Did treatment of opioid use disorder (OUD) among Medicaid enrollees change from 2014 to 2018?

A recent study published in the JAMA aims to understand the use of medications for OUD and potential indicators of quality of care in multiple US states. The research was conducted by ​​The Medicaid Outcomes Distributed Research Network (MODRN) led by Dr. Julie Donohue, Ph.D., chair and professor of the University of Pittsburgh Graduate School of Public Health Department of Health Policy and Management.

The data was obtained and de-identified from 11 states (Delaware, Kentucky, Maryland, Maine, Michigan, North Carolina, Ohio, Pennsylvania, Virginia, West Virginia, and Wisconsin; including the five states that rank among the highest for opioid overdose deaths).

The study found that 

  • In 2018, prevalence of OUD in these 11 states increased from 3.3% in 2014 to 5.0%
  • “Non-Hispanic Black enrollees had lower OUD medication use than White enrollees (prevalence ratio [PR], 0.72; 95% CI, 0.64 to 0.81; P < .001; 90% prediction interval, 0.52 to 1.00)”
  • Pregnant women had higher use of OUD medications and medication continuity than other eligibility groups
  • The variability across states in the quality measures of behavioral health counseling, urine testing and controlled substance prescribing varied greatly

One of the major limitations of the study is that the research may have  underestimated or overestimated opioid use disorder diagnoses due to limited sensitivity and specificity of the OUD diagnosis codes in Medicaid claims data. Nonetheless, the study provides critical insights on the trends in the treatment of opioid use disorder among medicaid enrollees to improve access to quality of care for OUD. 


The Medicaid Outcomes Distributed Research Network (MODRN). Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018. JAMA. 2021;326(2):154–164. doi:10.1001/jama.2021.7374

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