A Penn Medicine study found that Medicaid expansion helped increase access to medication for opioid use disorder, despite some existing limitations to widespread access.
The study, led by Perelman School of Medicine fellow Utsha Khatri, found that Medicaid expansion correlates to significant improvements in accessing medication for OUD. Previous clinical studies have found that medications for opioid use disorder result in more effective outcomes for retention in treatment, reduced illicit opioid use, decreased opioid-related overdose rates, and serious acute care.
Studies show that medication access is significantly more difficult for people who were formerly incarcerated, recently arrested, or are currently on parole. Of the 3,209,691 adults with OUD from 2008 to 2017, 21% were referred by a criminal justice agency, Penn Medicine News reported. After Medicaid expansion, the study found that among people with OUD who were referred by a criminal justice agency, the proportion of people receiving medicine for OUD jumped from 6.3% in 2008 to 16.5%.
“Medicaid alone will not entirely close gaps in care between people with and without criminal justice involvement. Additional work is needed to understand key drivers of the persistent disparities we identified,” senior author Tyler Winkelman, Co-Director of the Health, Homelessness, and Criminal Justice lab at the Hennepin Healthcare Research Institute, told Penn Medicine News.
The study's researchers told Penn Medicine News that a stigma against incarcerated people may have an influence on the kinds of treatment plans offered by treatment providers. To combat this stigma, additional policy changes, such as unrestricted access to medications for OUD, may be necessary in order to effectively combat existing disparities in the healthcare system, Khatri told Penn Medicine News.
Philadelphia is one of the most affected cities by the opioid epidemic, with 80% of the 1,150 deaths from drug overdoses attributed to opioids in 2017.