Hepatitis C Virus Screening among Medicaid-Insured Individuals with Opioid Use Disorder across Substance Use Disorder Treatment Settings.

Objective: Although the rapid increase in opioid use disorders (OUD) and concurrent increase in Hepatitis C virus (HCV) in the United States is well-documented, little is known about HCV testing among high-risk populations. We examine patterns of HCV testing across OUD treatment settings for individuals with OUD in New York. Methods: Using 2014 New York Medicaid claims data, we identified OUD diagnosis, OUD treatment (methadone, buprenorphine, naltrexone, other treatment (inpatient or outpatient non-medication-based psychosocial treatment, such as psychotherapy) and no treatment) utilization and HCV-testing status among beneficiaries. We performed multivariable logistic regression to identify factors associated with HCV screening across OUD treatment settings. Results: 79,764 individuals with OUD diagnoses were identified in 2014. The prevalence of HCV screening was 32.4%, 16.2%, 20.6%, 16.8%, and 18.1% for those receiving methadone, buprenorphine, naltrexone, other treatment, and no treatment, respectively. In the adjusted logistic regression, those receiving any OUD treatment had greater odds of being screened, with the highest odds among methadone clients. Conclusions: Engagement in medication for OUD is associated with increased HCV testing. Findings indicate the importance of access to medication-based treatment for OUD and a need to further improve HCV screening rates.

Age related medication for addiction treatment (MAT) use for opioid use disorder among Medicaid-insured patients in New York.

BACKGROUND: Medication for addiction treatment (MAT) has received much attention in recent years for treating individuals with opioid use disorders (OUD). However, these medications have been significantly underused among particular subgroups. In this paper, we describe the age distribution of treatment episodes for substance use disorder among Medicaid beneficiaries in New York and corresponding MAT use. METHODS: Using New York Medicaid claims, we identified individuals with OUD that received treatment for substance use disorder in 2015. The type of substance use treatment is the primary outcome measure, which includes methadone, buprenorphine, naltrexone or other non-medication treatment. RESULTS: A total of 88,637 individuals were diagnosed with OUD and received treatment for substance use disorder and 56,926 individuals received some type of MAT in 2015, with 40.2% receiving methadone, 21.9% receiving buprenorphine and 2.2% receiving naltrexone while 21.9% received non-medication based treatment. Young adults (ages 18-29) were a large proportion (25%) of individuals in treatment for OUD yet were the least likely to receive MAT. Relative to young adults, 30-39 year olds (adjusted odds ratio [AOR] = 1.62, 95% CI = 1.56-1.68), 40-49 year olds (AOR = 1.90, 95% CI = 1.82-1.99), 50-59 year olds (AOR = 2.65, 95% CI = 2.52-2.78), and 60-64 year olds (AOR = 5.03, 95% CI = 4.62-5.48) were more likely to receive MAT. CONCLUSIONS: These preliminary findings highlight high numbers of young adults in treatment for OUD and low rates of MAT, which is not consistent with treatment guidelines. Significant differences exist in the type of medication prescribed across age. More attention is needed to address the treatment needs among individuals of different age, notably young adults.