Medicaid Study: Few Young Overdose Survivors Receiving Evidence-Based Care

A review of seven years of Medicaid claims data from 16 states offers a stark assessment of young people's limited access to effective opioid use disorder (OUD) treatment after surviving an overdose.

Published online this month in JAMA Pediatrics, the review of 2009-2015 data led by researchers at Johns Hopkins Medicine found that more than two-thirds of adolescents and young adults received no addiction treatment in the 30 days following an opioid overdose. Only 29.3% of the 3,606 young people who were enrolled in Medicaid for 30 days after the overdose received behavioral health services, and only 67 of them (less than 2%) received one of the three approved medications for OUD along with counseling.

“If 1 in 54 young people with asthma or diabetes failed to receive standard therapies for emergency situations with their diseases, we wouldn't accept it,” Rachel Alinsky, MD, MPH, the study's lead researcher and an adolescent medicine fellow at the Johns Hopkins Children's Center, said in a news release.

The researchers reviewed Medicaid claims data covering youths ages 13 to 22 in 16 de-identified states. They offered several explanations for why most young people aren't receiving evidence-based care for OUD following an opioid overdose, including:

• A lack of awareness among pediatricians about OUD and the most effective treatment strategies to address it.

• A limited number of addiction treatment facilities available for youths.

• Lingering stigma around use of medications to treat OUD, with some seeing the practice as an intervention of last resort or as merely a replacement of one drug with another.

Alinsky and her colleagues concluded in the study's abstract, “Interventions are urgently needed to link youths to treatment after overdose, with priority placed on improving access to pharmacotherapy.”

Alinsky said in the news release, “If patients with overdoses don't get linked right there in the emergency department to the appropriate follow-up care that could help them avoid a recurrence, they or their families should ask for assistance in making it happen.”