Treatment of Opioid Use Disorder Among Commercially Insured Patients in the Context of the COVID-19 Pandemic

Huskamp, Haiden A.; Busch, Alisa B.; Uscher‐Pines, Lori; Barnett, Michael L.; Riedel, Lauren; Mehrotra, Ateev

doi:10.1001/jama.2020.21512

Cited by 71 publications

(95 citation statements)

References 3 publications

(8 reference statements)

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“…We used a nationwide sample of privately insured individuals to examine the impacts of the COVID-19 pandemic on use of buprenorphine for adults 19 years of age or older, finding that the rate of use of buprenorphine remained stable during the early stages of the pandemic. The national results are consistent with other recent studies during the initial stage of the COVID-19 pandemic (Huskamp et al, 2020;Nguyen et al, 2020). The current study adds important new information using county-level data.…”

Section: Discussionsupporting

confidence: 92%

Use of buprenorphine for those with employer-sponsored insurance during the initial phase of the COVID-19 pandemic

Cantor

Dick

Haffajee

et al. 2021

Journal of Substance Abuse Treatment

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Section: Discussionsupporting

confidence: 92%

Use of buprenorphine for those with employer-sponsored insurance during the initial phase of the COVID-19 pandemic

Cantor

Dick

Haffajee

et al. 2021

Journal of Substance Abuse Treatment

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“…Pandemic-associated changes in access to substance use disorder treatments could be exacerbating mortality from overdoses. 6 Decreases in MVA deaths in April coincided with less traffic, despite increases in drivers testing positive for drugs and alcohol and lower seatbelt use. 3 Increases in MVA deaths in June-July occurred as traffic increased (though still below 2019 levels), likely reflecting higher-risk behaviors.…”

Section: Discussionmentioning

confidence: 99%

Mortality from injury, overdose and suicide during the 2020 COVID-19 pandemic, March-July, 2020

Faust

Mayes

et al. 2021

Preprint

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Introduction The COVID-19 pandemic has been associated with substantial rates of all-cause excess mortality. The contribution of external causes of death to excess mortality including drug overdose, homicide, suicide, and unintentional injuries during the initial outbreak in the United States is less well documented. Methods Using public data published by the National Center for Health Statistics on February 10, 2021, we measured monthly excess mortality (the gap between observed and expected deaths) from five external causes using national-level data published by National Center for Health Statistics; assault (homicide); intentional self-harm (suicide); accidents (unintentional injuries); and motor vehicle accidents. We used seasonal autoregressive integrated moving average (sARIMA) models developed with cause-specific monthly mortality counts and US population data from 2015-2019 and estimated the contribution of individual cause-specific mortality to all-cause excess mortality from March-July 2020. Results From March-July, 2020, 212,825 (95% CI 136,236-290,776) all-cause excess deaths occurred in the US). There were 8,540 excess drug overdoses (all intents) (95% CI 5,106 to 11,975), accounting for 4% of all excess mortality; 1,455 excess homicide deaths (95% CI 708 to 2202, accounting for 0.7% of excess mortality; 5,492 excess deaths due to unintentional accidents occurred (95% CI 85 to 10,899, accounting for 2.6% of excess mortality. Though a non-significantly 135 (95% CI -1361 to 1,630) more MVA deaths were recorded during the study period, a significant decrease in April (525; 95% CI -817 to -233) and significant increases in June-July (965; 95% CI 348 to 1,587) were observed. Suicide deaths were statistically lower than projected by 2,067 (95% CI 941-3,193 fewer deaths). Meaning Excess deaths from drug overdoses, homicide, and addicents occurred during the pandemic but represented a small fraction of all-cause excess mortality. The excess external causes of death, however, still represent thousands of lives lost. Notably, deaths from suicide were lower than expected and therefore did not contribute to excess mortality.

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“… Huskamp et al (2020) used commercial and Medicare Advantage insurance claims data for OUD treatment, including medication fills, outpatient visits, and urine tests among insured individuals compared to the previous year (2019), and found no decrease in medication fills or clinician visits. Fewer new patients initiated OUD medications, however, and less urine testing occurred across all patients.…”

Section: Discussionmentioning

confidence: 99%

The COVID-19 pandemic and opioid use disorder: Expanding treatment with buprenorphine, and combining safety precautions with telehealth

Cales¹,

Cales²,

Shreffler

et al. 2022

Journal of Substance Abuse Treatment

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Background This study investigated the efficacy and safety of providing medication for opioid use disorder (MOUD) and individualized telehealth in Kentucky, a state severely impacted simultaneously by the opioid epidemic and the COVID-19 pandemic. Methods The investigation analyzed pre- and post-COVID-19 characteristics in 191 opioid use disorder (OUD) buprenorphine outpatients who completed an 18-question survey in late 2020 related to COVID testing, OUD relapses, obstacles to maintaining abstinence, and treatment resources. Results The study revealed no statistically significant changes in drug use before and after the onset of the COVID-19 pandemic despite monthly volume increases. Results further demonstrated statistically significant barriers to treatment, including loss of housing and transportation, food insecurity, and onset of depression. No patients required hospitalization or succumbed to OUD or COVID-19. Potentially effective resource utilization findings included clinic transportation and 24/7 crisis intervention. Respondents rated telehealth as helpful when used in an individualized hybrid model matching patient's need to available resources based on COVID-19 safety guidelines. Conclusion This report yields key clinical insights into providing outpatient MOUD care during the COVID-19 pandemic, validating in-person care as both safe and effective. Patients' experiences proved helpful in identifying and quantifying obstacles to abstinence in conjunction with facilitating continued patient access to essential clinical resources. Notably, telehealth can supplement rather than replace in-person treatment.

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Treatment of Opioid Use Disorder Among Commercially Insured Patients in the Context of the COVID-19 Pandemic

Abstract: Drs Huskamp and Mehrotra had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 71 publications

References 3 publications

Use of buprenorphine for those with employer-sponsored insurance during the initial phase of the COVID-19 pandemic

Use of buprenorphine for those with employer-sponsored insurance during the initial phase of the COVID-19 pandemic

Mortality from injury, overdose and suicide during the 2020 COVID-19 pandemic, March-July, 2020

The COVID-19 pandemic and opioid use disorder: Expanding treatment with buprenorphine, and combining safety precautions with telehealth

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