Publication date: Jan 14, 2020
Medicaid expansion was associated with a 6% lower rate of total opioid overdose deaths (RR 0. 94, 95% credible interval [CrI] 0. 91-0. 98), Nicole Kravitz-Wirtz, PhD, MPH, of the University of California Davis School of Medicine in Sacramento, and colleagues reported in JAMA Network Open.
In particular, states that expanded Medicaid had an 11% lower rate of fatal heroin overdoses at the county level, and a 10% lower rate of deaths involving synthetic opioids other than methadone, they found.
To determine whether or not the expansion of Medicaid — and access to substance use disorder services — might affect the opioid overdose epidemic, the researchers used data from the National Vital Statistics System to count the number of annual opioid overdose deaths from 2001 to 2017 in more than 3,000 counties in 49 states (excluding Alaska) and the District of Columbia.
They found that Medicaid expansion was associated with an overall lower risk of opioid-related mortality, and the study estimated that expansion may have prevented approximately 1,600 to 8,000 opioid overdose deaths from 2015 to 2017.
“The observed association between Medicaid expansion and decreased total opioid overdose deaths and deaths involving heroin and synthetic opioids other than methadone is likely in part attributable to the ACA’s inclusion of mental health and SUD services as essential health benefits,” the researchers wrote.
Noa Krawczyk, PhD, of the NYU Grossman School of Medicine in New York City who wasn’t involved in the study, told MedPage Today that understanding the association between access to Medicaid and opioid overdose deaths is valuable, especially in a landscape of changing healthcare policy.
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