Medicaid Expansion Linked to Fewer Opioid Overdose Deaths: Study

Medicaid expansion to include more patients is related to fewer opioid overdose deaths. It has been linked to higher numbers of methadone-related fatalities, according to statistics included in a study published in JAMA Network Open (January 10).

Researcher Nicole Kravitz-Wirtz, Ph.D., M.P.H., from the University of California Davis School of Medicine and her colleagues examined cross-sectional data collected from 3,109 counties in 49 states and the District of Columbia. They wanted to track annual mortality rates for overdoses from any of the following:

• Opioids, including natural and semisynthetic varieties
• Methadone
• Heroin
• Synthetic opioids other than methadone

Calculating Mean Rate of Opioid Overdoses by County

Using this data, the researchers noted there were 383, 091 deaths attributed to opioid overdoses in the US during the study period. The mean rate is calculated as 7.25 deaths per county.

To determine the mean, all the numbers in a set are added. The total (sum) is divided by the number of numbers making up the set.

In states where the Medicaid expansion was adopted, the fatal opioid overdose rate dropped by six percent as opposed to ones where coverage was not made available to more subscribers. Counties in expansion states also had lower death rates for heroin fatalities and deaths from synthetic opioids other than methadone.

No “Significant Association” Medicaid Expansion, Deaths from Certain Opioids

Deaths from methadone increased in expansion states. The researchers were unable to find any “significant association” between Medicaid expansion and deaths from natural and semisynthetic opioids. These are drugs that do not occur in nature; instead, they are made in a laboratory. These have a similar chemical structure to opiates and opioids. Examples of drugs in this category include the following:

• Hydrocodone
• Hydromorphone
• Oxycodone
• Oxymorphone

The study authors wrote, “[T]hese findings add to the emerging body of evidence that Medicaid expansion under the Affordable Care Act may be a critical component of state efforts to address the continuing opioid overdose epidemic in the United States.”