Black Medicaid patients newly diagnosed with opioid use disorder wait months longer than white patients to receive life-saving medications, according to a national study analyzing records from nearly 1.2 million enrollees across 44 states. Black patients were about one-third less likely than white patients to receive methadone or other medications to treat opioid use disorder.
Researchers found that Medicaid patients can wait up to six months to begin treatment, despite medical consensus that people with opioid use disorder should receive medication as quickly as possible. Between 27% and 34% of patients received medication within six months of diagnosis, meaning nearly 69% did not receive any medication during that critical period.
These delays have deadly consequences for Black communities. From 2010 to 2019, Black Americans went from being the least likely to die from an opioid overdose to dying at higher rates than white opioid users, according to federal data. From 2019 to 2020, deaths among Black Americans surged by 44%, marking the first time overdose deaths in this population surpassed those of white Americans.
Peter Treitler, a Boston University professor who co-authored the research, emphasized the need for policies ensuring treatment access regardless of where people live, how much money they make, or other personal characteristics. Methadone reduced overdose risk by 86% compared with receiving no medication, representing the strongest protective effect among treatments analyzed.
Pending federal Medicaid cuts threaten to worsen these disparities. Researchers warned that failure to protect funding could halt or reverse recent declines in overdose deaths, particularly impacting Black communities who disproportionately rely on Medicaid for coverage.
See: “Black Medicaid patients face deadly delays in opioid treatment” (January 17, 2026)
