TY - JOUR
PY - 2023//
TI - Medications for opioid use disorder are associated with reduced risk of repeat opioid overdose in Medicaid: a cohort study
JO - Journal of substance use and addiction treatment
A1 - Tipping, Andrew D.
A1 - Nowels, Molly
A1 - Moore, Clara
A1 - Samples, Hillary
A1 - Crystal, Stephen
A1 - Olfson, Mark
A1 - Williams, Arthur Robinson
A1 - Heaps-Woodruff, Jodi
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - INTRODUCTION: Following a nonfatal opioid overdose, patients are at high risk for repeat overdose. The objective of this study was to examine the association of MOUD after nonfatal opioid overdose with risk of repeat overdose in the following year.
METHODS: This retrospective cohort study analyzed Missouri Medicaid claims from July 2012 to December 2021. The study identified opioid overdoses occurring between 2013 and 2020 using diagnosis codes for opioid poisoning in an inpatient or emergency department setting. The study implemented Cox models with a time-varying covariate for post-overdose receipt of MOUD.
RESULTS: During the study period, MOUD receipt after overdose more than tripled, from 5.1 % to 17 %. Overall, only 10.7 % of patients received MOUD in the year after index. MOUD during follow-up was associated with significantly lower risk of repeat overdose (HR = 0.24, 95 % CI = 0.08-0.75). Out of 2962 individuals meeting inclusion criteria, 12.1 % had a repeat opioid overdose within 1 year. Repeat overdose risk was more than doubled for those whose index overdose involved heroin or synthetic opioids (HR = 2.1, 95 % CI = 1.62-2.72), but MOUD was associated with significantly reduced risk in this group (HR = 0.21, 95 % CI = 0.05-0.84).
CONCLUSIONS: MOUD receipt was associated with reduced risk of repeat overdose. Those whose index overdoses involved heroin or synthetic opioids were at greater risk of repeat overdose, but MOUD substantially mitigated risk in this group. Language: en
LA - en
SN - 2949-8767
UR - http://dx.doi.org/10.1016/j.josat.2023.209218
ID - ref1
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