Opioid Use Disorder: Treatment Among US Medicaid Enrollees

PainRelief.com Interview with:
Julie Donohue, Ph.D., Chair and Professor
University of Pittsburgh Graduate School of Public Health Department of Health Policy and Management.
Lead, Medicaid Outcomes Distributed Research Network

Dr. Donohue

PainRelief.com:  What is the background for this study?

Response: Medicaid plays an incredibly important role in our health system, and the population it serves overlaps with those most likely to have opioid use disorder. But Medicaid is 50-plus separate programs that can’t easily share data, so it can be difficult to draw evidence-based conclusions about the impact of interventions to prevent and treat opioid use disorder in this population.

PainRelief.com: What are the main findings?

Response: For the first time, we’ve pooled a large part of that data, enabling us to draw powerful conclusions that could better enable our country to address the opioid epidemic, which has only grown more intense during the COVID-19 pandemic. We found that the prevalence of opioid use disorder increased from 3.3% of enrollees in 2014 to 5% in 2018. Notably, the share of enrollees with opioid use disorder enrolled in Medicaid due to the ACA expansion grew from 27.3% to 50.7% in the same time period.

PainRelief.com: What should readers take away from your report?

Response: Our report demonstrates that state Medicaid expansion provided access to care for a population that needed to be engaged in the health care system. Opioid use disorder can be treated, just like any other disease, but treatment is most successful when the patient has regular, unimpeded access to trained clinicians who can not only treat the disorder, but also oversee the rest of their health care.

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: We shared our findings with state Medicaid officials, who were very engaged in determining measures on which they were performing particularly well, as well as areas where they could improve. And not only could they see where improvement was possible, but they also could talk with other state officials and learn about successful programs and practices. Improved understanding of factors driving increased use of medications for opioid use disorder is crucial to closing remaining treatment gaps.

PainRelief.com: Is there anything else you would like to add?

Response: Our analysis was possible because of a unique network called the Medicaid Outcomes Distributed Research Network (MODRN), which partnered academic institutions with state Medicaid programs. It is supported by AcademyHealth. MODRN’s collaborative involvement with Medicaid policymakers extended beyond the review of utilization and outcomes results and cultivated rich discussions on state policy differences that may influence outcomes, helping to bridge states together in their individual efforts to address the opioid epidemic.


The Medicaid Outcomes Distributed Research Network (MODRN). Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018. JAMA. 2021;326(2):154–164. doi:10.1001/jama.2021.7374

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