Opioid overdoses, fatalities and other harms of opioid addiction can be prevented if hospital emergency departments make better use of effective medications for opioid addiction, according to a new study from the University of Michigan.
This is based on an assessment in the U.S. of Medicaid claims data of patients ages 12 to 64 who were treated at. emergency departments (ED) for opioid overdoses in 2018, leading to financial charges approaching $5 billion per year. The review considered visits for opioid overdose and the rate of initiation of approved medications for opioid addiction.
The approved medications included buprenorphine, methadone and extended release naltrexone.
It was shown that less than 20 percent of Medicaid patients were started on these medications at the time of emergency care or within 30 days of discharge. This is despite the medical consensus that these medications can be lifesaving. Hence, the data suggests that crucial opportunities to prevent opioid overdose deaths are being missed for Medicaid patients.
The review has been driven by a growing public health crisis that saw a record 81,000 Americans die from opioid overdose in 2021.
The study brief was: “A variety of barriers contribute to low rates of treatment initiation, including an inadequate number of professionals offering treatment in the community, gaps in OUD medication training and resources for health providers, and effective referral systems for addiction care between EDs and outpatient treatment facilities.”
A more focused review of the data showed that eight states (Massachusetts, Rhode Island, Vermont, New Hampshire, Maine, Connecticut, Pennsylvania and Maryland) had initiation rates between 20 to 34 percent—considerably higher than the average.
This variation suggests that better performance is possible. What is incumbent upon health policy makers is with understanding why these states are performing better than others could inform policymakers’ strategies to expand treatment access following ED visits for opioid overdose.
To support this, as an example, policymakers could provide resources and incentives for hospitals to encourage treatment initiation models of care in the ED and outpatient settings, such as training or technical assistance.
The study is titled “Use of Medications for Opioid Use Disorder After Overdoses Among Medicaid Enrollees.”
