IssuesTo date, there has been no synthesis of research addressing the scale and nuances of the opioid epidemic in racial/ethnic minority populations in the United States that considers the independent and joint impacts of dynamics such as structural disadvantage, provider bias, health literacy, cultural norms and various other risk factors.ApproachUsing the “risk environment” framework, we conducted a scoping review on PubMed, Embase and Google Scholar of peer‐reviewed literature and governmental reports published between January 2000 and February 2024 on the nature and scale of opioid use, opioid prescribing patterns, and fatal overdoses among racial/ethnic minorities in the United States, while also examining macro, meso and individual‐level risk factors.Key FindingsResults from this review illuminate a growing, but fragmented, literature lacking standardisation in racial/ethnic classification and case reporting, specifically in regards to Indigenous and Asian subpopulations. This literature broadly illustrates racial/ethnic minorities' increasing nonmedical use of opioids, heightened burdens of fatal overdoses, specifically in relation to polydrug use and synthetic opioids, with notable elevations among Black/Latino subgroups, in addition uneven opioid prescribing patterns. Moreover, the literature implicates a variety of unique risk environments corresponding to dynamics such as residential segregation, provider bias, overpolicing, acculturative stress, patient distrust, and limited access to mental health care services and drug treatment resources, including medications for opioid use disorder.ImplicationsThere has been a lack of rigorous, targeted study on racial/ethnic minorities who use opioids, but evidence highlights burgeoning increases in usage, especially polydrug/synthetic opioid use, and disparities in prescriptions and fatal overdose risk‐phenomena tied to multi‐level forms of entrenched disenfranchisement.ConclusionThere is a need for further research on the complex, overlapping risk environments of racial/ethnic minorities who use opioids, including deeper inclusion of Indigenous and Asian individuals, and efforts to generate greater methodological synergies in population classification and reporting guidelines.

中文翻译：

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美国少数族裔中阿片类药物的使用、处方和致命过量模式：范围界定审查和概念风险环境模型

迄今为止，还没有针对美国少数族裔人口中阿片类药物流行的规模和细微差别的综合研究，该研究考虑了结构性劣势、提供者偏见、健康素养、文化背景等动态因素的独立和联合影响。方法使用“风险环境”框架，我们对 PubMed、Embase 和 Google Scholar 对 2000 年 1 月至 2024 年 2 月期间发表的关于阿片类药物使用的性质和规模的同行评审文献和政府报告进行了范围界定审查、阿片类药物处方模式以及美国少数族裔中的致命过量用药，同时还研究了宏观、中观和个人层面的风险因素。主要发现本次综述的结果表明，越来越多但支离破碎的文献缺乏种族/族裔方面的标准化分类和病例报告，特别是关于土著和亚洲亚人群的分类和病例报告。该文献广泛地说明了少数种族/族裔对阿片类药物的非医疗使用日益增加，致死过量的负担增加，特别是与多种药物的使用和合成阿片类药物有关，黑人/拉丁裔亚群体的比例显着升高，此外阿片类药物处方模式也不均匀。此外，文献还指出了与动态相对应的各种独特的风险环境，例如居住隔离、提供者偏见、过度警务、文化压力、患者不信任以及获得精神卫生保健服务和药物治疗资源（包括阿片类药物使用障碍药物）的机会有限。启示：目前缺乏对使用阿片类药物的少数种族/族裔进行严格、有针对性的研究，但证据表明使用量迅速增加，特别是多种药物/合成阿片类药物的使用，以及与多级形式相关的处方差异和致命过量风险现象结论需要对使用阿片类药物的少数种族/族裔复杂、重叠的风险环境进行进一步研究，包括更深入地纳入土著和亚洲个体，并努力在人口分类和报告指南中产生更大的方法协同作用。