A new analysis of North Carolina Medicaid data finds that, while progress is being made in combating the state’s opioid epidemic, more work is needed to increase the rate at which Medicaid enrollees diagnosed with Opioid Use Disorder (OUD) receive effective medications to treat it. The research is summarized in the blog Health Affairs.
The study was conducted by researchers at Duke University and UNC-Chapel Hill, with support from Arnold Ventures. The resulting white paper and data supplement identify some encouraging trends in the NC Medicaid population. For example, fewer Medicaid enrollees are using prescription opioids overall, and the rate of opioid overdoses has declined.
However, the number of Medicaid enrollees with a reported diagnosis of OUD increased from just over 27,000 in 2013-2014 (representing around 1 percent of the study population) to more than 45,000 by 2017-2018 (or nearly 2 percent of the study population).
During this same time period, the number of Medicaid enrollees receiving medications to treat OUD increased significantly. Unfortunately, the treatment rate has not kept up with the rising number of people who have OUD. While more people were receiving treatment in 2017 versus 2014, the treatment rate itself actually declined slightly.
The scientific literature indicates that people with OUD have better outcomes if medication therapy is ongoing and long-term. However, according to Dr. Marisa Domino, professor of health policy and management at the University of North Carolina Gillings School of Global Public Health, only “about half of N.C. Medicaid enrollees who initiate buprenorphine therapy for OUD remain on therapy for six months or more, suggesting that even the patients who get treatment face challenges to staying on it.”Friday Letter Submission, Publish on November 22