{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:22:41Z","timestamp":1777897361411,"version":"3.51.4"},"reference-count":93,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA045800]"],"award-info":[{"award-number":["R01DA045800]"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>Background: Buprenorphine is a key medication to treat opioid use disorder, but little is known about how treatment quality varies across sociodemographic groups. Objective: We examined measures of treatment quality and explored variation by sociodemographic factors. Methods: We used Medicaid MAX data from 50 states from 2006 to 2014 to identify buprenorphine treatment episodes ( N\u2009=\u2009317,494). We used multivariable logistic regression to examine the quality of buprenorphine treatment along four dimensions: (1) sufficient duration, (2) effective dosage, and concurrent prescribing of (3) opioid analgesics and (4) benzodiazepines. We explored how quality varied by race\/ethnicity, age, sex, and urbanicity. Results: In adjusted models, compared to non-Hispanic White individuals, non-Hispanic Black and Hispanic individuals had lower odds of receiving effective dosage (aORs = 0.79 and 0.89, respectively) and sufficient duration (aORs = 0.64 and 0.71, respectively), and lower odds of concurrent prescribing of opioid analgesics (aORs = 0.86 and 0.85, respectively) and benzodiazepines (aORs = 0.51 and 0.59, respectively). Older individuals had higher odds of sufficient duration (aORs from 1.21\u20131.33), but also had higher odds of concurrent opioid analgesics prescribing (aORs from 1.29\u20131.56) and benzodiazepines (aORs from 1.44\u20131.99). Females had higher odds of sufficient duration (aOR = 1.12), but lower odds of effective dosage (aOR = 0.77) and higher odds of concurrent prescribing of opioid analgesics (aOR = 1.25) and benzodiazepines (aOR = 1.16). Compared to individuals living in metropolitan areas, individuals living in non-metropolitan areas had higher odds of sufficient duration (aORs = 1.11 and 1.24) and effective dosage (aORs = 1.06 and 1.33), and lower odds of concurrent prescribing (aORs from 0.81\u20130.98). Conclusions: Black and Hispanic individuals were less likely to receive effective buprenorphine dosage and sufficient duration. Quality results were mixed for older and female individuals; although these individuals were more likely to receive treatment of sufficient duration, they were also more likely to be concurrently prescribed potentially contraindicated medications, and females were less likely to receive effective dosage. Findings raise concerns about adequacy of care for minority and other at-risk populations.<\/jats:p>","DOI":"10.1080\/08897077.2022.2060424","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T09:30:52Z","timestamp":1650447052000},"page":"1057-1071","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Sociodemographic Differences in Quality of Treatment to Medicaid Enrollees Receiving Buprenorphine"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4618-9430","authenticated-orcid":false,"given":"Rachel K.","family":"Landis","sequence":"first","affiliation":[{"name":"George Washington University Trachtenberg School of Public Policy and Public Administration, Washington, District of Columbia, USA"},{"name":"RAND Corporation, Arlington, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan S.","family":"Levin","sequence":"additional","affiliation":[{"name":"RAND Corporation, Arlington, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Saloner","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-8871","authenticated-orcid":false,"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Salt Lake City, Utah, USA"},{"name":"Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA"},{"name":"Informatics, Decision-Enhancement, and Analytic Sciences Center (IDEAS), Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W.","family":"Dick","sequence":"additional","affiliation":[{"name":"RAND Corporation, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tisamarie B.","family":"Sherry","sequence":"additional","affiliation":[{"name":"RAND Corporation, Arlington, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas L.","family":"Leslie","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Center for Applied Studies in Health Economics, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Sorbero","sequence":"additional","affiliation":[{"name":"RAND Corporation, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1544-458X","authenticated-orcid":false,"given":"Bradley D.","family":"Stein","sequence":"additional","affiliation":[{"name":"RAND Corporation, Pittsburgh, Pennsylvania, USA"},{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,1,1]]},"reference":[{"key":"bibr1-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122957"},{"key":"bibr2-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108382"},{"key":"bibr3-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1058-y"},{"issue":"4","key":"bibr4-08897077.2022.2060424","first-page":"1","volume":"61","author":"Murphy SL","year":"2013","journal-title":"Natl Vital Stat Rep."},{"key":"bibr5-08897077.2022.2060424","unstructured":"Kaiser Family Foundation.\n                      Opioid overdose deaths and opioid overdose deaths as a percent of all drug overdose deaths\n                      . 2018. https:\/\/www.kff.org\/other\/state-indicator\/opioid-overdose-deaths\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D"},{"issue":"2","key":"bibr6-08897077.2022.2060424","first-page":"CD002207","author":"Mattick RP","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr7-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022164"},{"issue":"3","key":"bibr8-08897077.2022.2060424","first-page":"CD002209","author":"Mattick RP","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr9-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12137"},{"key":"bibr10-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2014.07.010"},{"key":"bibr11-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-3-17"},{"key":"bibr12-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2015.04.009"},{"key":"bibr13-08897077.2022.2060424","unstructured":"Bauhoff S, Stein B.D., Pacula R.L., Dick A.W., Gordon A.J., Burns R.M., Leslie D.L., editors. Do substance abuse policies influence opioid agonist therapies in substance abuse treatment facilities? Presented at the Addiction Health Services Research Conference; 2014;13."},{"key":"bibr14-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2015.1080208"},{"key":"bibr15-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.1205"},{"key":"bibr16-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201500228"},{"key":"bibr17-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.3109\/00952990.2012.741167"},{"key":"bibr18-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1452327"},{"key":"bibr19-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000164"},{"key":"bibr20-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2014.991469"},{"key":"bibr21-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000727"},{"key":"bibr22-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10542"},{"key":"bibr23-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.10.002"},{"key":"bibr24-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.01559"},{"key":"bibr25-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108062"},{"key":"bibr26-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2018.24.9.875"},{"key":"bibr27-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000210"},{"key":"bibr28-08897077.2022.2060424","doi-asserted-by":"crossref","unstructured":"Incze MA, Kelley AT, Gordon AJ. Improving opioid use disorder treatment through quality assessment.\n                      J Gen Intern Med\n                      . 2021;36(9):2820\u20132822.","DOI":"10.1007\/s11606-021-06614-x"},{"key":"bibr29-08897077.2022.2060424","unstructured":"National Quality Forum.\n                      Behavioral Health 2016\u20132017: Final Report\n                      . 2017 https:\/\/www.qualityforum.org\/WorkArea\/linkit.aspx?LinkIdentifier=id&ItemID=85831"},{"key":"bibr30-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2011.642758"},{"key":"bibr31-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2016.02.014"},{"issue":"8","key":"bibr32-08897077.2022.2060424","first-page":"648","volume":"19","author":"Liu Y","year":"2013","journal-title":"Am J Manag Care"},{"key":"bibr33-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2016.1267071"},{"key":"bibr34-08897077.2022.2060424","unstructured":"Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2004."},{"key":"bibr35-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1449166"},{"key":"bibr36-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201700363"},{"key":"bibr37-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1640831"},{"key":"bibr38-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.00147"},{"key":"bibr39-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12834"},{"key":"bibr40-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.0876"},{"key":"bibr41-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.2943"},{"key":"bibr42-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.10.016"},{"key":"bibr43-08897077.2022.2060424","volume-title":"Rapid Growth in Medicaid Spending and Prescriptions to Treat Opioid Use Disorder and Opioid Overdose from 2010 to 2017","author":"Clemans-Cope L","year":"2019"},{"key":"bibr44-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.12174"},{"key":"bibr45-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108569"},{"key":"bibr46-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2013.07.007"},{"key":"bibr47-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/10550490701860971"},{"key":"bibr48-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002357"},{"key":"bibr49-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1089\/whr.2020.0128"},{"key":"bibr50-08897077.2022.2060424","unstructured":"Rural Urban Continuum Codes (RUCC). In.50. https:\/\/www.networktools.nchn.org\/uploads\/2\/7\/8\/5\/27858331\/map_rural_final_report_2018.pdf"},{"key":"bibr51-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2020.106625"},{"key":"bibr52-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1177\/1073110518782949"},{"key":"bibr53-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2020.1793367"},{"key":"bibr54-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2009.10.002"},{"key":"bibr55-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-720X.2001.tb00039.x"},{"key":"bibr56-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2006.9.1454"},{"key":"bibr57-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-9-199711010-00006"},{"key":"bibr58-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200004063421411"},{"key":"bibr59-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.1915"},{"key":"bibr60-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2003.03034.x"},{"key":"bibr61-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1516047113"},{"key":"bibr62-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(00)70099-0"},{"key":"bibr63-08897077.2022.2060424","unstructured":"Sabin JA. How we fail black patients in pain. Washington, DC: Association of American Medical Colleges; 2020."},{"issue":"3","key":"bibr64-08897077.2022.2060424","first-page":"1","volume":"12","author":"Pro G","year":"2019","journal-title":"J Health Dispar Res Pract."},{"key":"bibr65-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1176\/ps.62.11.pss6211_1273"},{"key":"bibr66-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2014.0139"},{"key":"bibr67-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2014.902787"},{"key":"bibr68-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.09.001"},{"key":"bibr69-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1177\/0022042616678614"},{"key":"bibr70-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-016-0542-8"},{"key":"bibr71-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108370"},{"key":"bibr72-08897077.2022.2060424","unstructured":"Vestal C. New momentum for addiction treatment behind bars. Pew Stateline Web site. https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/blogs\/stateline\/2018\/04\/04\/new-momentum-for-addiction-treatment-behind-bar. Published 2018. Accessed January 4, 2022."},{"key":"bibr73-08897077.2022.2060424","unstructured":"Justice Community Opioid Innovation Network. https:\/\/heal.nih.gov\/research\/research-to-practice\/jcoin. Published 2021. Accessed January 4, 2022."},{"key":"bibr74-08897077.2022.2060424","unstructured":"Justice Community Opioid Innovation Network (JCOIN). Treatment alternatives for safe communities web site. https:\/\/www.centerforhealthandjustice.org\/chjweb\/tertiary_page.aspx?id=68&title=Justice-Community-Opioid-Innovation-Network-(JCOIN). Published 2018. Accessed January 4, 2022."},{"key":"bibr75-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01251"},{"key":"bibr76-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0558"},{"key":"bibr77-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302903"},{"key":"bibr78-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.2307\/2136508"},{"key":"bibr79-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1177\/135581969900400207"},{"key":"bibr80-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(91)90293-L"},{"key":"bibr81-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(01)00379-2"},{"key":"bibr82-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.12.008"},{"key":"bibr83-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(95)80004-4"},{"key":"bibr84-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000337"},{"key":"bibr85-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800321"},{"key":"bibr86-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15659"},{"key":"bibr87-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.02.012"},{"key":"bibr88-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.13084"},{"key":"bibr89-08897077.2022.2060424","unstructured":"National Quality Forum. A core set of rural-relevant measures and measuring and improving access to care: 2018 Recommendations from the MAP Rural Health Workgroup. 2018. https:\/\/www.networktools.nchn.org\/uploads\/2\/7\/8\/5\/27858331\/map_rural_final_report_2018.pdf"},{"key":"bibr90-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000703"},{"key":"bibr91-08897077.2022.2060424","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.1588"},{"key":"bibr92-08897077.2022.2060424","volume-title":"Medicaid Policy Brief: Guide to MAX Data","author":"Ruttner L","year":"2015"},{"key":"bibr93-08897077.2022.2060424","volume-title":"Medicaid Policy Brief: Assessing the Usability of Encounter Data for Enrollees in Comprehensive Managed Care across MAX 2007-2009","author":"Byrd V","year":"2012"}],"container-title":["Substance Abuse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2022.2060424","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1080\/08897077.2022.2060424","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2022.2060424","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:56:23Z","timestamp":1777625783000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1080\/08897077.2022.2060424"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,1]]},"references-count":93,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1080\/08897077.2022.2060424"],"URL":"https:\/\/doi.org\/10.1080\/08897077.2022.2060424","relation":{},"ISSN":["0889-7077","1547-0164"],"issn-type":[{"value":"0889-7077","type":"print"},{"value":"1547-0164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,1]]}}}