Indigenous peoples and medications for opioid use disorders: A scoping review

This scoping review was to synthesize the rapidly accelerating literature on Indigenous peoples and medications for opioid use disorder (MOUD) and to identify barriers to implementation and sustainability. The article also addressed outcomes, perspectives, and suggestions for implementing culturally adapted MOUD programs.

We conducted a scoping review of articles indexed in MEDLINE, APA PsycInfo, Scopus, and ERIC (through September 2024). Articles needed to include substantive information on an Indigenous population (in Canada, the United States, New Zealand, or Australia), include content on MOUD, and address the intersection of MOUD and Indigenous populations. Titles/abstracts were screened by two reviewers, followed by a full-text review and data extraction.

Forty articles met inclusion criteria, organized under two primary categories: medication type (n = 18) and nonmedication specific (n = 22). Overall, Indigenous clients have a mixed degree of engagement, retention, and positive outcomes within methadone, buprenorphine, and injectable opioid agonist treatment programs. Promising findings emerged for MOUD programs targeting Indigenous youth and that incorporate comprehensive cultural and health frameworks. Across MOUD types, Indigenous clients had consistently lower rates of treatment access and retention than did non-Indigenous clients.

The findings emphasize the importance of aligning MOUD programs with Indigenous cultural frameworks and involving Indigenous consultation at all stages. (PsycInfo Database Record (c) 2025 APA, all rights reserved).