Expansion of Medicaid linked to increase in opioid treatment

Opioid addiction claimed 15,000 lives in the United States in 2015, according to the Centers for Disease Control and Prevention.

By Amy Wallace

March 16 (UPI) -- A study from the University of Kentucky College of Public Health found states where Medicaid coverage was expanded under the Affordable Care Act had an increase in prescriptions for a drug to combat opioid addiction.

According to the Centers for Disease Control and Prevention, more than 15,000 people died in the United States from overdoses of opioid prescriptions in 2015.


The drug, buprenorphine, is an "opioid partial agonist" that reduces opioid use, promotes abstinence from opioids and aids in recovery from dependency.

Researchers analyzed trends in Medicaid-covered prescriptions for buprenorphine in states that had expanded Medicaid coverage under the ACA and states that did not.

In 2014, 26 states and Washington, D.C., expanded their Medicaid programs under the ACA and showed an increase in prescriptions for buprenorphine. Conversely, states that did not expand Medicaid coverage saw no increase in buprenorphine prescriptions.

"Our findings suggest that Medicaid expansion has the potential to reduce the financial barriers to buprenorphine utilization and improve access to medication-assisted treatment of opioid use disorder," Dr. Hefei Wen, a researcher at the University of Kentucky, said in a press release.

The study showed Medicaid expansion was linked to a 70 percent increase in the number of buprenorphine prescriptions and a 50 percent increase in Medicaid spending on buprenorphine.


Buprenorphine is a controlled substance with strict federal regulations for its use, as well as on the qualifications of the physicians permitted to prescribe the drug and the number of patients they can treat.

Researchers found the number of physicians approved to prescribe buprenorphine was a contributing factor in increased access to the drug.

The study revealed for each 10 percent increase in the number of physicians approved to treat up to 100 patients each year for opioid addiction, there was a 45 percent increase in buprenorphine prescriptions written and a 31 percent increase in spending on buprenorphine.

Lack of health insurance coverage has been a significant barrier to treatment with buprenorphine for opioid addiction in low-income populations with high rates of opioid use disorder.

"Sufficient physician prescribing capacity is necessary for ensuring that Medicaid expansion achieves its full potential in improving buprenorphine utilization," Wen said.

The study was published in Medical Care.

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