Social Determinants of Health and 1-Year Buprenorphine Initiation Among Justice-Involved Veterans
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By
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Sharmin Sultana
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Feiyun Ouyang
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Junhui Qian
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Yifan Zhang
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Avijit Mitra
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Richeek Pradhan
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Yousef Moradi
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Terri K. Pogoda
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Joel I. Reisman
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Hong Yu
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April 17, 2026
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Clinical Scorecard: Impact of Social Factors on Buprenorphine Treatment Initiation After One Year in Veterans Involved with the Justice System
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Social determinants of health (SDOH), including financial hardship and unstable housing, significantly impact treatment initiation and retention. |
| Target Population | |
| Care Setting | |
Key Highlights
- Veterans experience nearly twice the overdose mortality of nonveterans.
- Only 27% of JIVs with prior prison involvement receive medications for OUD.
- Social factors such as financial hardship, unstable housing, stigma, and reentry challenges hinder treatment initiation.
Guideline-Based Recommendations
Diagnosis
Management
- Implement buprenorphine as a first-line treatment for OUD.
- Enhance access to behavioral health services for JIVs, focusing on stigma reduction.
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Only 45% of veterans with OUD receive medications for OUD, compared to higher rates in non-JIV populations.
Clinical Best Practices
- Utilize natural language processing to extract SDOH from clinical narratives.
- Coordinate care through programs like Veterans Justice Outreach (VJO).
- Address stigma and reentry challenges to improve treatment initiation, including training for providers.
References
