Medicaid Enrollees Who Overdose On Opioids Often Continue To Be Prescribed An Opioid

Aug 23, 2017

A new University of Pittsburgh-led study reveals Pennsylvania Medicaid enrollees prescribed an opioid are still highly likely to continue that prescription after an overdose from a legal opioid or heroin. 

Researcher Julie Donohue says that's because doctors often don't know if their patient has overdosed, either because the patient doesn't disclose this information or because emergency room information is not passed along to the prescriber. 

The study notes the results indicate a "relatively weak health system response to a life threatening event," and that different kinds of interventions have been shown to reduce overdose risk. The study says for every fatal opioid overdose, there are 30 non-fatal ones.

According to health care statistics from the state, 124,000 Pennsylvanians on Medicaid have been able to access addiction treatment since 2015. As of February, more than 700,000 residents are covered by the Medicaid expansion. But opioid addiction is still considered an epidemic in Pennsylvania, which had an estimated 4,600 overdoses in 2016, and more than 600 in Allegheny County alone.

"There's a need for more education at the patient level and at the broader society level about the effectiveness of addiction treatment," Donohue said. "Providing information to the public on where it's available and what to do to help family members."

The report's data is based on Medicaid information from 2008 through 2013, and Donohue admits the results could be slightly different if it were studied in recent years. However, she said the differences wouldn't likely compromise the study.

"We might see a slightly higher prevalence of overdoses from heroin versus prescription opioids and the overall prevalence of opioid prescribing has dropped a little bit, although I don't think either of these changes would dramatically change our findings," she said.

Donohue says she hopes the study will encourage hospitals to develop addiction care strategies, as she says the best way to start opioid intervention is in the emergency room after an overdose. However, she notes that many hospitals don't have the means to start addiction care.

"Clinical interventions, like initiating naloxone, in the emergency department setting has been shown to improve rates of recovery in both the short term and long term," she said.

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