An Evaluation of Medication Regimen Changes Pre-and Post-Inpatient Non-Fatal Overdose Among a Medicaid Population

Poster for An Evaluation of Medication Regimen Changes Pre-and Post-Inpatient Non-Fatal Overdose Among a Medicaid Population

William Finke, PharmD, lead author

Research Team:

Mahsa Salsabili, PharmD, PhD
Elham Heidari, PharmD, MSc
Matthew Alcusky, PharmD, PhD

Both opioids and benzodiazepines (BZDs) have risks of abuse, misuse, and addiction, which can lead to overdose or death, especially when used together. In 2021, approximately 2.5 million adults were diagnosed with opioid use disorder within the previous year. However, only 36 percent of these individuals underwent any form of substance use treatment, and 22 percent were prescribed medications specifically for opioid use disorder.

Few studies have examined medication changes related to prescription opioids, BZDs, and medication-assisted treatment (MAT) post-overdose in individuals with Medicaid insurance. Limited literature exists in terms of non-fatal ODs requiring hospital admission, with most reported ODs being linked to emergency department and outpatient visits.

This research evaluated changes in prescribing patterns of opioids, BZDs, and MAT after a non-fatal overdose inpatient hospitalization. The team studied Mass. Medicaid (MassHealth) members 18 to 64 years of age with an inpatient claim related to a non-fatal overdose, and continuous MassHealth enrollment for ≥90 days pre- and post-OD event.

In the 90 days after a non-fatal overdose event, 54.2 percent of members who used opioids before hospitalization had zero claims for opioids, and 26.4 percent of members who used BZDs before hospitalizations had zero claims for BZDs. A total of 13.2 percent of members began MAT after experiencing a non-fatal overdose event, and 73.3 percent of members previously on MAT continued treatment after the overdose event.

The differing outcomes across opioids, BZDs, and MAT groups highlight the importance of tailoring interventions to address specific substance use patterns and individual patient needs. Future evaluations should assess the total patient risk profile, including recurrence of overdoses in all settings, polypharmacy and dose reduction approaches, and medication regimen changes. Further studies need to evaluate appropriate interventions to establish those with meaningful impact and improved outcomes overall.

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