The expansion of Medicaid coverage for low-income adults permitted by the Affordable Care Act (ACA) was associated with a six percent reduction in total opioid overdose deaths nationally, according to new research from NYU Grossman School of Medicine and University of California, Davis.
Published online January 10 in JAMA Network Open , the study is the first to look at whether the ACA-related Medicaid expansion is associated with county-level opioid overdose mortality. The researchers analyzed cause-of-death data from the National Vital Statistics System from 3,109 counties within 49 states and the District of Columbia between 2001 and 2017--looking at changes in opioid overdose rates in counties that expanded Medicaid and compared those to changes that occurred in the same time period in counties within states that did not expand Medicaid.
Drug overdose remains a leading cause of injury death in the United States and is responsible for more than 70,000 deaths annually. After examining the association of Medicaid expansion with county-by-year counts of opioid overdose deaths and by class of opioid, the researchers found that: Medicaid expansion may have prevented between 1,678 and 8,132 opioid overdose deaths in 2015 to 2017 in the 32 states that expanded Medicaid between 2014 and 2016. Adoption of Medicaid expansion was associated with a six percent lower rate of total opioid overdose deaths, 11 percent lower rate of death involving heroin, and a 10 percent lower rate of death involving synthetic opioids other than methadone (such as fentanyl). Unexpectedly, an 11 percent increase in methadone overdose mortality was observed with Medicaid expansion.
Our findings suggest that as states invest more resources in addressing the opioid overdose epidemic, policymakers should pay attention to the role that expanding Medicaid can play in reducing opioid overdose deaths by providing greater access to health care, and in particular, to treatment for opioid use disorder. At a broader level, the findings of this study suggest that providing expanded access to health care may be a key policy lever to address the opioid overdose crisis." Magdalena Cerdá, DrPH, associate professor and director of the Center for Opioid Epidemiology and Policy in the Department of Population Health at NYU Langone Health, and the study's senior author Related Stories
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