Heroin, Fentanyl Deaths Drop in Medicaid Expansion States – By Katelyn Newman (US News) / Jan 10 2020
States that increased Medicaid also saw an increase in their methadone-related deaths, researchers found.
Rates of opioid overdose deaths, particularly those involving heroin and fentanyl, dropped in states that expanded their Medicaid program between 2001 and 2017, a new study finds, while those involving methadone increased in these states.
Researchers from California, New York and Rhode Island examined mortality data from the Centers for Disease Control and Prevention’s National Vital Statistics System of 3109 counties in 49 states and the District of Columbia from Jan. 1, 2001, to Dec. 31, 2017 to determine whether the Affordable Care Act-related Medicaid expansion had an impact on opioid-related overdose deaths by specific type of opioid between states that expanded their public insurance programs and those that did not, according to the study, published Friday in the online journal JAMA Network Open. Alaska was excluded from the analysis due to “substantial changes in the size and shape of counties within the state during the study period,” the report said.
They found that 383,091 opioid-related overdose deaths occurred across the included counties, and the overall opioid mortality rate more than quadrupled – from 2.49 deaths per 100,000 people in 2001 to 11.41 deaths per 100,000 in 2017 – in that time frame. While opioid overdose death rates were generally higher in expansion states than in non-expansion states, the researchers found Medicaid expansion to be associated with a lower overall rate of opioid-related deaths.
“Specifically, counties within states that expanded Medicaid had a 6% decreased rate of opioid overdose deaths after expansion compared with counties within states that did not expand Medicaid eligibility,” according to the study. Broken down by type of opioid, these counties also had an 11% decreased rate of fatal heroin overdoses and a 10% decreased rate of overdose deaths involving synthetic opioids other than methadone, such as fentanyl.
“The observed association between Medicaid expansion and decreased total opioid overdose deaths and deaths involving heroin and synthetic opioids other than methadone is likely in part attributable to the (Affordable Care Act)’s inclusion of mental health and (substance use disorder) services as essential health benefits,” the study said. “Expanded Medicaid eligibility has substantially increased access to these services among the low-income population.”
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