patients hospitalized for an opioid use disorder or opioid overdose do not engage in SUD treatment after their hospitalization, and Black patients have lower rates of addiction treatment than other racial groups. Peer support specialists have lived experience with SUD and help to engage patients in SUD treatment. This study examined the effectiveness of peer support specialists in linking patients in emergency department and inpatient settings to SUD treatment and analyzed the impact on Black and white patients to understand if this model addressed health disparities in access to care.


White patients were more likely than Black patients to engage in SUD treatment after connection to a peer support specialist. There was no statistically significant difference between the rates of Black and white patients agreeing to be transported to SUD treatment from inpatient settings. However, white individuals in the emergency department were more likely to be successfully transported to SUD treatment than Black individuals.


This study adds to the evidence on racial disparities in access to SUD treatment. Initiatives to employ peer support specialists must be designed to proactively address these racial disparities, through strategies such as racially matching specialists with clients or providing cultural sensitivity training to specialists.

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