Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17

Shen, Karen; Barrette, Eric; Dafny, Leemore

doi:10.1377/hlthaff.2019.01041

Cited by 21 publications

(18 citation statements)

References 6 publications

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“…18,44 This approach carries known limitations, like failing to identify patients receiving treatment without diagnoses while capturing others with misuse but not addiction. 45,46 Although we identified changes in OTP engagement associated with the PHE, we did not observe the specific mechanism(s) by which these changes occurred. For example, decreases in OTP services receipt could represent increased rates of relapse (and no OTP services), increased takehome supply, or transition from an OTP to another setting such as office-based opioid treatment.…”

Section: Limitationsmentioning

confidence: 66%

Trends in Engagement With Opioid Use Disorder Treatment Among Medicaid Beneficiaries During the COVID-19 Pandemic

et al. 2022

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IMPORTANCEDisruptions in care during the COVID-19 pandemic may have decreased access to care for patients with opioid use disorder. OBJECTIVE To examine trends in opioid use disorder treatment including buprenorphine possession, urine drug testing, and opioid treatment program services during the COVID-19 public health emergency. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 6453 parent and childless adult Medicaid beneficiaries, aged 18 to 64 years, with opioid use disorder and continuous enrollment from December 1, 2018, to September 30, 2020, in Wisconsin. Logistic regression compared differences in study outcomes before, early, and later in the COVID-19 public health emergency. Analyses were

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Section: Limitationsmentioning

confidence: 66%

Trends in Engagement With Opioid Use Disorder Treatment Among Medicaid Beneficiaries During the COVID-19 Pandemic

et al. 2022

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“…Recent reports indicate increased use of medications for OUD in the US with larger increases in Medicaid than among patients who are commercially insured . Less is known about whether increased use of medications for OUD was accompanied by changes in care patterns associated with improved outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…5 Recent reports indicate increased use of medications for OUD in the US with larger increases in Medicaid than among patients who are commercially insured. [6][7][8] Less is known about whether increased use of medications for OUD was accompanied by changes in care patterns associated with improved outcomes. For example, there is little recent evidence on changes in the duration of medication treatment, in services frequently used in conjunction with medications for OUD such as counseling and urine drug tests, or in coprescribing of other medications such as benzodiazepines and opioids that may pose risks.…”

mentioning

confidence: 99%

Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018

Donohue

Jarlenski

Kim

et al. 2021

JAMA

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The Medicaid Outcomes Distributed Research Network (MODRN)IMPORTANCE There is limited information about trends in the treatment of opioid use disorder (OUD) among Medicaid enrollees.OBJECTIVE To examine the use of medications for OUD and potential indicators of quality of care in multiple states. DESIGN, SETTING, AND PARTICIPANTS Exploratory serial cross-sectional study of 1 024 301 Medicaid enrollees in 11 states aged 12 through 64 years (not eligible for Medicare) with International Classification of Diseases, Ninth Revision (ICD-9 or ICD-10) codes for OUD from 2014 through 2018. Each state used generalized estimating equations to estimate associations between enrollee characteristics and outcome measure prevalence, subsequently pooled to generate global estimates using random effects meta-analyses. EXPOSURES Calendar year, demographic characteristics, eligibility groups, and comorbidities. MAIN OUTCOMES AND MEASURES Use of medications for OUD (buprenorphine, methadone, or naltrexone); potential indicators of good quality (OUD medication continuity for 180 days, behavioral health counseling, urine drug tests); potential indicators of poor quality (prescribing of opioid analgesics and benzodiazepines). RESULTSIn 2018, 41.7% of Medicaid enrollees with OUD were aged 21 through 34 years, 51.2% were female, 76.1% were non-Hispanic White, 50.7% were eligible through Medicaid expansion, and 50.6% had other substance use disorders. Prevalence of OUD increased in these 11 states from 3.3% (290 628 of 8 737 082) in 2014 to 5.0% (527 983 of 10 585 790) in 2018. The pooled prevalence of enrollees with OUD receiving medication treatment increased from 47.8% in 2014 (range across states, 35.3% to 74.5%) to 57.1% in 2018 (range, 45.7% to 71.7%). The overall prevalence of enrollees receiving 180 days of continuous medications for OUD did not significantly change from the 2014-2015 to 2017-2018 periods (−0.01 prevalence difference, 95% CI, −0.03 to 0.02) with state variability in trend (90% prediction interval, −0.08 to 0.06). Non-Hispanic Black enrollees had lower OUD medication use than White enrollees (prevalence ratio [PR], 0.72; 95% CI, 0.64 to 0.81; P < .001; 90% prediction interval, 0.52 to 1.00). Pregnant women had higher use of OUD medications (PR, 1.18; 95% CI, 1.11-1.25; P < .001; 90% prediction interval, 1.01-1.38) and medication continuity (PR, 1.14; 95% CI, 1.10-1.17, P < .001; 90% prediction interval, 1.06-1.22) than did other eligibility groups.CONCLUSIONS AND RELEVANCE Among US Medicaid enrollees in 11 states, the prevalence of medication use for treatment of opioid use disorder increased from 2014 through 2018. The pattern in other states requires further research.

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“…Pharmacotherapy was assessed on the basis of pharmacy and medical claims for buprenorphine, naltrexone, or methadone (for a list of codes used to identify psychosocial treatment, see an online supplement to this article). Detoxification encounters were not regarded as treatment unless they were inseparable from the treatment types identified (7).…”

Section: Data Selectionmentioning

confidence: 99%

Factors Associated With Initial Treatment Choice, Engagement, and Discontinuation for Patients With Opioid Use Disorder

Mutter

Spencer

McPheeters

2022

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Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17

Cited by 21 publications

References 6 publications

Trends in Engagement With Opioid Use Disorder Treatment Among Medicaid Beneficiaries During the COVID-19 Pandemic

Trends in Engagement With Opioid Use Disorder Treatment Among Medicaid Beneficiaries During the COVID-19 Pandemic

Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018

Factors Associated With Initial Treatment Choice, Engagement, and Discontinuation for Patients With Opioid Use Disorder

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