Objective Evaluate racial and ethnic differences in the duration of buprenorphine treatment among veterans diagnosed with opioid use disorder (OUD) between 2016 and 2021.Method A longitudinal retrospective cohort analysis was conducted using nationwide Veterans Health Administration electronic health records. The study included veterans diagnosed with OUD between January 14, 2016, to April 1, 2021. The main outcome was the duration of continuous buprenorphine treatment and retention, in weeks, with no more than a 14-day gap in treatment, in the year pre-COVID and during COVID.Results Sample included 112,151 veterans with OUD, of which 26,712 (24%) initiated buprenorphine. Overall median treatment duration was 21.3 weeks. Prior to COVID-19, Asian veterans had the longest median duration (22 weeks) and Black veterans the shortest (4.14 weeks); following COVID onset, NH/OPI veterans had the longest duration (14.43 weeks) and Asian and Black veterans the shortest (4 weeks). Retention also declined after COVID-19 onset: 38.2% reached 26 weeks pre-COVID compared with 26.1% during COVID. Black veterans consistently showed the lowest retention. The adjusted hazard of discontinuation was higher for Black versus White veterans pre-COVID (HR = 1.32) and COVID (HR = 1.29) periods.Conclusion Retention in buprenorphine treatment was significantly impacted by the COVID-19 pandemic, while racial and ethnic differences persisted across both periods. Black veterans consistently demonstrated the shortest treatment duration and highest risk of discontinuation. Less than half of the overall sample reached 180 days. Further research is required to understand and mitigate barriers to long-term buprenorphine retention.
Mandavia et al. (Thu,) studied this question.