Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid

Winfred Frazier, Gerald Cochran, Wei-Hsuan Lo-Ciganic, Walid Gellad, Adam J. Gordon, Chung-Chou H. Chang, Julie M. Donohue

Research output: Contribution to journalLetter

14 Citations (Scopus)

Abstract

For every fatal opioid overdose, there are approximately 30 nonfatal overdoses. Nonfatal overdoses that receive medical attention represent intervention opportunities for clinicians to mitigate risk by reducing opioid prescribing or advocating addiction treatment. Studies evaluating commercially insured patients suggest these potential interventions are underutilized. For example, a 2000-2012 study reported high rates of opioid prescribing for patients even after they had sustained a nonfatal opioid overdose. Another study of patients with opioid use disorder (OUD) showed low rates of buprenorphine treatment after hospitalization for overdose. However, little is known about how opioid prescribing and medication-assisted treatment (MAT) changes from before to after overdose among Medicaid enrollees, who have a 3-times higher risk of opioid overdose. We used data from a large Medicaid program to compare (1) prescription opioid use, (2) duration of opioid use, and (3) rates of MAT (buprenorphine, methadone, or naltrexone) among enrollees before and after an overdose event.
Original languageEnglish (US)
Pages (from-to)750-752
JournalJAMA - Journal of the American Medical Association
Volume318
Issue number8
DOIs
StatePublished - Aug 22 2017

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Medicaid
Opioid Analgesics
Buprenorphine
Therapeutics
Naltrexone
Methadone
Prescriptions
Hospitalization

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Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid. / Frazier, Winfred; Cochran, Gerald; Lo-Ciganic, Wei-Hsuan; Gellad, Walid; Gordon, Adam J.; Chang, Chung-Chou H.; Donohue, Julie M. .

In: JAMA - Journal of the American Medical Association, Vol. 318, No. 8, 22.08.2017, p. 750-752.

Research output: Contribution to journalLetter

Frazier, Winfred ; Cochran, Gerald ; Lo-Ciganic, Wei-Hsuan ; Gellad, Walid ; Gordon, Adam J. ; Chang, Chung-Chou H. ; Donohue, Julie M. . / Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid. In: JAMA - Journal of the American Medical Association. 2017 ; Vol. 318, No. 8. pp. 750-752.
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abstract = "For every fatal opioid overdose, there are approximately 30 nonfatal overdoses. Nonfatal overdoses that receive medical attention represent intervention opportunities for clinicians to mitigate risk by reducing opioid prescribing or advocating addiction treatment. Studies evaluating commercially insured patients suggest these potential interventions are underutilized. For example, a 2000-2012 study reported high rates of opioid prescribing for patients even after they had sustained a nonfatal opioid overdose. Another study of patients with opioid use disorder (OUD) showed low rates of buprenorphine treatment after hospitalization for overdose. However, little is known about how opioid prescribing and medication-assisted treatment (MAT) changes from before to after overdose among Medicaid enrollees, who have a 3-times higher risk of opioid overdose. We used data from a large Medicaid program to compare (1) prescription opioid use, (2) duration of opioid use, and (3) rates of MAT (buprenorphine, methadone, or naltrexone) among enrollees before and after an overdose event.",
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AU - Gordon, Adam J.

AU - Chang, Chung-Chou H.

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AB - For every fatal opioid overdose, there are approximately 30 nonfatal overdoses. Nonfatal overdoses that receive medical attention represent intervention opportunities for clinicians to mitigate risk by reducing opioid prescribing or advocating addiction treatment. Studies evaluating commercially insured patients suggest these potential interventions are underutilized. For example, a 2000-2012 study reported high rates of opioid prescribing for patients even after they had sustained a nonfatal opioid overdose. Another study of patients with opioid use disorder (OUD) showed low rates of buprenorphine treatment after hospitalization for overdose. However, little is known about how opioid prescribing and medication-assisted treatment (MAT) changes from before to after overdose among Medicaid enrollees, who have a 3-times higher risk of opioid overdose. We used data from a large Medicaid program to compare (1) prescription opioid use, (2) duration of opioid use, and (3) rates of MAT (buprenorphine, methadone, or naltrexone) among enrollees before and after an overdose event.

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