Recyclable bioplastic membrane to clear oil spills from water

UNIVERSITY OF GRONINGEN

Research News

 

IMAGE: THE NEW, VITRIMER MEMBRANE IS MADE BY PRESSING AND SINTERING OF POLYMERS FROM THE NATURAL MONOMER MALIC ACID. THIS MEMBRANE CAN BE RECYCLED BY BALL MILLING AND SUBSEQUENT PRESSING AND... view more 

CREDIT: CHONGNAN YE, UNIVERSITY OF GRONINGEN

Polymer scientists from the University of Groningen and NHL Stenden University of Applied Sciences, both in the Netherlands, have developed a polymer membrane from biobased malic acid. It is a superamphiphilic vitrimer epoxy resin membrane that can be used to separate water and oil. This membrane is fully recyclable. When the pores are blocked by foulants, it can be depolymerized, cleaned and subsequently pressed into a new membrane. A paper describing the creation of this membrane was published in the journal Advanced Materials on 7 March 2021.

How do you clean up an oil spill in water? This is quite a challenge. Superamphiphilic membranes, that 'love' both oil and water, are a promising solution but not yet a very practical one. These membranes are often not robust enough for use outside the laboratory environment and the membrane pores can clog up as a result of fouling by algae and sand. Chongnan Ye and Katja Loos from the University of Groningen and Vincent Voet and Rudy Folkersma from NHL Stenden used a relatively new type of polymer to create a membrane that is both strong and easy to recycle.

Dynamic network

In recent years, the researchers from both institutes have joined forces to investigate vitrimer plastics, polymer materials that have the mechanical properties and chemical resistance of a thermoset plastic. However, vitrimer plastics can also behave like a thermoplastic, since they can be depolymerized and reused. This means that a vitrimer plastic has all the qualities to make a good membrane for oil spill remediation. 'Furthermore, it was made from malic acid, a natural monomer,' adds Loos.

'The polymers in the vitrimer are crosslinked in a reversible manner,' explains Voet. 'They form a dynamic network, which enables recycling of the membrane.' The vitrimer is produced through base-catalysed ring-opening polymerization between pristine and epoxy-modified biobased malic acid. The polymers are ground into a powder by ball milling and turned into a porous membrane through the process of sintering.

Pores

Both water and oil will spread out on the resulting superamphiphilic membrane. In an oil spill, much more water is present than oil, which means that the membrane is covered by water that can then pass through the pores. Voet: 'The water film on the membrane's surface keeps the oil out of the pores so that it is separated from the water.'

The membrane is firm enough to filter oil from the water. When sand and algae clog up the pores, the membrane can be depolymerized and recreated from the building blocks after removal of the pollutants. 'We have tested this on a laboratory scale of a few square centimetres,' says Loos. 'And we are confident that our methods are scalable, both for the polymer synthesis and for the production and recycling of the membrane.' The scientists are hoping that an industrial partner will take up further development.

Applications

Creating this new membrane for oil spill remediation shows the power of cooperation between a research university and an applied university. 'A while ago, we decided that the polymer groups at the two institutes should become one, by sharing students, staff and facilities. We recently started the first hybrid research group in the Netherlands,' explains Loos. This makes it easier to find applications for newly designed materials. Voet: 'Polymer chemists strive to link molecular structures to material properties and applications. Our hybrid research team has the experience to do just that.'

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Reference: Chongnan Ye, Vincent S. D. Voet, Rudy Folkersma and Katja Loos: Robust Superamphiphilic Membrane with a Closed-loop Life Cycle. Advanced Materials, 7 March 2021.

The neoliberal city needs to change, argues Concordia professor Meghan Joy

A new policy agenda calls for progressive measures to restrict widening inequality

CONCORDIA UNIVERSITY

Research News

 

IMAGE: MEGHAN JOY: "THE NEOLIBERAL URBAN MODEL HAS HAD TIME TO PROVE WHETHER IT WORKS FOR ALL THE PEOPLE IN A CITY. IT IS CLEAR THAT IT DOES NOT. " view more 

CREDIT: CONCORDIA UNIVERSITY

What would a truly progressive city look like? A city that pays more than lip service to issues that directly affect low-income residents, seniors, marginalized communities and others whom neoliberal policies have seemingly left behind?

Meghan Joy, an assistant professor of political science, argues that urban studies, and particularly urban political scientists, should re-assess the concept of the progressive city. The once-widely embraced notion fell out of favour over the past several decades as local politicians embraced neoliberal policies that she says prioritized wealth generation over liveability and accessibility for all city residents. In a new paper recently published in Urban Affairs Review, Joy and co-author Ronald K. Vogel of Ryerson University, lay out a policy agenda for urban policy thinkers who believe it may be time to shift the thinking around how cities are run and for whose benefit.

"The neoliberal urban model has had time to prove whether it works for all the people in a city," Joy says. "It is clear that it does not, especially for vulnerable people or those living on low incomes."

Policy problems and progressive solutions

Joy believes many cities are at a point of crisis, especially in four key areas: housing, employment, transportation and climate change. The authors do not address issues of policing in this paper, though they do acknowledge that rethinking current approaches to crime and enforcement is essential to a progressive city policy agenda.

In their agenda, Joy and Vogel identify each area's major problem and offer progressive solutions.

They write that affordable housing often depends on incentives offered to developers who in turn wind up building more homes for residents of moderate rather than low income. Joy and Vogel point to creative solutions employed by cities as disparate as Vienna and Hong Kong: governments either own large amounts of housing stock directly or back non-market-driven developers to ensure low-income earners are not pushed out of their city.

Deindustrialization has had a major effect on the nature of employment in many cities, as well as their overall finances. Neoliberal policies have led to a surge in the service economy, but wage inequality and job precarity have led to increasing poverty and a squeezing of the middle class. The authors believe city governments should spend more on hiring employees to provide public services and rely more on in-house talent rather than contracting out to for-profit consultants.

Neoliberalism's effects on transportation include chronic underfunding and underservicing of areas that need public transit the most. The issue is closely tied to housing, with homes conveniently located near transit access points often priced well beyond the means of low-income earners. The authors call for the implementation of social equity transit planning to better serve disadvantaged communities, including subsidies and expanded access.

Finally, climate change has increased the probability and severity of natural disasters such as floods, hurricanes, winter storms and tornadoes, which often require mass evacuations or emergency assistance. Many low-income residents lack the ability to get out of harm's way even with advance warning and often lack relocation options. Joy and Vogel want to see options other than those relying on market forces and entrepreneurialism and push for policies that reduce the overall carbon footprint.

Grassroots movements growing

Joy does believe that grassroots resistance to neoliberalism is growing in cities and there is evidence of movements increasingly pushing on the levers of municipal power.

"We are certainly seeing a groundswell of movement building, especially with Black Lives Matter and the call to defund the police, and around COVID-19 and housing," she says.

"There is more visibility around the question of who we are thinking about when we make urban policy and who benefits in the city. We need to think about how to translate this movement building into an urban policy agenda."

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Milk prebiotics are the cat's meow, Illinois research shows

UNIVERSITY OF ILLINOIS COLLEGE OF AGRICULTURAL, CONSUMER AND ENVIRONMENTAL SCIENCES

Research News

 

IMAGE: RESEARCH FROM THE UNIVERSITY OF ILLINOIS IDENTIFIES KEY MILK OLIGOSACCHARIDES IN DOG AND CAT MILK, AND SHOWS A MOLECULAR MIMIC OF THESE COMPOUNDS IN PET FOODS MAKE THEM HIGHLY PALATABLE... view more 

CREDIT: UNIVERSITY OF ILLINOIS

URBANA, Ill. - If you haven't been the parent or caregiver of an infant in recent years, you'd be forgiven for missing the human milk oligosaccharide trend in infant formulas. These complex carbohydrate supplements mimic human breast milk and act like prebiotics, boosting beneficial microbes in babies' guts.

Milk oligosaccharides aren't just for humans, though; all mammals make them. And new University of Illinois research suggests milk oligosaccharides may be beneficial for cats and dogs when added to pet diets.

But before testing the compounds, scientists had to find them.

"When we first looked into this, there had only been one study on milk oligosaccharides in dogs, and none in domestic cats. The closest were really small studies on a single lion and a single clouded leopard," says Kelly Swanson, the Kraft Heinz Company Endowed Professor in Human Nutrition in the Department of Animal Sciences and the Division of Nutritional Sciences at Illinois.

"Our study was the first robust characterization of dog and cat milk oligosaccharides," he adds. "Our data not only provide a better understanding of how milk meets the nutritional needs of newborn kittens and puppies, but also how it helps promote gut immunity and establish a healthy gut microbial community early in life." That research appears in the journal PLoS ONE.

The foundational study identified three predominant oligosaccharide structures in canine milk: 3'sialyllactose, 6'-sialyllactose, and 2'fucosyllactose, the same compound showing up in many infant formulas today. Together, these three structures made up more than 90% of the total oligosaccharides in canine milk.

Feline milk was much more complex and balanced, with approximately 15 structures making up 90% of total oligosaccharides. Of these, difucosyllactose-N-hexaose b, 3'-sialyllactose, and lacto-N-neohexaose represented more than 10% each.

"Even though domestic dogs and cats both evolved as carnivores, they are metabolically distinct in many ways. Although pet cats still exist as true carnivores, pet dogs are omnivorous in nature," Swanson says. "These new milk oligosaccharide data highlight another interesting difference between the species, justifying further research to reveal their role in the nutritional and health status of newborn puppies and kittens."

Even before Swanson and his colleagues identified the oligosaccharides in cat and dog milk, the pet food industry was beginning to recognize the potential benefits of these compounds as supplements in pet foods. In 2019, Swiss biotech company Gnubiotics Sciences announced an animal milk oligosaccharide-like product known as GNU100, but it hadn't been tested in animals. Swanson's team took that on.

In two separate studies, both published in the Journal of Animal Science, Swanson and his colleagues determined the safety, palatability, and digestibility of GNU100 in dogs and cats.

First, in vitro laboratory tests with cellular colonies showed no toxic effects or tendencies to cause cell mutation. There was no reason to expect toxicity, but the result satisfies one of the basic FDA requirements for inclusion of any new ingredient in pet foods.

Next, the researchers mixed GNU100 at 1% with a fat source and coated commercial dry diets for cats or dogs. As a control, fat-coated diets without GNU100 were also offered. When animals got to choose between the control and 1% bowls, they went crazy for the GNU100.

"In the cats, it was a huge preference. They ate nearly 18 times more food with GNU100 than the control food. We had just been hoping they wouldn't reject it. You know, cats can be pretty finicky," Swanson says. "When we got the data back it was like, wow, they really love that stuff! And the dogs did, too."

Swanson explains GNU100 is composed of a complex mixture of oligosaccharides and peptides, small protein-containing compounds that may make the food more appetizing to cats and dogs.

Finally, the researchers included GNU100 in experimental diets at 0%, 0.5%, 1%, and 1.5% and fed them to healthy adult dogs and cats for six months. During that time, they measured stool quality, blood metabolites, and nutrient digestibility, and evaluated changes in gut metabolites and the gut microbial community.

Overall, cats and dogs did well with GNU100, with no adverse health effects. And the researchers saw shifts in the gut microbiome toward more beneficial species and their metabolite profiles.

Aside from the palatability test, changes associated with GNU100 were as expected, showing intriguing trends in gut microbiota and gut metabolites that Gnubiotics plans to explore in future studies. Swanson thinks they would have seen bigger benefits in a more targeted study focusing on newborn cats and dogs, geriatrics, or pets with compromised immune systems.

"Theoretically, these products should stabilize and feed good bacteria in the gut as well as limit the growth of potentially undesirable bacteria. So if an animal is undergoing treatment for something with antibiotics or is in a high stress situation, having that product in the diet might keep the gut from destabilizing," Swanson says. "Another target group for these products might be young animals as a way to maintain beneficial bacteria in the gut as they wean off their mothers. We'd need to do more testing to see if the product holds up in those target groups, but at least we know now that it is safe and well tolerated."

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The three articles referenced here can be found online at:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243323 (Identifying milk oligosaccharides in dogs and cats)

https://academic.oup.com/jas/article-abstract/99/1/skaa399/6035126?redirectedFrom=fulltext (GNU100 tested in cats)

https://academic.oup.com/jas/article-abstract/99/1/skab014/6102879?redirectedFrom=fulltext (GNU100 tested in dogs)

The Department of Animal Sciences is in the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois.

New lung cancer screening recommendation expands access but may not address inequities

UNC LINEBERGER COMPREHENSIVE CANCER CENTER

Research News

 

IMAGE:  "THE REVISED U.S. PREVENTIVE SERVICES TASK FORCE'S RECOMMENDATIONS ARE SOUND AND BASED ON WELL-CONCEIVED EVIDENCE AND MODELING STUDIES, BUT THEY ALONE ARE NOT ENOUGH, AS WE HAVE SEEN LIMITED UPTAKE... view more 

CREDIT: UNC LINEBERGER COMPREHENSIVE CANCER CENTER

CHAPEL HILL, NC -- Calling the U.S. Preventive Services Task Force's newly released recommendation statement to expand eligibility for annual lung cancer screening with low-dose computed tomography a step forward, UNC Lineberger Comprehensive Cancer Center researchers say future changes should address equity and implementation issues.

In an editorial published in JAMA, Louise M. Henderson, PhD, professor of radiology at UNC School of Medicine, M. Patricia Rivera, MD, professor of medicine at UNC School of Medicine, and Ethan Basch, MD, MSc, the Richard M. Goldberg Distinguished Professor in Medical Oncology and chief of oncology at the UNC School of Medicine, outlined their concerns and offered potential approaches to make the screening recommendation more inclusive of populations that have been historically underserved.

"The revised U.S. Preventive Services Task Force's recommendations are sound and based on well-conceived evidence and modeling studies, but they alone are not enough, as we have seen limited uptake of the prior recommendations," Basch said. "Implementation will require broader efforts by payers, health systems and professional societies, and, in the future, a more tailored, individual risk prediction approach may be preferable."

The task force has made two significant changes to the screening recommendation it issued in 2013: Annual screening will begin at age 50, instead of 55, and smoking intensity has been reduced from 30 to 20 pack-year history. These more inclusive criteria could more than double the number of adults eligible for lung cancer screening, from 6.4 million to 14.5 million, according to some estimates. This represents an 81% increase.

Henderson, Rivera and Basch are encouraged that lung cancer screening will be available to more people, and they point out that expanding access alone won't reduce racial inequities, especially as measured by lung cancer deaths prevented and life-years gained.

It may be possible to counter this shortcoming, they said, by adding risk-prediction models that identify high-benefit individuals who do not meet USPSTF criteria. This could reduce or eliminate some, though not all, racial disparities, according to one study. Also, future research should explore risks such as family history of lung cancer and genetic susceptibility to develop risk assessment strategies that may identify individuals who never smoked and still have a high risk for lung cancer but currently are not eligible to be screened.

Financial-based barriers are also an issue. Expanding screening access to include people as young as 50 may lead to greater inequities for those who are enrolled in Medicaid, the state-based public health insurance program.

"Medicaid is not required to cover the USPSTF recommended screenings and even when screening is covered, Medicaid programs may use different eligibility criteria," Henderson said. She adds this is problematic because people who receive Medicaid are twice as likely to be current smokers than those with private insurance (26.3% compared to 11.1%), and they are disproportionately affected by lung cancer. "This is a significant issue, particularly in the nine states where Medicaid does not cover lung cancer screening."

Putting the screening recommendation into practice will be a substantial challenge, Rivera said. Primary care providers are critical to implementing the screening process because they initiate the conversation with their patients about the potential benefits and risk of lung cancer screening and make the screening referral. However, Rivera said many already have an overburdened workload, and it may be unrealistic to expect them to be able to spend the necessary time to have these complex conversations.

"A significant barrier to implementation of lung cancer screening is provider time. Many primary care providers do not have adequate time to have a shared decision-making conversation and to conduct a risk assessment," Rivera said. "Although a lung cancer screening risk model that incorporates co-morbidities and clinical risk variables may be the best tool for selecting high risk individuals who are most likely to benefit from screening, such a model requires input of additional clinical information, thereby increasing the time a provider will spend; the use of such a model in clinical practice has not been established."

Despite these limitations and challenges, the new recommendation can expand access to lung cancer screening, the researchers said in the editorial. "Beyond implementation challenges, the future of screening strategies lies in individualized risk assessment including genetic risk. The 2021 USPSTF recommendation statement represents a leap forward in evidence and offers promise to prevent more cancer deaths and address screening disparities. But the greatest work lies ahead to ensure this promise is actualized."

CAPTION

"Medicaid is not required to cover the USPSTF recommended screenings and even when screening is covered, Medicaid programs may use different eligibility criteria," Louise M. Henderson, PhD, said. She adds this is problematic because people who receive Medicaid are twice as likely to be current smokers than those with private insurance (26.3% compared to 11.1%), and they are disproportionately affected by lung cancer. "This is a significant issue, particularly in the nine states where Medicaid does not cover lung cancer screening."

CREDIT

UNC Lineberger Comprehensive Cancer Center

CAPTION

"A significant barrier to implementation of lung cancer screening is provider time. Many primary care providers do not have adequate time to have a shared decision-making conversation and to conduct a risk assessment," M. Patricia Rivera, MD, said. "Although a lung cancer screening risk model that incorporates co-morbidities and clinical risk variables may be the best tool for selecting high risk individuals who are most likely to benefit from screening, such a model requires input of additional clinical information.

CREDIT

UNC Lineberger Comprehensive Cancer Center

Disclosures

Henderson reported receiving grants from the National Cancer Institute. Rivera reported receiving grants from the National Cancer Institute for research in lung cancer screening, serving on the advisory panel for Biodesix and bioAffinity, and serving as a research consultant to Johnson & Johnson, outside the submitted work. Basch reported receiving fees from Astra Zeneca, CareVive Systems, Navigating Cancer, and Sivan Healthcare for serving as a scientific advisor/consultant, outside the submitted work.

Humidity in breath makes cotton masks more effective at slowing the spread of COVID-19

Cotton fabrics become better filters when exposed to humid conditions; synthetic fabrics do not

NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY (NIST)

Research News

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VIDEO: A SWATCH OF COTTON FABRIC THAT HAS BEEN EXPOSED TO HIGH HUMIDITY TYPICAL OF A PERSON'S EXHALED BREATH (LEFT) FILTERS OUT MORE DROPLETS THAN A SWATCH OF COTTON FABRIC THAT... view more 

CREDIT: CREDIT: NIST

Researchers have come up with a better way to test which fabrics work best for masks that are meant to slow the spread of COVID-19. By testing those fabrics under conditions that mimic the humidity of a person's breath, the researchers have obtained measurements that more accurately reflect how the fabrics perform when worn by a living, breathing person.

The new measurements show that under humid conditions, the filtration efficiency -- a measure of how well a material captures particles -- increased by an average of 33% in cotton fabrics. Synthetic fabrics performed poorly relative to cotton, and their performance did not improve with humidity. The material from medical-procedure masks also did not improve with humidity, though it performed in roughly the same range as cottons.

This study, conducted by scientists at the National Institute of Standards and Technology (NIST) and the Smithsonian's Museum Conservation Institute, was published in ACS Applied Nano Materials.

An earlier study by the same research team showed that dual-layer masks made of tightly woven cotton fabrics with a raised nap, such as flannels, are particularly effective at filtering breath. That study was conducted under relatively dry conditions in the lab, and its main finding still stands.

"Cotton fabrics are still a great choice," said NIST research scientist Christopher Zangmeister. "But this new study shows that cotton fabrics actually perform better in masks than we thought."

The researchers also tested whether humidity makes the fabrics harder to breathe through and found no change in breathability.

The Centers for Disease Control and Prevention (CDC) recommends that people wear masks to slow the spread of COVID-19. When worn correctly, those masks filter out some of the virus-filled droplets that an infected person exhales and also offer some protection to the wearer by filtering incoming air.

This study is one of several, conducted by NIST and other organizations, that contributed to the first standards for fabric masks meant to slow the spread of COVID-19. Those standards were recently released by the standards-developing organization ASTM International.

The filtration efficiency of cotton fabrics increases in humid conditions because cotton is hydrophilic, meaning it likes water. By absorbing small amounts of the water in a person's breath, cotton fibers create a moist environment inside the fabric. As microscopic particles pass through, they absorb some of this moisture and grow larger, which makes them more likely to get trapped.

[See more images of what's happening on a microscopic level inside your mask]

Most synthetic fabrics, on the other hand, are hydrophobic, meaning they dislike water. These fabrics do not absorb moisture, and their filtration efficiency does not change in humid conditions.

For this study, the team tested fabric swatches, not actual masks. First, they prepared dual-layer fabric swatches by placing them inside a small box where the air was maintained at 99% humidity -- roughly the same as a person's exhaled breath. For comparison, a second set of swatches were prepared at 55% humidity. After the fabrics reached an equilibrium with the humidified air, the researchers placed them in front of a pipe that emitted air at about the same velocity as exhaled breath. That air carried salt particles in a range of sizes typical of the droplets that a person exhales when breathing, speaking and coughing. This salt particle method is recommended by the CDC's National Institute for Occupational Safety and Health (NIOSH) for measuring the filtration performance of mask-making materials.

The researchers calculated filtration efficiency by measuring the number of particles in the air before and after it passed through the fabric. They measured breathability by measuring the air pressure on both sides of the fabric as the air passed through it.

The researchers tested nine different types of cotton flannel, which under humid conditions increased their filtration efficiencies from 12% to 45%, with an average increase of 33%. They tested six types of synthetic fabric, including nylon, polyester and rayon. All performed poorly in comparison to cotton flannel regardless of humidity. Medical-procedure masks and N95 respirator masks provided the same filtration efficiency under both high and low humidity conditions.

While the change in performance for cotton flannels is large, they don't actually absorb very much water. Under humid conditions, a two-layer cotton flannel mask absorbs about 150 milligrams of water from human breath, the equivalent of just one or two drops. If fabric masks actually get wet in other ways, they may become difficult to breathe through, and the CDC advises that people not wear them for activities such as swimming. If masks become wet due to weather, they should be changed.

While this research provides useful information for people who wear face masks, it also holds lessons for scientists who are working to improve masks and measure their performance.

"To understand how these materials perform in the real world," Zangmeister said, "we need to study them under realistic conditions."

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Paper: C.D. Zangmeister, J.G. Radney, M.E. Staymates, E.P. Vicenzi and J.L. Weaver. Hydration of Hydrophilic Cloth Facial Coverings Greatly Increases the Filtration Properties for Nanometer and Micron-sized Particles. ACS Applied Nano Materials. March 8, 2021. DOI: 10.1021/acsanm.0c03319

CAPTION

Scanning electron microscope images of cotton flannel (left) and polyester (right). Cotton fibers absorb moisture from breath, which increases filtration. Each segment of the image scale bars is 50 micrometers, or millionths of a meter -- roughly the width of a human hair.

CREDIT

Credit: E.P. Vicenzi/Smithsonian's Museum Conservation Institute and NIST

More evidence is urgently needed on opioid use in Black communities

PROVING THE CURRENT OPIOD CRISIS IS A WHITE PROBLEM 

WOLTERS KLUWER HEALTH

Research News

 

March 9, 2021 - Although the prevalence of opioid use among Black people is comparatively low, the rate of opioid deaths has increased the sharpest and fastest among that population in recent years, according to an article in the March/April issue of Harvard Review of Psychiatry. The journal is published in the Lippincott portfolio by Wolters Kluwer.

The review by Ayana Jordan, MD, PhD, of Yale University School of Medicine and colleagues stresses how important it is to develop much better evidence on how the opioid crisis has affected Black communities. "Focusing on the unique needs of Black people who use opioids is warranted to increase treatment initiation and adherence among a population less likely to engage with the traditional health care system," according to the authors.

Key themes in understanding and responding to the opioid crisis in Black communities

As the opioid epidemic has unfolded, most studies have focused on white populations, with limited inclusion of Black individuals. "Over the past decade, opioid overdose rates among Black people have been rising, resulting in an increasing need to obtain timely information," Dr. Jordan and coauthors write.

Dr. Jordan and coauthors performed a comprehensive review of the research literature to identify evidence relevant to opioid use among Black people. The researchers analyzed 42 studies providing up-to-date information on key themes, including:

Opioid use rates. National studies have reported relatively low rates of opioid use, especially prescription opoids, by Black individuals, compared to white individuals. However, those studies have often excluded or under-represented people with low incomes, those experiencing homelessness or unstable housing, and those who are incarcerated. All of these populations include disproportionately high numbers of Black people, due to the effects of structural racism.

"Thus, the prevalence of opioid use among Black people may be underestimated," Dr. Jordan and coauthors write. "It is also likely that the absence of culturally informed interview techniques could lead to underreporting of prescription opioid misuse in the Black community."

Overdose risk. Even though Black people are less likely to use opioids, those who start using are at higher risk of dying from an overdose than those from other races. Evidence also suggests that deaths due to synthetic opioids - particularly fentanyl - are rising rapidly among Black people.

Treatment for opioid use disorder. Research finds that Black people are less likely than white people to have access to opioid and other substance treatment options in their geographic communities and care networks. In one study, 15.5 percent of Black patients diagnosed with opioid use disorder (OUD) received treatment, compared to 21 percent of white patients. Evidence suggests that even after they receive care, Black patients have lower treatment completion rates, likely due to social determinants such as unemployment, access to transportation, and absence of culturally informed care.

Prescription opioid use. Black patients are less likely than their white counterparts to receive prescription opioid medication for pain. For Black patients who do receive opioids for treatment of non-cancer pain, there are persistent disparities in ongoing pain management, including lower daily doses and fewer days' supply of opioids, compared to white patients.

Social determinants of health. A handful of studies are beginning to document that social determinants of health - a wide range of conditions affecting many different behavioral or health outcomes - are the key drivers of opioid use and overdose risks among Black people. The authors note that more investigation needs to be undertaken to determine how social determinants of health, such as access to education, job training, food, transportation, and technology, can be harnessed to facilitate better access to opioid treatment for Black patients. The authors note that a better understanding of the social determinants of health affecting OUD among Black people is crucial for the development of "culturally acceptable treatment settings, where Black people are more likely to access care."

Dr. Jordan and colleagues see "great opportunity" for new research to understand and respond to the impact of the opioid crisis in Black communities. Priorities must include increased funding specifically earmarked by governmental agencies for research that addresses racial disparities in OUD. Dr. Jordan and colleagues conclude, "Building on the information presented here will promote better care of this population, with the hope of improving health outcomes."

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Click here to read "An Evaluation of Opioid Use in Black Communities: A Rapid Review of the Literature."

DOI: 10.1097/HRP.0000000000000285

About the Harvard Review of Psychiatry

The Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on a diverse range of important topics in psychiatry. Founded by the Harvard Medical School Department of Psychiatry, the journal is peer reviewed and not industry sponsored. It is the property of Harvard University and is affiliated with all of the Departments of Psychiatry at the Harvard teaching hospitals. Articles encompass major issues in contemporary psychiatry, including neuroscience, epidemiology, psychopharmacology, psychotherapy, history of psychiatry, and ethics.

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