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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

INTRODUCTION

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.

METHODS

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...

Notes

Acknowledgements

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.

References

  1. 1.
    National Institute on Drug Abuse. West Virginia Opioid Summary: Opioid-Related Overdose Deaths.; 2018. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/west-virginia-opioid-summary. Accessed 6 November 2018.
  2. 2.
    Larochelle MR, Bernson D, Land T, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study. Ann Inter Med. 2018.Google Scholar
  3. 3.
    Frazier W, Cochran G, Lo-Ciganic W-H, et al. Medication-assisted treatment and opioid use before and after overdose in pennsylvania medicaid. JAMA. 2017;318(8):750–752.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Larochelle MR, Liebschutz JM, Zhang F, Ross-Degnan D, Wharam JF. Opioid prescribing after nonfatal overdose and association with repeated overdose: a cohort study. Ann Intern Med. 2016;164(1):1.CrossRefPubMedGoogle Scholar
  5. 5.
    Bohnert ASB, Ilgen MA, Ignacio RV, McCarthy JF, Valenstein M, Blow FC. Risk of death from accidental overdose associated with psychiatric and substance use disorders. Am J Psychiatry. 2012;169(1):64–70.CrossRefPubMedGoogle Scholar
  6. 6.
    Moore B, Barrett M. Case Study: Exploring How Opioid-Related Diagnosis Codes Translate From ICD-9-CM to ICD-10-CM. U.S. Agency for Healthcare Research and Quality; 2017. https://www.hcup-us.ahrq.gov/reports/methods/methods.jsp. Accessed 6 November 2018.

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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