Age related medication for addiction treatment (MAT) use for opioid use disorder among Medicaid-insured patients in New York

Abstract

Background Medication for addiction treatment (MAT) has received much attention in recent years for treating individuals with opioid use disorders (OUD). However, these medications have been significantly underused among particular subgroups. In this paper, we describe the age distribution of treatment episodes for substance use disorder among Medicaid beneficiaries in New York and corresponding MAT use. Methods Using New York Medicaid claims, we identified individuals with OUD that received treatment for substance use disorder in 2015. The type of substance use treatment is the primary outcome measure, which includes methadone, buprenorphine, naltrexone or other non-medication treatment. Results A total of 88,637 individuals were diagnosed with OUD and received treatment for substance use disorder and 56,926 individuals received some type of MAT in 2015, with 40.2% receiving methadone, 21.9% receiving buprenorphine and 2.2% receiving naltrexone while 21.9% received non-medication based treatment. Young adults (ages 18–29) were a large proportion (25%) of individuals in treatment for OUD yet were the least likely to receive MAT. Relative to young adults, 30–39 year olds (adjusted odds ratio [AOR] = 1.62, 95% CI = 1.56–1.68), 40–49 year olds (AOR = 1.90, 95% CI = 1.82–1.99), 50–59 year olds (AOR = 2.65, 95% CI = 2.52–2.78), and 60–64 year olds (AOR = 5.03, 95% CI = 4.62–5.48) were more likely to receive MAT. Conclusions These preliminary findings highlight high numbers of young adults in treatment for OUD and low rates of MAT, which is not consistent with treatment guidelines. Significant differences exist in the type of medication prescribed across age. More attention is needed to address the treatment needs among individuals of different age, notably young adults.

Factors Associated with Opioid Overdose During Medication-Assisted Treatment: How Can We Identify Individuals at Risk?

“…(9,21,23) While OUD can impact any individual regardless of age, the pediatric and adolescent stages represent important periods for intervention as most individuals report use before 25 years of age. (9,24,25) This nding is similarly re ected in our data, where patients who had an ED visit for opioid overdose in the last year started using opioids at a mean age of 22.4 years. Recent literature has highlighted that a large proportion of individuals in treatment for OUD are actually young adults but only a small number of them are receiving MAT.…”

“…Recent literature has highlighted that a large proportion of individuals in treatment for OUD are actually young adults but only a small number of them are receiving MAT. (24)(25)(26) This underuse of an effective treatment in a vulnerable population is certainly alarming. (27) For these reasons, further research is needed on identifying barriers to accessing treatment both within and outside the clinical environment for younger adults with OUD.…”

Factors associated with opioid overdose during medication-assisted treatment: How can we identify individuals at risk?

“…This finding is in keeping with current research that younger individuals are often at higher risk of both fatal and non-fatal overdoses, highlighting the need for further advocacy and research to improve outcomes for this population [ 9 , 21 , 23 ]. While OUD can impact any individual regardless of age, the pediatric and adolescent stages represent important periods for intervention as most individuals report use before 25 years of age [ 9 , 24 , 25 ]. This finding is similarly reflected in our data, where patients who had an ED visit for opioid overdose in the last year started using opioids at a mean age of 22.4 years.…”

Facility Attractiveness and Social Vulnerability Impacts on Spatial Accessibility to Opioid Treatment Programs in South Carolina

“…Additionally, driving short distances for the treatment can decrease the rate of opioid-related mortality [6]. Despite the demonstrated effectiveness of the FDA-approved medications for the treatment of opioid-use disorder (OUD), studies have demonstrated low rates of treatment use [7]. In 2017, over 70 percent of people who needed treatment for OUD did not receive medication [8].…”