The following is a summary of ““Catching Chain” With Medicaid: The Impact of Medicaid Access on Opioid Overdose Mortality in Adults Released From State Detention,” published in the June 2024 issue of Psychiatry by Blumberger et al.

Researchers conducted a retrospective study investigating the impact of a 2017 Pennsylvania policy change, which allowed Medicaid coverage to be suspended instead of terminated during incarceration, on the opioid overdose mortality risk (OOMR) among adults released from Pennsylvania prisons.

They utilized administrative data from the Pennsylvania Department of Corrections, including adult participants (aged 18 or older) diagnosed with opioid use disorder (OUD) who were released from prison (2015 or 2018). Death certificate information was used to compare the rates of OOMR within the first year of release, both before and after the policy change regarding Medicaid suspension. Bivariate analyses were used to evaluate demographic characteristics, treatment details, and cause of death. Multivariable logistic regression analyses investigated the potential association between qualifying for Medicaid suspension and post-release mortality.

The analysis revealed that qualifying for Medicaid suspension was not statistically linked to a reduced OOMR (OR = 0.82, 95% CI [0.47–1.46]) or overall mortality (OR = 1.02, 95% CI [0.67–1.57]) within 1 year of release for individuals with OUD.  Additionally, the study found an increased risk of OOMR after release from prison, 0.6% to 1.7%, P-value<0.0001 (2015 to 2018). The rise was particularly evident for deaths involving synthetic narcotics (from 57.1% to 83.1%; P-value<0.001). Drug overdose remained the leading cause of death (74.0%) within the first year following release.

Investigators concluded that the ineffectiveness of Medicaid suspension highlights the need for more targeted overdose prevention strategies for individuals with OUD leaving prison, exploring the impact of broader post-release insurance access.

Source: onlinelibrary.wiley.com/doi/10.1176/appi.prcp.20230080