Observational studyDrug and alcohol dependence2025
Assessing inequities in buprenorphine treatment across the care cascade.
Observational study in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Racial and Ethnic Disparities in Buprenorphine and Naloxone among Medicaid Beneficiaries after Emergency Department Visits and Hospitalizations.Journal of general internal medicine · 2026Article
- Statewide trends in access to medications for opioid use disorder (moud) among adolescents with opioid use disorders in Indiana.Drug and alcohol dependence reports · 2026Article
- Aligning Efforts to Boost Medications for Opioid Use Disorder and Pre-Exposure Prophylaxis for HIV.Journal of general internal medicine · 2026Article
- Substance-induced mental disorders and discontinuation of medication for opioid use disorder.Drug and alcohol dependence · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveDescribe buprenorphine treatment gaps across the care cascade by race, ethnicity, age, sex and key clinical characteristics.
designObservational cohort study of new opioid use disorder (OUD) treatment episodes, 1/1/15-12/31/21
participantsIndividuals 16-89 years at Boston Medical Center and affiliated Boston-area clinics with OUD or buprenorphine prescription following 90-day washout MAIN OUTCOMES AND MEASURES: Buprenorphine initiation (by 14d), engagement (second prescription by 34d), and retention (continuous buprenorphine through 180d without >14d gap). Covariates: sex, race and ethnicity, age, past 12-month buprenorphine, past 12-month overdose, co-occurring substance use disorder (SUD) and psychiatric diagnosis.
results24,165 episodes (14,182 individuals) included the following characteristics: female (34.1 %); Black (21.5 %), Latino (16.2 %), White (59.2 %); 16-25 years (4.1 %), 65-89 years (4.9 %). Initiation, engagement and retention were low: 39.3 %, 19.3 %, and 12.4 %. In adjusted models, compared with males, females' lower probability of overall retention reflected lower engagement conditional on initiation (41 % vs. 53 %; OR:0.61, 95 %CI:0.56-0.67, p < 0.001). Black individuals' lower probability of retention overall reflected lower initiation than White individuals (28 % vs 44 %; OR:0.50, 95 %CI:0.46-0.55, p < 0.001). The retention disadvantage for younger and older groups reflected cascade-wide gaps. Lower overall retention associated with co-occurring SUDs reflected lower initiation (OUD only:46 %; OUD plus: alcohol:19 % OR:0.27, 95 %CI:0.21-0.34, p < 0.001; sedatives:21 %, OR:0.31, 95 %CI:0.20-0.49, p < 0.001; stimulants:25 %, OR:0.40, 95 %CI:0.33-0.48, p < 0.001; ≥3 SUDs:25 %, OR:0.40, 95 %CI:0.37-0.43, p < 0.001). CONCLUSIONS AND RELEVANCE: Inequities in buprenorphine use emerged across the care cascade with unique patterns by sociodemographic and clinical subgroup. Health systems aiming to reduce buprenorphine inequities should identify the optimal cascade step based on the population of interest.
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