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Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.

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Title: Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
Authors: Springer, Rachel (AUTHOR), Marino, Miguel (AUTHOR), Bailey, Steffani R. (AUTHOR), Angier, Heather (AUTHOR), O'Malley, Jean P. (AUTHOR), Hoopes, Megan (AUTHOR), Lindner, Stephan (AUTHOR), DeVoe, Jennifer E. (AUTHOR), Huguet, Nathalie (AUTHOR)
Source: Addiction. Oct2019, Vol. 114 Issue 10, p1775-1784. 10p. 2 Charts, 3 Graphs.
Subjects: Drug abuse treatment, Tumor diagnosis, Substance abuse diagnosis, Diagnosis of drug addictions, Chronic diseases, Confidence intervals, Drug addiction, Drug prescribing, Hospice care, Insurance, Medicaid, Morphine, Narcotics, Substance abuse, Physician practice patterns, Disease prevalence, Cross-sectional method, Patient Protection & Affordable Care Act, Odds ratio
Geographic Terms: Oregon
Abstract: Background/Aims: Evidence suggests that Medicaid beneficiaries in the United States are prescribed opioids more frequently than are people who are privately insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion. Design Cross‐sectional study using inverse‐propensity weights to adjust for differences among insurance groups. Setting: Oregon. Participants: A total of 225 295 Oregon Medicaid adult beneficiaries insured during 2014–15 and either: (1) newly enrolled, (2) returning in 2014 after a > 12‐month gap or (3) continuously insured between 2013 and 2015. We excluded patients in hospice care or with cancer diagnoses. Measurements Any opioid‐dispensed, chronic (> 90‐days) and high‐dose (> 90 daily morphine milligram equivalence) opioid use, documented OUD diagnosis and MAT receipt. Findings Compared with the continuously insured, newly and returning insured enrollees were less likely to be dispensed opioids [newly: 42.3%, 95% confidence interval (CI) = 42.0–42.7%; returning: 49.3%, 95% CI = 48.8–49.7%; continuously: 52.5%, 95% CI = 52.0–53.0%], use opioids chronically (newly: 12.8%, 95% CI = 12.4–13.1%; returning: 11.9%, 95% CI = 11.5–12.3%, continuously: 15.8%, 95% CI = 15.4–16.2%), have OUD diagnoses (newly: 3.6%, 95% CI = 3.4–3.7%; returning: 3.9%, 95% CI = 3.8–4.1%, continuously: 4.7%, 95% CI = 4.5–4.9%) and receive MAT after OUD diagnosis [hazard ratio newly: 0.57, 95% CI = 0.53–0.61; hazard ratio returning: 0.60, 95% CI = 0.56–0.65 (ref: continuously)]. Conclusions: Residents of Oregon, United States who enrolled or re‐enrolled in Medicaid health insurance after expansion of coverage in 2014 as a result of the Affordable Care Act were less likely than those already covered to receive opioids, use them chronically or receive medication‐assisted treatment for opioid use disorder. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
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  Data: <searchLink fieldCode="AR" term="%22Springer%2C+Rachel%22">Springer, Rachel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marino%2C+Miguel%22">Marino, Miguel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bailey%2C+Steffani+R%2E%22">Bailey, Steffani R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Angier%2C+Heather%22">Angier, Heather</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22O'Malley%2C+Jean+P%2E%22">O'Malley, Jean P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoopes%2C+Megan%22">Hoopes, Megan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lindner%2C+Stephan%22">Lindner, Stephan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22DeVoe%2C+Jennifer+E%2E%22">DeVoe, Jennifer E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huguet%2C+Nathalie%22">Huguet, Nathalie</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Oct2019, Vol. 114 Issue 10, p1775-1784. 10p. 2 Charts, 3 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Drug+abuse+treatment%22">Drug abuse treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Tumor+diagnosis%22">Tumor diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+diagnosis%22">Substance abuse diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis+of+drug+addictions%22">Diagnosis of drug addictions</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+diseases%22">Chronic diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+addiction%22">Drug addiction</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+prescribing%22">Drug prescribing</searchLink><br /><searchLink fieldCode="DE" term="%22Hospice+care%22">Hospice care</searchLink><br /><searchLink fieldCode="DE" term="%22Insurance%22">Insurance</searchLink><br /><searchLink fieldCode="DE" term="%22Medicaid%22">Medicaid</searchLink><br /><searchLink fieldCode="DE" term="%22Morphine%22">Morphine</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotics%22">Narcotics</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Physician+practice+patterns%22">Physician practice patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+prevalence%22">Disease prevalence</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+Protection+%26+Affordable+Care+Act%22">Patient Protection & Affordable Care Act</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Oregon%22">Oregon</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background/Aims: Evidence suggests that Medicaid beneficiaries in the United States are prescribed opioids more frequently than are people who are privately insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion. Design Cross‐sectional study using inverse‐propensity weights to adjust for differences among insurance groups. Setting: Oregon. Participants: A total of 225 295 Oregon Medicaid adult beneficiaries insured during 2014–15 and either: (1) newly enrolled, (2) returning in 2014 after a > 12‐month gap or (3) continuously insured between 2013 and 2015. We excluded patients in hospice care or with cancer diagnoses. Measurements Any opioid‐dispensed, chronic (> 90‐days) and high‐dose (> 90 daily morphine milligram equivalence) opioid use, documented OUD diagnosis and MAT receipt. Findings Compared with the continuously insured, newly and returning insured enrollees were less likely to be dispensed opioids [newly: 42.3%, 95% confidence interval (CI) = 42.0–42.7%; returning: 49.3%, 95% CI = 48.8–49.7%; continuously: 52.5%, 95% CI = 52.0–53.0%], use opioids chronically (newly: 12.8%, 95% CI = 12.4–13.1%; returning: 11.9%, 95% CI = 11.5–12.3%, continuously: 15.8%, 95% CI = 15.4–16.2%), have OUD diagnoses (newly: 3.6%, 95% CI = 3.4–3.7%; returning: 3.9%, 95% CI = 3.8–4.1%, continuously: 4.7%, 95% CI = 4.5–4.9%) and receive MAT after OUD diagnosis [hazard ratio newly: 0.57, 95% CI = 0.53–0.61; hazard ratio returning: 0.60, 95% CI = 0.56–0.65 (ref: continuously)]. Conclusions: Residents of Oregon, United States who enrolled or re‐enrolled in Medicaid health insurance after expansion of coverage in 2014 as a result of the Affordable Care Act were less likely than those already covered to receive opioids, use them chronically or receive medication‐assisted treatment for opioid use disorder. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/add.14667
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      – Code: eng
        Text: English
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    Subjects:
      – SubjectFull: Drug abuse treatment
        Type: general
      – SubjectFull: Tumor diagnosis
        Type: general
      – SubjectFull: Substance abuse diagnosis
        Type: general
      – SubjectFull: Diagnosis of drug addictions
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Drug addiction
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      – SubjectFull: Drug prescribing
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      – SubjectFull: Hospice care
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      – SubjectFull: Insurance
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      – SubjectFull: Patient Protection & Affordable Care Act
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      – SubjectFull: Odds ratio
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      – SubjectFull: Oregon
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      – TitleFull: Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon.
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              Text: Oct2019
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