This invited commentary examines racial and ethnic differences in buprenorphine and methadone dosing reported in a secondary analysis of three opioid use disorder treatment trials. The authors note lower observed doses for some Black participants compared with White participants, while emphasizing that several differences were no longer statistically significant after adjustment. They question whether adjusting for withdrawal severity may obscure inequities if clinician assessments or patients’ reporting of symptoms are influenced by stigma and prior discrimination. The commentary also discusses unequal trial enrollment, insurance restrictions, and barriers to dose adjustments. It calls for more equitable treatment processes and improved assessment of withdrawal symptoms. This article interprets other researchers’ findings; it does not report a new trial.
