Opioid Prescribing, Use Continues Even After Overdose

HealthDay News — After treatment for an opioid overdose, many Medicaid patients continue to receive prescriptions for them and few are prescribed anti-addiction medications after hospital discharge, according to a research letter published in the August 22/29 issue of the Journal of the American Medical Association.

Julie Donohue, PhD, an associate professor of health policy and management at the University of Pittsburgh’s Graduate School of Public Health, and colleagues used 2008 to 2013 claims data for all Pennsylvania Medicaid patients aged 12 to 64 with a heroin or prescription opioid overdose. The authors focused on prescription opioid use, duration, and rates of medication-assisted treatment with buprenorphine, methadone, or naltrexone 6 months before and after an overdose. 

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One-third of the 6,013 patients had survived a heroin overdose. Their rate of opioid prescription dropped from 10.5 to 9.0%, the researchers found. Of the 3,945 who had overdosed on prescription opioids, prescriptions decreased from 32.4% before the overdose to 28.3% after. Meanwhile, the number of patients receiving medication-assisted treatment rose from 29.4 to 33.0% after a heroin overdose. The increase was even smaller – from 13.5 to 15.1% – after an opioid overdose.

“Forty percent of those with a heroin overdose and 60% of those with a prescription opioid overdose filled a prescription in the 6 months after overdose for the very kind of medication that contributed to the overdose in the first place,” Donohue told HealthDay. “We need to increase treatment capacity so people treated for overdose in hospitals can begin addiction treatment while in the hospital, reduce stigma associated with treatment, and educate providers on how to motivate patients to engage with treatment.”

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