Journal of General Internal Medicine

, Volume 34, Issue 6, pp 789–791 | Cite as

Changes in Outpatient Services and Medication Use Following a Non-fatal Opioid Overdose in the West Virginia Medicaid Program

  • Neel KoyawalaEmail author
  • Rachel Landis
  • Colleen L. Barry
  • Bradley D. Stein
  • Brendan Saloner
Concise Research Reports


West Virginia leads the USA in opioid overdoses, with a rate more than three times the national average.1 Post-overdose medications for opioid use disorder (MOUD) are protective against future deaths,2 yet are infrequently prescribed.2, 3, 4

Mental health disorders increase opioid overdose risk.5 Given the substantial burden of psychiatric comorbidities among people who overdose, it is important to understand how both MOUD and treatment for co-occurring mental health conditions change following overdoses.


We obtained West Virginia Medicaid claims data for individuals enrolled under the Affordable Care Act expansion from 2014 to 2016. Opioid overdoses were identified using diagnosis codes for opioid poisoning (965.00-965.02, 965.09, E850.0-E850.2, appropriate T40 codes) as defined by ICD-9/10.6Office visits (99x) for opioid use disorder (OUD) (304.00-304.03, 305.50-305.53, F11x) and counseling (H0004, H0031, H0036, H0040, H2036, 90791, 90792, 908x) and diagnoses...



Funding disclosure: Dr. Saloner receives funding from the National Institute on Drug Abuse (K01 DA042139) and Dr. Stein receives funding from the National Institute on Drug Abuse (P50DA046351, R01DA045800-01).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


  1. 1.
    National Institute on Drug Abuse. West Virginia Opioid Summary: Opioid-Related Overdose Deaths.; 2018. Accessed 6 November 2018.
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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Neel Koyawala
    • 1
    • 2
    Email author
  • Rachel Landis
    • 3
  • Colleen L. Barry
    • 2
    • 4
    • 5
  • Bradley D. Stein
    • 6
  • Brendan Saloner
    • 2
    • 4
    • 5
  1. 1.Johns Hopkins School of MedicineBaltimoreUSA
  2. 2.Center for Mental Health and Addiction Policy ResearchJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.The George Washington University Trachtenberg School of Public Policy and Public AdministrationWashingtonUSA
  4. 4.Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.RAND CorporationPittsburghUSA

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