Federal study examines care following nonfatal overdose among Medicare beneficiaries; Identifies effective interventions and gaps in care

June 18, 2024
These findings contribute to the growing body of research showing that while MOUD and overdose reversal medications save lives, they are rarely incorporated into care following an overdose.

Researchers from the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institutes of Health’s (NIH) National Institute on Drug Abuse (NIDA), Centers for Medicare & Medicaid Services (CMS), and the Centers for Disease Control and Prevention (CDC) found that among a cohort of 137,000 Medicare beneficiaries who experienced a nonfatal overdose in 2020, almost 24,000 (17.4%) experienced a subsequent nonfatal overdose, and about 1,300 (1%) died from overdose in the following year. Results were published in JAMA Internal Medicine, identifying both effective interventions and significant gaps in care.

The study identifies effective, lifesaving interventions following initial nonfatal overdoses. The odds of dying from a subsequent lethal overdose decreased among cohort members who received methadone (58% lower odds), buprenorphine (52% lower odds), or behavioral health assessment or crisis services (75% lower odds). The risk of overdose mortality among those who filled a prescription for naloxone was also reduced by 30%.

However, significant gaps in care were also noted. Only 4.1% of the cohort received medications for opioid use disorder (MOUD), and only 6.2% filled a prescription for naloxone, commonly known as Narcan, despite these being gold-standard interventions. Beneficiaries receiving MOUD waited a mean of 72 days between their nonfatal overdose and receiving medication.

Overall, 89% of beneficiaries in the cohort received behavioral health services in the 12 months following their nonfatal overdose for a median duration of 15 days throughout the year.

NIH release