Table 2 –
Trends in opioid overdose risk of Medicaid beneficiaries 2014 to 2019, by opioid type and beneficiary characteristics.
| Any Opioid Overdose | Heroin/Synthetic Opioid Overdosea | Prescription Opioid Overdoseb | |
|---|---|---|---|
|
| |||
| Characteristics | Rate Ratio (95% CI)c | Rate Ratio (95% CI)c | Rate Ratio (95% CI)c |
|
| |||
| Overall | 3.56 (3.23, 3.93) | 4.39 (3.89, 4.96) | 2.03 (1.76, 2.35) |
|
| |||
| Age | |||
| 12–24 | 1.94 (1.40, 2.68) | 2.11 (1.41, 3.16) | 1.32 (0.81, 2.16) |
| 25–39 | 3.87 (3.35, 4.47) | 4.10 (3.45, 4.87) | 2.62 (2.05, 3.34) |
| 40–55 | 3.72 (3.17, 4.36) | 4.99 (4.04, 6.16) | 2.13 (1.70, 2.66) |
| 56–64 | 3.15 (2.35, 4.22) | 7.18 (4.73, 0.90) | 1.32 (0.92, 1.89) |
|
| |||
| Racial/Ethnic Group | |||
| White | 3.27 (2.89, 3.69) | 3.89 (3.34, 4.53) | 1.97 (1.63, 2.39) |
| Black | 4.81 (3.90, 5.93) | 7.70 (5.86, 10.11) | 2.30 (1.73, 3.06) |
| Hispanic | 3.19 (2.19, 4.64) | 3.65 (2.30, 5.81) | 1.98 (1.09, 3.59) |
| Other/Unknown | 2.51 (1.84, 3.43) | 2.68 (1.78, 4.02) | 1.96 (1.42, 2.72) |
|
| |||
| Sex | |||
| Female | 3.18 (2.74, 3.68) | 4.20 (3.47, 5.09) | 1.81 (1.47, 2.23) |
| Male | 3.81 (3.35, 4.34) | 4.42 (3.77, 5.18) | 2.21 (1.79, 2.71) |
|
| |||
| SUD Comorbidities | |||
| Alcohol Use Disorder | 2.94 (2.48, 3.47) | 4.18 (3.39, 5.14) | 1.64 (1.29, 2.10) |
| Cannabis Use Disorder | 3.60 (2.86, 4.54) | 5.10 (3.76, 6.92) | 1.96 (1.42, 2.72) |
| Benzodiazepine Use Disorder | 2.42 (1.89, 3.10) | 3.13 (2.29, 4.29) | 1.62 (1.12, 2.35) |
| Opioid Use Disorder | 2.10 (1.87, 2.35) | 2.64 (2.30, 3.03) | 1.96 (1.42, 2.72) |
|
| |||
| Psychiatric | |||
| Schizophrenia | 2.75 (2.10, 3.62) | 3.15 (2.19, 4.53) | 1.96 (1.42, 2.72) |
| Bipolar Disorder | 2.71 (2.26, 3.24) | 3.72 (2.95, 4.70) | 1.67 (1.28, 2.17) |
| Major Depression | 2.13 (1.79, 2.53) | 3.09 (2.44, 3.93) | 1.24 (0.99, 1.55) |
|
| |||
| Medical Comorbidities | |||
| HIV | 3.76 (2.32, 6.10) | 6.81 (3.62, 2.82) | 2.12 (1.12, 4.03) |
| Hepatitis C | 2.96 (2.41, 3.64) | 3.44 (2.73, 4.35) | 2.24 (1.56, 3.22) |
| Diabetes | 3.91 (3.13, 4.88) | 8.43 (5.98, 1.87) | 1.57 (1.19, 2.08) |
| Heart Failure | 2.04 (1.55, 2.69) | 3.16 (2.19, 4.57) | 1.26 (0.86, 1.87) |
| Cerebrovascular Disease | 2.06 (1.45, 2.95) | 3.33 (2.05, 5.40) | 1.31 (0.83, 2.05) |
| Chronic Pain Diagnosis | 3.08 (2.58, 3.69) | 4.93 (3.88, 6.26) | 1.81 (1.43, 2.28) |
| Asthma | 2.64 (2.13, 3.26) | 3.92 (2.96, 5.20) | 1.61 (1.22, 2.14) |
| COPD | 2.11 (1.53, 2.92) | 3.23 (1.98, 5.26) | 1.34 (0.92, 1.96) |
| Pneumonia | 2.53 (2.01, 3.18) | 4.26 (3.04, 5.98) | 1.96 (1.42, 2.72) |
| Sleep Apnea | 1.77 (1.11, 2.80) | 3.71 (1.72, 8.02) | 1.24 (0.69, 2.20) |
ICD-9 codes for synthetic opioids did not exist in 2014 (under ICD-9) and were captured as other opioids. However, our analyses of drug seizures in NJ show that there were only 1.7 fentanyl seizures per 100 heroin seizures in 2014, indicating that heroin adulteration with fentanyl was relatively uncommon.
Prescription opioids include methadone or other natural/semisynthetic opioids. Individuals with overdoses involving both heroin/synthetic opioid and methadone/other natural opioid during the year were assigned to the heroin/synthetic category. Beneficiaries in this column may have also had overdose caused by methadone or other natural/semi-synthetic opioids.
Rate ratios compare risk of opioid overdose in 2019 compared to 2014.