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Published Online: 30 April 2019

The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder

Ramin Mojtabai, M.D., Ph.D. [email protected], Christine Mauro, Ph.D., Melanie M. Wall, Ph.D., Colleen L. Barry, Ph.D., and Mark Olfson, M.D., M.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 70, Number 7
https://doi.org/10.1176/appi.ps.201900025
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Abstract

Objective:

The study examined whether the use of opioid agonist therapy (OAT) for treatment of opioid use disorder in specialty substance use treatment settings increased following Medicaid expansion.

Methods:

Administrative data on 943,430 admissions from the Treatment Episodes Data Set–Admissions (2010–2016) were used to examine the association between Medicaid expansion and the use of OAT and to assess whether this association was mediated by increased proportion of admissions with Medicaid in expansion states.

Results:

From 2010–2013 to 2014–2016, OAT use among patients with opioid use disorder increased in both expansion (39.1% and 50.2%, respectively) and nonexpansion (39.9% and 40.5%, respectively) states. The effect of Medicaid expansion on OAT use was mainly mediated through a larger proportion of admissions with Medicaid in expansion states.

Conclusions:

As the nation grapples with the opioid epidemic, expanding Medicaid coverage has the potential to promote greater access to evidence-based treatment.

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Information & Authors

Information

Published In

Go to Psychiatric Services
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Cover: XXXX

Psychiatric Services
Volume 70 • Number 7 • July 01, 2019
Pages: 617 - 620
PubMed: 31035894

History

Received: 14 January 2019
Revision received: 18 February 2019
Accepted: 7 March 2019
Published online: 30 April 2019
Published in print: July 01, 2019

Keywords

  1. Opioid use disorder in the United States
  2. Methadone
  3. Opioid agonist therapy
  4. Medication-assisted treatment

Authors

Details

Ramin Mojtabai, M.D., Ph.D. [email protected]
Department of Mental Health (Mojtabai, Barry) and Department of Health Policy and Management (Barry), Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, School of Medicine (Mojtabai), Johns Hopkins University, Baltimore; Mailman School of Public Health (Mauro, Wall Olfson), and Department of Psychiatry, Vagelos College of Physicians and Surgeons (Wall, Olfson), Columbia University, New York.
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Christine Mauro, Ph.D.
Department of Mental Health (Mojtabai, Barry) and Department of Health Policy and Management (Barry), Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, School of Medicine (Mojtabai), Johns Hopkins University, Baltimore; Mailman School of Public Health (Mauro, Wall Olfson), and Department of Psychiatry, Vagelos College of Physicians and Surgeons (Wall, Olfson), Columbia University, New York.
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Melanie M. Wall, Ph.D.
Department of Mental Health (Mojtabai, Barry) and Department of Health Policy and Management (Barry), Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, School of Medicine (Mojtabai), Johns Hopkins University, Baltimore; Mailman School of Public Health (Mauro, Wall Olfson), and Department of Psychiatry, Vagelos College of Physicians and Surgeons (Wall, Olfson), Columbia University, New York.
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Colleen L. Barry, Ph.D.
Department of Mental Health (Mojtabai, Barry) and Department of Health Policy and Management (Barry), Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, School of Medicine (Mojtabai), Johns Hopkins University, Baltimore; Mailman School of Public Health (Mauro, Wall Olfson), and Department of Psychiatry, Vagelos College of Physicians and Surgeons (Wall, Olfson), Columbia University, New York.
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Mark Olfson, M.D., M.P.H.
Department of Mental Health (Mojtabai, Barry) and Department of Health Policy and Management (Barry), Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, School of Medicine (Mojtabai), Johns Hopkins University, Baltimore; Mailman School of Public Health (Mauro, Wall Olfson), and Department of Psychiatry, Vagelos College of Physicians and Surgeons (Wall, Olfson), Columbia University, New York.
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Notes

Send correspondence to Dr. Mojtabai ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

National Institute on Drug Abusehttp://dx.doi.org/10.13039/100000026: R01 DA039137
This study was supported by the National Institute on Drug Abuse (grant R01 DA039137).

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