NYC Opioid Treatment is Segregated by Income

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In New York City, opioid addiction treatment is sharply segregated by income, according to addiction experts and an analysis of demographic data provided by the city health department, the New York Times reports. More affluent patients can avoid the methadone clinic entirely, receiving a new treatment directly from a doctor’s office. Many poorer Hispanic and black individuals struggling with drug addiction must rely on highly regulated clinics, which they must visit daily to receive their plastic cup of methadone. That is what opioid addiction recovery is like for more than 30,000 patients enrolled in New York City’s 70 methadone-based treatment programs, which provide medication-assisted treatment, counseling and other social services. Hundreds of thousands of patients across the U.S. are enrolled in similar programs.

For more than 40 years, methadone was the most effective method for people addicted to heroin to keep their cravings in check. In 2002, the Food and Drug Administration approved another medication to treat opioid addiction: buprenorphine, sold widely in a compound called Suboxone. Both methadone and buprenorphine are effective in keeping recovering users from relapsing, but Suboxone is engineered to reduce the possibility of abuse and overdose. Crucially, the medication can be prescribed in doctors’ offices and then taken at home. Many hoped that buprenorphine could mean an end to the daily hurdles to receiving treatment for tens of thousands of patients: no additional commute, no security check, no waiting, no line for the plastic cup. In New York, that is primarily true only for middle-class or upper-middle-class patients seeking help with their addiction. In New York City, 53 percent of participants in methadone programs are Latino, 23 percent are black, and 21 percent are white.

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