A new report published Monday in JAMA Internal Medicine sheds light on nonfatal prescription drug overdoses in Medicare beneficiaries.
Of about 137,000 people using Medicare, 17.4% had nonfatal overdoses in 2020 and 1% died from overdoses the following year, the data showed.
“People who have experienced one overdose are more likely to experience another,” Miriam E. Delphin-Rittmon, PhD, Department of Health and Human Services assistant secretary for mental health and substance use and the leader of Substance Abuse and Mental Health Services Administration (SAMHSA), one of the organizations involved in the research, said in a statement. “But we found that when survivors received gold-standard care such as medications for opioid use disorder and naloxone, the chances of dying from an overdose in the following year drop dramatically. In short, medications for opioid use disorder, opioid overdose reversal medications, and behavioral health supports save lives.”
The odds of dying from a subsequent lethal overdose fell by 58% in those who received methadone, by 52% in those who took buprenorphine and by 75% if the person had crisis intervention or behavioral health care. The risk of dying from an overdose in those who were prescribed naloxone (Narcan) dropped by 30%.
There were some gaps in care that the team pointed out. For example, 4.1% of nonfatal overdose participants received medications for opioid use disorder and 6.2% filled prescriptions for naloxone —low percentages despite the medications being gold-standard treatments. And the same group — nonfatal overdose participants — who received medications for opioid use disorder waited on average 72 days from their nonfatal overdose until they actually received medication.
Overall, 89% of people received behavioral health services in the 12 months after their nonfatal overdose. The services lasted for a median of 15 days throughout the year.
“These findings underscore the importance of high-quality care following an overdose, and the opportunities that remain to connect people with needed care. Only 4% of beneficiaries received these medications after experiencing a nonfatal overdose and — for those who did receive the medications — there was a significant delay ranging from 6 to 105 days,” Dora Hughes, MD, activating chief medical officer and acting director of the Center for Clinical Standards and Quality for CMS, said in a statement. “Increasing the number of beneficiaries accessing these medications in a timely manner will save lives.”
