• Danielle S Jackson, Nguemeni TiakoMax JordanMJDepartment of Internal Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA. Electronic address: https://twitter.com/MaxJordan_N., and Ayana Jordan.
• Department of Psychiatry, Rutgers- Robert Wood Johnson Medical School, 671 Hoes Lane West, 2nd Floor, Piscataway, NJ 08854, USA. Electronic address: danielle.jackson@yale.edu.
• Med. Clin. North Am. 2022 Jan 1; 106 (1): 29-41.

AbstractThe Half-Century long problem of addiction treatment disparities. We cannot imagine addressing disparities in addiction treatment without first acknowledging and deconstructing the etiology of this inequity. This article examines the history of addiction treatment disparities beginning with early twentieth-century drug policies. We begin by discussing structural racism, its contribution to treatment disparities, using opioid use disorder as a case study to highlight the importance of a structural competency framework in obtaining care. We conclude by discussing diversity in the workforce as an additional tool to minimizing disparities. Addiction treatment should be aimed at addressing care delivery in the context of the social, economic, and political determinants of health, which require appreciation of their historical origins to move toward equitable treatment.Copyright © 2021 Elsevier Inc. All rights reserved.

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