Social Determinants of Health Affecting Response to Opioid Addiction Treatment
Author(s)
Tushar Srivastava, MSc1, Raju Gautam, PhD1, Saeed Anwar, MPharm2, Madhusudan Kabra, MSc3, Radha Sharma, PhD4.
1ConnectHEOR, London, United Kingdom, 2ConnectHEOR, Delhi, India, 3MK Global Consulting, London, United Kingdom, 4ConnectHEOR, Edmonton, AB, Canada.
1ConnectHEOR, London, United Kingdom, 2ConnectHEOR, Delhi, India, 3MK Global Consulting, London, United Kingdom, 4ConnectHEOR, Edmonton, AB, Canada.
OBJECTIVES: Discrepancies exist in the initiation, retention and success of individuals seeking treatment for opioid use disorder (OUD). While individual factors such as education and employment influence OUD treatment, less is known about the role of environmental factors beyond the individual level such as social determinants of health (SDOH). We aimed to summarize the literature on the SDOH and OUD treatment and their impact on each other.
METHODS: Desk research was conducted in two databases (PubMed and Google Scholar) to identify peer-reviewed articles reporting SDOH in the context of OUD and published in the last 5 years (January-2020-March-2025). Search terms included combinations of ‘opioid addiction’ or ‘opioid use disorder’ and ‘social determinants of health’. We applied no restriction on countries and both systematic reviews (SLRs) and primary studies were included.
RESULTS: We identified three SLRs and nine primary observational studies. One SLR evaluating the impact of long-acting injectable buprenorphine (LAIB) on SDOH demonstrated the positive association of LAIB on employment, social relationships, accessibility, abstinence, and forensic matters. Another SLR assessing social and cognitive determinants of OUD outcomes stated mixed evidence whether neuropsychological deficits in individuals with OUD are responsive to treatment, especially those disadvantaged by SDOH (educational attainment, premorbid intellectual functioning, employment status). A SLR focusing on SDOH of interventions for incarcerated adults with OUD in the US described several studies suggesting SDOH as a barrier to receiving care. Evidence from primary studies consistently revealed that three SDOH (level of education, housing stability, and employment) had a significant association with the frequency of opioid use, and with initiation and retention of OUD treatment.
CONCLUSIONS: This study highlights that SDOH influences OUD treatment initiation, retention and success. However, further research is needed on the OUD and SDOH particularly in the context of cognitive factors, access to treatment, insurance coverage, payer policies, and incarcerated settings.
METHODS: Desk research was conducted in two databases (PubMed and Google Scholar) to identify peer-reviewed articles reporting SDOH in the context of OUD and published in the last 5 years (January-2020-March-2025). Search terms included combinations of ‘opioid addiction’ or ‘opioid use disorder’ and ‘social determinants of health’. We applied no restriction on countries and both systematic reviews (SLRs) and primary studies were included.
RESULTS: We identified three SLRs and nine primary observational studies. One SLR evaluating the impact of long-acting injectable buprenorphine (LAIB) on SDOH demonstrated the positive association of LAIB on employment, social relationships, accessibility, abstinence, and forensic matters. Another SLR assessing social and cognitive determinants of OUD outcomes stated mixed evidence whether neuropsychological deficits in individuals with OUD are responsive to treatment, especially those disadvantaged by SDOH (educational attainment, premorbid intellectual functioning, employment status). A SLR focusing on SDOH of interventions for incarcerated adults with OUD in the US described several studies suggesting SDOH as a barrier to receiving care. Evidence from primary studies consistently revealed that three SDOH (level of education, housing stability, and employment) had a significant association with the frequency of opioid use, and with initiation and retention of OUD treatment.
CONCLUSIONS: This study highlights that SDOH influences OUD treatment initiation, retention and success. However, further research is needed on the OUD and SDOH particularly in the context of cognitive factors, access to treatment, insurance coverage, payer policies, and incarcerated settings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR217
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Mental Health (including addition)