TY  - JOUR
PY  - 2022//
TI  - Opioid overdose survivors: medications for opioid use disorder and risk of repeat overdose in Medicaid patients
JO  - Drug and alcohol dependence
A1  - Crystal, Stephen
A1  - Nowels, Molly
A1  - Samples, Hillary
A1  - Olfson, Mark
A1  - Williams, Arthur Robin
A1  - Treitler, Peter
SP  - e109269
EP  - e109269
VL  - e232
IS  - 
N2  - BACKGROUND: Patients with medically-treated opioid overdose are at high risk for subsequent adverse outcomes, including repeat overdose. Understanding factors associated with repeat overdose can aid in optimizing post-overdose interventions. <br><br>METHODS: We conducted a longitudinal, retrospective cohort study using NJ Medicaid data from 2014 to 2019. Medicaid beneficiaries aged 12-64 with an index opioid overdose from 2015 to 2018 were followed for one year for subsequent overdose. Exposures included patient demographics; co-occurring medical, mental health, and substance use disorders; service and medication use in the 180 days preceding the index overdose; and MOUD following index overdose. <br><br>RESULTS: Of 4898 individuals meeting inclusion criteria, 19.6% had repeat opioid overdoses within one year. Index overdoses involving heroin/synthetic opioids were associated with higher repeat overdose risk than those involving prescription/other opioids only (HR = 1.44, 95% CI = 1.22-1.71). Risk was higher for males and those with baseline opioid use disorder diagnosis or ED visits. Only 21.7% received MOUD at any point in the year following overdose. MOUD was associated with a large decrease in repeat overdose risk among those with index overdose involving heroin/synthetic opioids (HR = 0.30, 95% CI = 0.20-0.46). Among those receiving MOUD at any point in follow-up, 10.5% (112/1065) experienced repeat overdose versus 22.1% (848/3833) for those without MOUD. <br><br>CONCLUSIONS: Repeat overdose was common among individuals with medically-treated opioid overdose. Risk factors for repeat overdose varied by type of opioid involved in index overdose, with differential implications for intervention. MOUD following index opioid overdose involving heroin/synthetic opioids was associated with reduced repeat overdose risk.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2022.109269
ID  - ref1
ER  -