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

Koyawala, Neel; Landis, Rachel K.; Barry, Colleen L.; Stein, Bradley D.; Saloner, Brendan

doi:10.1007/s11606-018-4817-8

Cited by 19 publications

(12 citation statements)

References 4 publications

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“…[8][9][10][11] However, few patients successfully transition to treatment following nonfatal overdose. [12][13][14] In evidence from 2 states, less than 5% of Medicaid patients initiated treatment with medication for opioid use disorder (MOUD) following overdose. 13,14 For patients who are ready to engage in treatment, care coordination can help to overcome barriers to access.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14] In evidence from 2 states, less than 5% of Medicaid patients initiated treatment with medication for opioid use disorder (MOUD) following overdose. 13,14 For patients who are ready to engage in treatment, care coordination can help to overcome barriers to access. 4,9 Yet hospitals have few incentives and capacity to provide resource-intensive care navigation after ED visits.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have focused on single states, the Medicaid population, and MOUD treatment. [12][13][14]29 To our knowledge, no previous studies have included the full scope of treatment services available to patients.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients

et al. 2020

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IMPORTANCE Timely initiation and referral to treatment for patients with opioid use disorder seen in the emergency department is associated with reduced mortality. It is not known how often commercially insured adults obtain follow-up treatment after nonfatal opioid overdose. OBJECTIVE To investigate the incidence of follow-up treatment following emergency department discharge after nonfatal opioid overdose and patient characteristics associated with receipt of follow-up treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients

et al. 2020

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“…Medications for opioid use disorder (MOUD) are now recommended for treatment of opioid use disorder (National Academies of Sciences, Engineering, and Medicine, 2019). Yet many with this use disorder do not voluntarily seek treatment, even after an overdose (Koyawala, Landis, Barry, Stein, & Saloner, 2019). Cognitive motivation theories suggest that individuals have increased readiness for change at certain points (DiClemente, 2018;Herman & Mandiberg, 2010), and patients who have survived a recent life-threatening overdose might be more willing to engage in treatment and recovery if they were approached and presented with specific options for linking into treatment.…”

Section: Introductionmentioning

confidence: 99%

Outreach to people who survive opioid overdose: Linkage and retention in treatment

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Champagne‐Langabeer

Luber

et al. 2020

Journal of Substance Abuse Treatment

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Cognitive motivation theories contend that individuals have greater readiness for behavioral change during critical periods or life events, and a non-fatal overdose could represent such an event. The objective of this study was to examine if the use of a specialized mobile response team (assertive outreach) could help identify, engage, and retain people who have survived an overdose into a comprehensive treatment program. We developed an intervention, consisting of mobile outreach followed by medication and behavioral treatment, in Houston Texas between April and December 2018. Our primary outcome variables were the level of willingness to engage in treatment, and percent who retained in treatment after 30 and 90 day endpoints. We screened 103 individuals for eligibility, and 34 (33%) elected to engage in the treatment program, while two-thirds chose not to engage in treatment, primarily due to low readiness levels. The average age was 38.2 ± 12 years, 56% were male, 79% had no health insurance, and the majority (77%) reported being homeless or in temporary housing. There were 30 (88%) participants still active in the treatment program after 30 days, and 19 (56%) after 90 days. Given the high rates of relapse using conventional models, which wait for patients to present to treatment, our preliminary results suggest that assertive outreach could be a promising strategy to motivate people to enter and remain in long-term treatment.

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“…Additionally, access to evidence-based drug treatment options in WV is insufficient. A recent analysis demonstrated that less than 10% of Medicaid recipients received MOUD or mental health counseling after a NFOD, lower than rates reported in other states [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Correlates of recent nonfatal overdose among people who inject drugs in West Virginia

et al. 2021

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Aim Experiencing a nonfatal overdose (NFOD) is a significant risk factor for a subsequent nonfatal or fatal overdose. Overdose mortality rates in rural Appalachian states are some of the highest in the USA, but little is known about correlates of overdose among rural populations of people who inject drugs (PWID). Our study aimed to identify correlates of experiencing a recent (past 6 months) NFOD among rural PWID in Cabell County, West Virginia. Methods Using data from a June–July 2018 cross-sectional survey that was designed to estimate the size and characteristics of the PWID population in Cabell County, West Virginia, we used log binomial regression to identify correlates (e.g., structural vulnerabilities and substance use) of NFOD in the past 6 months. Results The majority of our sample of 420 PWID were male (61.2%), White, non-Hispanic (83.6%), and reported recent heroin injection (81.0%). More than two-fifths (42.6%) experienced a recent NFOD. Independent correlates of NFOD included witnessing an overdose in the past 6 months (adjusted prevalence ratio [aPR] = 2.28; 95% CI 1.48–3.50), attempting to quit using drugs in the past 6 months (aPR = 1.54; 95% CI 1.11–2.14), and the number of drugs injected (aPR = 1.16; 95% CI 1.10–1.23) Conclusions A large proportion of rural PWID in Appalachia reported having recently overdosed. The associations between witnessing an overdose, attempting to quit using drugs, and number of drugs injected with recent nonfatal overdose underscore the need for expanded access to overdose prevention resources that are tailored to the needs of this population. Expanding access to evidence-based overdose prevention strategies—such as take-home naloxone programs, treatment with methadone or buprenorphine, and harm reduction services—may decrease overdose morbidity and mortality among rural PWID in Appalachia.

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

Cited by 19 publications

References 4 publications

Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients

Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients

Outreach to people who survive opioid overdose: Linkage and retention in treatment

Correlates of recent nonfatal overdose among people who inject drugs in West Virginia

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