Study Reveals High Risk of Subsequent Overdoses Among Medicare Beneficiaries

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WASHINGTON, D.C. — Researchers from several federal health agencies have found that Medicare beneficiaries who survive a nonfatal overdose face a high risk of subsequent overdoses and death. The study, published in JAMA Internal Medicine, highlights both effective interventions and significant gaps in care.

Key Findings

The study analyzed data from 137,000 Medicare beneficiaries who experienced a nonfatal overdose in 2020. Among this group, nearly 24,000 (17.4%) experienced another nonfatal overdose within the following year. Tragically, about 1% (1,300 individuals) died from an overdose during that period.

Miriam E. Delphin-Rittmon, Ph.D., Assistant Secretary for Mental Health and Substance Use at the Substance Abuse and Mental Health Services Administration (SAMHSA), noted the high recurrence rate of overdoses among survivors. She emphasized the importance of providing “gold-standard care” such as medications for opioid use disorder and naloxone to reduce the risk of fatal overdoses.

Effective Interventions

The study identified several interventions that significantly reduce the likelihood of subsequent lethal overdoses:

  • Methadone: Use decreased the odds of dying by 58%.
  • Buprenorphine: Use decreased the odds by 52%.
  • Behavioral Health Services: Access reduced the odds by 75%.
  • Naloxone: Filling a prescription reduced the risk of overdose mortality by 30%.

Despite these effective measures, the study found that only a small percentage of the cohort received them. Just 4.1% received medications for opioid use disorder (MOUD), and only 6.2% filled a prescription for naloxone.

Gaps in Care

The research also revealed critical gaps in care. Many beneficiaries waited an average of 72 days between their initial overdose and receiving MOUD. This delay can be life-threatening, given the high risk of repeat overdoses.

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Dr. Dora Hughes, Acting Chief Medical Officer and Acting Director of the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS), pointed out the urgency of timely intervention. “Increasing the number of beneficiaries accessing these medications in a timely manner will save lives,” she said.

Behavioral Health Services

The study found that 89% of beneficiaries accessed behavioral health services within a year of their nonfatal overdose. However, the median duration of these services was only 15 days, indicating that many patients did not receive sustained care.

Saving Lives After Overdose – Bridging the Gap in Care

This study sheds light on the urgent need for comprehensive post-overdose care. While medications like methadone, buprenorphine, and naloxone are proven to save lives, they are underutilized. The findings stress the importance of immediate and continuous care following an overdose to prevent future incidents and fatalities.

The high recurrence rate of overdoses among survivors underscores the chronic nature of substance use disorders. Effective interventions are available but are not being widely implemented. This gap in care not only endangers lives but also places a significant burden on the healthcare system.

The study’s findings highlight both the lifesaving potential of certain treatments and the critical need for improved access to these therapies. As researchers and policymakers continue to address the opioid crisis, ensuring timely and widespread access to effective treatments will be essential in reducing overdose deaths.

The federal agencies involved urge healthcare providers to incorporate these evidence-based interventions into standard care practices and call for policies that facilitate quicker access to lifesaving medications. The goal is clear: to save lives and provide ongoing support for individuals struggling with substance use disorders.

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