A scoping review of interventions addressing social determinants of health and their influence on opioid use disorder outcomes.
Background: Over the past decade, opioid overdose deaths have sharply increased. The Social Determinants of Health (SDOH) framework can guide interventions to improve opioid use disorder (OUD) outcomes. No comprehensive review of SDOH interventions and their impacts on OUD outcomes is available. This scoping review addresses that gap.
Methods: We extracted articles from PubMed, Embase, Web of Science, and Cochrane databases. Interventions were categorized according to SDOH domains: healthcare system, social and community context, neighborhood environment, economic stability, and education. Interventions and OUD outcomes (e.g., treatment initiation, opioid use, overdose) were summarized.
Results: Twenty-seven peer-reviewed studies targeted SDOH domains. The healthcare system domain (37% of studies) was the most frequently addressed, focusing on provider training, access, and quality-of-care improvements with outcomes like increased initiation of medication for OUD, reduced opioid use, and reduced provider stigma. Community and social context (30%) interventions included social support programs and community coalitions that reduced opioid use, overdose, and community-level stigma. Economic stability (16%) interventions included employment-based reinforcements and financial incentives to promote abstinence. Neighborhood and physical environment (9%) interventions included Housing-First initiatives that reduced opioid use. In the education domain (2%), an early education intervention reduced adulthood OUD risk. Over half of all studies (52%) used randomized designs; the remainder used quasi-experimental approaches. Gaps included a limited range of SDOH interventions, inconsistent definitions and measurements of SDOH, and a lack of rigorous evaluations.
Conclusion: Future research should harmonize SDOH terminology and metrics, rigorously assess SDOH intervention outcomes, and expand the range of SDOH interventions.