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

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dc.contributor.authorMedicaid Outcomes Distributed Research Network (MODRN)
dc.contributor.authorDonohue, Julie M
dc.contributor.authorJarlenski, Marian P
dc.contributor.authorKim, Joo Yeon
dc.contributor.authorIdala, David
dc.contributor.authorMohamoud, Shamis
dc.contributor.authoret al
dc.date.accessioned2023-01-04T10:16:40Z
dc.date.available2023-01-04T10:16:40Z
dc.date.issued2021-07-13
dc.descriptionAuthors:- Medicaid Outcomes Distributed Research Network (MODRN); Julie M Donohue , Marian P Jarlenski , Joo Yeon Kim , Lu Tang , Katherine Ahrens , Lindsay Allen , Anna Austin , Andrew J Barnes , Marguerite Burns , Chung-Chou H Chang , Sarah Clark, Evan Cole , Dushka Crane , Peter Cunningham , David Idala , Stefanie Junker , Paul Lanier , Rachel Mauk, Mary Joan McDuffie , Shamis Mohamoud , Nathan Pauly , Logan Sheets, Jeffery Talbert , Kara Zivin , Adam J Gordon, Susan Kennedyen_US
dc.description.abstractImportance: 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). Results: In 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.en_US
dc.description.sponsorshipThis study was supported by grant R01DA048029 from the National Institute on Drug Abuse (Drs Donohue, Allen, Cole, Crane, Cunningham, Mauk, Talbert, and Zivin and Ms Maohamoud and Mr Sheets).en_US
dc.description.urihttps://pubmed.ncbi.nlm.nih.gov/34255008/en_US
dc.genrejournal articlesen_US
dc.identifierdoi:10.13016/m25xd2-u9q1
dc.identifier.citationMedicaid Outcomes Distributed Research Network (MODRN), Donohue JM, Jarlenski MP, Kim JY, Tang L, Ahrens K, Allen L, Austin A, Barnes AJ, Burns M, Chang CH, Clark S, Cole E, Crane D, Cunningham P, Idala D, Junker S, Lanier P, Mauk R, McDuffie MJ, Mohamoud S, Pauly N, Sheets L, Talbert J, Zivin K, Gordon AJ, Kennedy S. Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018. JAMA. 2021 Jul 13;326(2):154-164. doi: 10.1001/jama.2021.7374. PMID: 34255008; PMCID: PMC8278273.en_US
dc.identifier.urihttps://doi.org/10.1001/jama.2021.7374
dc.identifier.urihttp://hdl.handle.net/11603/26517
dc.language.isoen_USen_US
dc.publisherJAMA Networken_US
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofA. All Hilltop Institute (UMBC) Works
dc.relation.ispartofE. Behavioral Health (The Hilltop Institute, UMBC)
dc.rightsThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.en_US
dc.subjectopioid use disorder (OUD)en_US
dc.subjectmedications for ouden_US
dc.subjecttreatment of opioid useen_US
dc.titleUse of Medications for Treatment of Opioid Use Disorder among US Medicaid Enrollees in 11 States, 2014-2018en_US
dc.typeTexten_US

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