Social Determinants of Health and 1-Year Buprenorphine Initiation Among Justice-Involved Veterans

What is the 1-year buprenorphine medication for opioid use disorder (OUD; hereafter buprenorphine) initiation rate among justice-involved veterans (JIVs) with OUD, and how are social determinants of health (SDOH) associated with treatment uptake?In this nested case-control study of 1372 case episodes with buprenorphine initiation matched with 5436 control episodes without initiation drawn from 13 321 OUD episodes involving 12 511 JIVs, only 11.16% initiated buprenorphine within 1 year. Multiple SDOH domains—financial problems, food insecurity, social problems, and transitions of care—were associated with lower odds of buprenorphine initiation.The findings of this study suggest that buprenorphine initiation among JIVs is low and social challenges substantially hinder treatment uptake, underscoring the need for interventions that address SDOH to improve access to effective OUD treatment.

Corresponding Author: Hong Yu, PhD, CHOIR, Veterans Affairs Bedford Healthcare System, 200 Springs Rd (152), Bldg 70, Bedford, MA 01730 (hong_yu@uml.edu).

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