Over the past two decades, opioid overdose mortality nationwide more than doubled from 21,000 deaths in 2000 to 47,000 deaths in 2017. In a new study of Medicaid enrollees, a team of LDI fellows sheds light on the degree to which new or repeated overdoses may be driving this trend—with significant implications for overdose reduction.
In the study, current and former fellows Francesco DeMayo, Mark Neuman, Sean Hennessy, Young Hee Nam, and Penn Medicine’s Warren Bilker found that opioid overdoses did not increase among new users of prescription opioids in four states, even as nationwide overdoses increased. Their findings suggest that the growing number of opioid overdoses among Medicaid enrollees may have largely been driven by repeated overdoses.
The cohort included about 1.3 million individuals with new prescription opioid use, or over 240,000 person-years (PYs)—which reflects the number of individuals in the cohort and their length of time in the cohort. The incidence of opioid overdose among the cohort was 247 for every 100,000 PYs.
This study reinforces that there are subpopulations with different types and levels of risk for opioid overdose; for example, new users of prescription opioids vs. prevalent opioid users who have already developed opioid dependence or experience recurrent overdose. Therefore, effective interventions to reduce opioid overdose need to be tailored for specific subpopulations. The authors suggest that further studies identify subpopulation-specific evidence on the level of risk and types of risk factors for opioid overdose.
Additionally, the study suggests that in this high-risk population—Medicaid enrollees—increasing overdoses may have been largely driven by repeated overdoses rather than incident overdoses among new prescription opioid users.
This story is by Megan McCarthy-Alfano. Read more at Penn LDI.
