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Medicaid expansion and drug overdose mortality during the COVID-19 pandemic in the United States.
Auty, Samantha G; Griffith, Kevin N.
  • Auty SG; Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, Massachusetts 02118, USA. Electronic address: sgauty@bu.edu.
  • Griffith KN; Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Avenue, Nashville, Tennessee 37203, USA; Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA 02130, USA.
Drug Alcohol Depend ; 232: 109340, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1729685
ABSTRACT

BACKGROUND:

The COVID-19 pandemic caused disruptions in the delivery of health services, which may have adversely affected access to substance use disorder (SUD) treatment services. Medicaid expansion has been previously associated with increased access to SUD services for low-income adults. Thus, the pandemic may have differentially impacted overdose mortality depending on expansion status. This study examined trends in overdose mortality nationally and by state Medicaid expansion status from 2013 to 2020.

METHODS:

State-level data on overdose mortality were obtained from the Centers for Disease Control and Prevention's WONDER database for 2013-2020 (N = 408 state-years). The primary outcomes were drug and opioid overdose deaths per 100,000 residents. The primary exposure was Medicaid expansion status as of January 1st, 2020. Difference-in-difference (DID) models were used to compare changes in outcomes between expansion and non-expansion states after the onset of the COVID-19 pandemic.

RESULTS:

The U.S. experienced 91,799 drug overdose deaths in 2020, a 29.9% relative increase from 2019. Expansion states experienced an adjusted increase of 7.0 drug overdose deaths per 100,000 residents (95% CI 3.3, 10.7) and non-expansion states experienced an increase of 4.3 deaths (95% CI 1.5, 8.2) from 2019 to 2020. Similar trends were observed in opioid overdose deaths. In DID models, Medicaid expansion was not associated with changes in drug (0.9 deaths, 95% CI -2.0, 3.7) or opioid overdose deaths (0.8 deaths, 95% CI -1.8, 3.5).

CONCLUSIONS:

The increase in drug or opioid overdose deaths experienced during the first year of the COVID-19 pandemic was similar in states with and without Medicaid expansion.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / COVID-19 Type of study: Observational study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / COVID-19 Type of study: Observational study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article