Researchers discovered that out of 137,000 Medicare beneficiaries who had a nonfatal overdose in 2020, 17.4% experienced another nonfatal overdose, and 1% died in the subsequent year. The study, conducted by Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), Centers for Medicare & Medicaid Services (CMS), and the Centers for Disease Control and Prevention (CDC), revealed both effective interventions and areas lacking in care.
Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use, highlighted that individuals who received quality care after an overdose, like opioid use disorder medications and naloxone, had significantly lower risks of fatal overdose. Medications, overdose reversal drugs, and behavioral health support were emphasized for saving lives.
The research identified successful interventions after initial nonfatal overdoses. Beneficiaries who received methadone (58% lower odds), buprenorphine (52% lower odds), or behavioral health services (75% lower odds) were less likely to die from a subsequent overdose. Fillings naloxone prescriptions also reduced overdose mortality risk by 30%.
However, gaps in care were evident, with only 4.1% receiving medications for opioid use disorder (MOUD) and 6.2% filling naloxone prescriptions despite being gold-standard interventions. Beneficiaries waited an average of 72 days to receive MOUD after a nonfatal overdose.
Around 89% received behavioral health services within a year of their nonfatal overdose, with a median duration of 15 days.
Dr. Dora Hughes from CMS stressed the importance of timely access to medications post-overdose to prevent deaths, pointing out that only 4% received these vital medications.
The study highlighted the underutilization of MOUD and overdose reversal medications even though they are proven to save lives.
Nora D. Volkow, M.D., from the National Institute on Drug Abuse, emphasized the need to prioritize access to effective treatments, especially for high-risk individuals.
President Biden’s Unity Agenda aims to provide crucial medication and care nationwide to combat the opioid epidemic.
- The US Department of Health and Human Services focuses on evidence-based treatments, expanded access to methadone, buprenorphine, and opioid overdose reversal medications.
- Policy changes have been made post-analysis to save lives and aid communities:
- Providers no longer need specialized waivers to prescribe buprenorphine, and multiple naloxone medications are now available over-the-counter.
- SAMHSA updated regulations to improve access to MOUD, especially in rural and transportation-challenged areas, and CDC awarded funds for overdose prevention efforts.
- NIH and CMS support research and initiatives for addiction treatment strategies and improved behavioral health care access.
- CMS is implementing a Behavioral Health Strategy to enhance coverage and access to mental health care, including through telehealth services and innovative care models.
Allison Arwady, M.D., from CDC, stressed the need for collaboration across all levels to prevent fatal overdoses, indicating that more efforts are required to save lives.
