Leveraging National Databases to Understand Access to Medication-Assisted Treatment for Opiate Abuse under Medicaid
Abstract: Fatalities from opiate overdose among young and middle-aged adults have risen to epidemic levels. This proposal will measure the impact of Medicaid, and specifically Medicaid expansions through the Affordable Care Act (ACA), on mitigating this public health threat. We propose to examine the association between ACA expansion and changes in prescriptions for medication-assisted treatment (MAT), as measured by prescriptions for methadone, buprenorphine, and naltrexone. We will also measure the relationship between access to MAT according to state prescription policies and statelevel overdose deaths over time, as well as differences in MAT prescriptions between Medicaid prospective payment systems and managed care which may have the incentive to ration expensive treatments. Finally, we will assess whether increased availability of naloxone rescue treatment options may have served to decrease the propensity to seek longer-term treatment options for opiate abuse.