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Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment

Bibliographic Data

ID11027992
AuthorsAlana Sharp (0000-0001-7160-9292, All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.), Austin Jones (0000-0003-0680-1477, All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.), Jennifer Sherwood (0000-0003-2814-1684, All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.), Oksana Kutsa (0000-0002-8148-6166, All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.), Brian Honermann (0000-0002-4907-0603, All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.), Gregorio A Millett (American Foundation for AIDS Research), Gregorio Millett (All of the authors are with amfAR, The Foundation for AIDS Research, Washington, DC.)
Year2018
Volume108
Issue5
Pages642-648
Publication date2018-05-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2018.304338
PMID29565661
OpenAlexW2792562585
LanguageEN
Citations received18
References cited4

Objectives. To assess the impact of the expansion of Medicaid eligibility in the United States on the opioid epidemic, as measured through increased access to opioid analgesic medications and medication-assisted treatment. Methods. Using Medicaid enrollment and reimbursement data from 2011 to 2016 in all states, we evaluated prescribing patterns of opioids and the 3 Food and Drug Administration–approved medications used in treating opioid use disorders by using 2 statistical models. We used difference-in-differences and interrupted time series models to measure prescribing rates before and after state expansions. Results. Although opioid prescribing per Medicaid enrollee increased overall, we observed no statistical difference between expansion and nonexpansion states. By contrast, per-enrollee rates of buprenorphine and naltrexone prescribing increased more than 200% after states expanded eligibility, while increasing by less than 50% in states that did not expand. Methadone prescribing decreased in all states in this period, with larger decreases in expansion states. Conclusions. The Medicaid expansion enrolled a population no more likely to be prescribed opioids than the base Medicaid population while significantly increasing uptake of 2 drugs used in medication-assisted treatment

Analgesic · Family medicine · Health care · Medicaid · Medication adherence · Opioid · Opioid epidemic · Opioid use disorder · Psychiatry · Healthcare Policy and Management · Internal Medicine · Medicine · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes

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Unique citing works18
Citations per year2,57
Citation span2019 - 2025 (7)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 18

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