Opioid overdose is a common and serious complication of opioid use disorder (OUD) and individuals who experience an overdose are at higher risk for another. In this study, researchers used New Jersey Medicaid data from 2014 to 2019 to evaluate associations between receipt of medications for OUD (MOUD; methadone, buprenorphine, and naltrexone) and repeat overdose.
- There were 4898 enrollees aged 12–64 years who experienced an initial opioid overdose requiring medical intervention and who had not received MOUD in the 180 days prior to the index event.
- The overall rate of repeat overdose within 12 months of the index overdose was 20%; one in five of these occurred within 30 days. Only 22% of people who experienced an overdose received MOUD in the follow-up period.
- Among individuals who received MOUD at any time during the follow-up period, 11% experienced a repeat overdose, compared with 22% of those who did not receive MOUD (hazard ratio, 0.35).
Comments: This study reinforces the benefits of MOUD for prevention of overdose and shows that we need to do a better job of linking individuals who experience overdose with evidence-based care. Not offering these medications during emergency department encounters for overdose is a missed opportunity for a life-saving intervention. The percentage of overdose survivors who receive MOUD within 30 days should be a publicly available quality of care metric.
Darius A. Rastegar, MD
Reference: Crystal S, Nowels M, Samples H, et al. Opioid overdose survivors: medications for opioid use disorder and risk of repeat overdose in Medicaid patients. Drug Alcohol Depend. 2022;232:109269.