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Literature Review On Opioid Overdose Video

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If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response. Not all submitted comments are published. Please see our commenting policy for details. Expansion was associated with increased mortality involving methadone. Uptake of substance use disorder services with medications for opioid use disorder has increased more in Medicaid expansion states than in nonexpansion states, but whether ACA-related Medicaid expansion is associated with county-level opioid overdose mortality has not been examined. Overdose deaths were modeled using hierarchical Bayesian Poisson models. Analyses were performed from April 1,to July 31, By the end of study observation ina total of 32 states and the District of Columbia had expanded Medicaid eligibility. A secondary analysis examined fatal overdoses involving all drugs.

An association between Medicaid expansion and deaths involving natural and semisynthetic opioids was not well supported RR, 1. As states invest more resources in addressing the opioid overdose epidemic, attention should be paid to the role that Medicaid expansion may play in reducing opioid overdose mortality, in part through greater Literature Review On Opioid Overdose to medications for opioid use disorder. Fatal drug overdoses have increased markedly during the past 2 decades in large part because of overdoses involving opioids, including prescription Literature Review On Opioid Overdose and illegal opioids, such as heroin and illicitly manufactured fentanyl. Between andthe age-adjusted mortality rate for opioid-related overdoses more than quadrupled, from 3.

Medicaid provides essential health care access to millions of low-income people and, by extension, greater access to low-cost prescription medications, including opioid pain relievers OPRs. Such increased access to OPRs, particularly among a patient population with higher rates of chronic disease and disability compared with non-Medicaid recipients, 5 has led some observers to question whether Medicaid expansion will contribute to additional opioid-related harms.

Background

To the contrary, recent studies 6 - 8 have found that although Medicaid expansion was associated with an increased rate of overall Medicaid-reimbursed prescriptions, changes in prescriptions for OPRs before vs after the expansion were not significantly different in expansion vs nonexpansion states.

Furthermore, Medicaid expansion has been an important source of coverage for SUD treatment, including for people with opioid use disorder OUD. Previous research suggests that uptake of medications for opioid use disorder MOUDsincluding methadone, buprenorphine, and extended-release naltrexone, has increased more in expansion states compared with nonexpansion states.

However, to our knowledge, with only 1 recent exception, 17 no study has examined the association of ACA-related Medicaid expansion with opioid-related overdose mortality more specifically. Previous studies 121617 of the association of Medicaid expansion with fatal overdoses have been conducted at the state level. Although the most appropriate spatial scale for this association remains unclear, state-level analyses may not adequately reflect local within-state variation in the level and rate of growth of overdose deaths or differences in policy implementation, such as local disparities in the capacity for or accessibility of SUD treatment.

Using overdose mortality and related covariates measured at the county rather than the state level, this Revuew aimed to provide improved estimates of the association between Medicaid expansion under the ACA and fatal opioid-involved overdoses from to For comparison with prior research, we also examined all drug overdose deaths as a secondary outcome. This serial, cross-sectional study used data from counties in 49 states and the District of Columbia from Ovedrose 1,to December 31, Analyses excluded Alaska because of substantial changes in the size Oipoid shape of counties within the state during the study period.

Individual data were aggregated to the county level. This study and was approved by the institutional review board of the University of California, Davis. No informed consent was required because this was a retrospective review of existing mortality data. We determined annual, county-level counts Literature Review On Opioid Overdose opioid overdose deaths from the restricted-use version of the National Liyerature Statistics System multiple-cause-of-death files. Among deaths with drug overdose as the underlying cause, we used the following ICD specific drug codes to identify our outcomes: all opioids, T Deaths involving more Literature Review On Opioid Overdose 1 class of opioid were included in the Literaturd for each opioid subcategory; thus, opioid subcategories are not mutually exclusive. Data on state Medicaid expansion status were obtained from the Kaiser Family Foundation.

Of the 32 states including the District of Columbia in our study population that opted to expand Medicaid eligibility, 26 did so on January 1,then 2 additional states click at this page so later that same year, followed by 2 states in and 2 states in Table 1.

We also considered the presence of co-occurring state policies, which have been associated in prior research 19 - 21 with changes in opioid-related harm, including prescription drug monitoring programs, overdose Good Samaritan laws, naloxone access laws, and medical marijuana laws. Information on these policies was derived from the Prescription Drug Abuse Policy System 22 and from McClellan and colleagues 19 and updated by us. We introduced a 1-year lag between Revieew rates and Medicaid expansion to address the possibility of temporal bias and to allow time for changes in Medicaid Literature Review On Opioid Overdose, services, and related behaviors to materialize.

Analyses with Medicaid expansion instead measured concurrently with overdose rates produced similar results eTable 2 in the Supplement.]