{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:53:14Z","timestamp":1791899594846,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA055061"],"award-info":[{"award-number":["K23DA055061"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R61DA057629"],"award-info":[{"award-number":["R61DA057629"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Racial and sex disparities are noted in the administration and prescribing of buprenorphine from emergency departments (EDs) nationally. It is unknown whether disparities persist when accounting for the specific discharge diagnosis addressed during encounters such as opioid overdose or withdrawal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional analysis of opioid\u2010related ED encounters from January 2020 through December 2023 using a national database, Epic Cosmos. We analyzed the effect of opioid encounter subtype\u2014overdose or withdrawal\u2014on receipt of buprenorphine using multivariable logistic regression adjusting for demographics and measured confounding variables. Encounter subtypes were defined by diagnosis codes and buprenorphine receipt was defined as administration or prescribing. We evaluated for racial, ethnic, and sex disparities within encounter subtypes for withdrawal and overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We examined 1,088,033 opioid\u2010related encounters. Adjusted odds for buprenorphine receipt were greater for encounters involving withdrawal (odds ratio [OR]\u20092.22, 95% CI 2.18\u20132.26), though reduced for overdose (OR 0.52, 95% CI 0.51\u20130.53) and other opioid complications (OR 0.69, 95% CI 0.64\u20130.70). Males were more likely to receive buprenorphine (OR 1.18, 95% CI 1.16\u20131.19) than females. All racial minorities excepting American Indian\/Native American patients (OR 1.04, 95% CI 1.00\u20131.08) were less likely to receive buprenorphine than White patients (Asian OR 0.85, 95% CI 0.79\u20130.81; Black OR 0.80, 95% CI 0.79\u20130.81; Native Hawaiian\/Pacific Islander OR 0.79, 95% CI 0.71\u20130.89). Subtype analyses indicated decreased odds for buprenorphine receipt for female patients across all subtypes. An increased odds for buprenorphine receipt among Black patients (OR 1.04, 95% CI 1.01\u20131.07; ref. White race) was noted in encounters involving opioid withdrawal but disparities persisted for opioid overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The administration and prescribing of buprenorphine in the ED is heavily influenced by the presence of opioid withdrawal. Disparities disadvantage female patients and racial minorities. Some racial disparities, particularly among Black patients, are not evident when solely considering encounters involving opioid withdrawal. System\u2010level interventions are needed to address disparities and improve the equitable uptake of ED\u2010initiated buprenorphine.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.70035","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T08:01:29Z","timestamp":1745568089000},"page":"985-993","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Racial, ethnic, and sex disparities in buprenorphine treatment from emergency departments by discharge diagnosis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0945-1233","authenticated-orcid":false,"given":"Neeraj","family":"Chhabra","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of Illinois Chicago  Chicago Illinois USA"},{"name":"AI.Health4All Center for Health Equity Using Machine Learning and Artificial Intelligence  Chicago Illinois USA"},{"name":"Institute for Research on Addictions University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"Smith","sequence":"additional","affiliation":[{"name":"AI.Health4All Center for Health Equity Using Machine Learning and Artificial Intelligence  Chicago Illinois USA"},{"name":"Department of Psychiatry University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0072-7499","authenticated-orcid":false,"given":"Natalie","family":"Parde","sequence":"additional","affiliation":[{"name":"AI.Health4All Center for Health Equity Using Machine Learning and Artificial Intelligence  Chicago Illinois USA"},{"name":"Natural Language Processing Laboratory, Department of Computer Science University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Hsing\u2010Smith","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Bianco","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9082-6644","authenticated-orcid":false,"given":"R. 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