Opioid Users Don’t See Overdose as Wakeup Call
Brush with death had little effect on subsequent use
As described in a JAMA research letter, Julie M. Donohue, PhD, of the University of Pittsburgh, and colleagues looked at five years of claims data for Medicaid-covered patients in Pennsylvania. They examined records of opioid use both before and after the overdose for 6,000 patients with continuous coverage. About a third of those patients had overdosed on heroin, while the rest overdosed on prescription drugs.
Both heroin and prescription overdosers saw a slight reduction in use, at least as measured by filled prescriptions. Filled opioid prescriptions fell from 43.2% before a heroin overdose to 39.7% afterward. Prescription overdosers, meanwhile, fell from 66.1% to 59.6%.
Along the same lines, rates of medication-assisted treatment such as buprenorphine or methadone similarly increased after an overdose, but not by much.
The slight changes in behavior represented a failed opportunity by the medical community, the authors wrote.
“Despite receiving medical attention for an overdose, these patients in Pennsylvania Medicaid continued to have persistently high prescription opioid use, with only slight increases in MAT engagement, signaling a relatively weak health system response to a life-threatening event,” they wrote.
