{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:39:17Z","timestamp":1792247957560,"version":"4.4.0"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:sec id=\"ab-ioi240032-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Recognizing and providing services to individuals at highest risk for drug overdose are paramount to addressing the drug overdose crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine receipt of medications for opioid use disorder (MOUD), naloxone, and behavioral health services in the 12 months after an index nonfatal drug overdose and the association between receipt of these interventions and fatal drug overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>\n                      This cohort study was conducted in the US from January 2020 to December 2021 using claims, demographic, mortality, and other data from the Centers for Medicare &amp;amp;amp; Medicaid Services, the Centers for Disease Control and Prevention, and other sources. The cohort comprised Medicare fee-for-service beneficiaries aged 18 years or older with\n                      <jats:italic>International Statistical Classification of Diseases, Tenth Revision, Clinical Modification<\/jats:italic>\n                      codes for a nonfatal drug overdose. Data analysis was performed from February to November 2023.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Demographic and clinical characteristics, substance use disorder, and psychiatric comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Receipt of MOUD, naloxone, and behavioral health services as well as subsequent nonfatal and fatal drug overdoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort consisted of 136\u202f762 Medicare beneficiaries (80\u202f140 females [58.6%]; mean (SD) age of 68.2 [15.0] years) who experienced an index nonfatal drug overdose in 2020. The majority of individuals had Hispanic (5.8%), non-Hispanic Black (10.9%), and non-Hispanic White (78.8%) race and ethnicity and lived in metropolitan areas (78.9%). In the 12 months after their index nonfatal drug overdose, 23\u202f815 beneficiaries (17.4%) experienced at least 1 subsequent nonfatal drug overdose and 1323 (1.0%) died of a fatal drug overdose. Opioids were involved in 72.2% of fatal drug overdoses. Among the cohort, 5556 (4.1%) received any MOUD and 8530 (6.2%) filled a naloxone prescription in the 12 months after the index nonfatal drug overdose. Filling a naloxone prescription (adjusted odds ratio [AOR], 0.70; 95% CI, 0.56-0.89), each percentage of days receiving methadone (AOR, 0.98; 95% CI, 0.98-0.99) or buprenorphine (AOR, 0.99; 95% CI, 0.98-0.99), and receiving behavioral health assessment or crisis services (AOR, 0.25; 95% CI, 0.22-0.28) were all associated with reduced adjusted odds of fatal drug overdose in the 12 months after the index nonfatal drug overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi240032-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study found that, despite their known association with reduced risk of a fatal drug overdose, only a small percentage of Medicare beneficiaries received MOUD or filled a naloxone prescription in the 12 months after a nonfatal drug overdose. Efforts to improve access to behavioral health services; MOUD; and overdose-prevention strategies, such as prescribing naloxone and linking individuals to community-based health care settings for ongoing care, are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamainternmed.2024.1733","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T11:34:03Z","timestamp":1718624043000},"page":"954","source":"Crossref","is-referenced-by-count":25,"title":["Overdose, Behavioral Health Services, and Medications for Opioid Use Disorder After a Nonfatal Overdose"],"prefix":"10.1001","volume":"184","author":[{"given":"Christopher M.","family":"Jones","sequence":"first","affiliation":[{"name":"Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Shoff","sequence":"additional","affiliation":[{"name":"Office of the Administrator, Centers for Medicare & Medicaid Services, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Blanco","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan L.","family":"Losby","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari M.","family":"Ling","sequence":"additional","affiliation":[{"name":"Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson M.","family":"Compton","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"11","key":"ioi240032r2","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1001\/jamapsychiatry.2020.1045","article-title":"Risks of mortality following nonfatal intentional and unintentional opioid overdoses.","volume":"77","author":"Olfson","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"ioi240032r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.107923","article-title":"The role of substance use disorders in experiencing a repeat opioid overdose, and substance use treatment patterns among patients with a non-fatal opioid overdose.","volume":"209","author":"Karmali","year":"2020","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"ioi240032r4","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.amepre.2020.02.012","article-title":"Mortality following nonfatal opioid and sedative\/hypnotic drug overdose.","volume":"59","author":"Goldman-Mellor","year":"2020","journal-title":"Am J Prev Med"},{"issue":"8","key":"ioi240032r5","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1001\/jamapsychiatry.2018.1471","article-title":"Causes of death after nonfatal opioid overdose.","volume":"75","author":"Olfson","year":"2018","journal-title":"JAMA Psychiatry"},{"issue":"187","key":"ioi240032r6","first-page":"1","article-title":"National Hospital Care Survey Demonstration Projects: mortality following nonfatal opioid overdose visits to the emergency department.","volume":"187","author":"Spencer","year":"2023","journal-title":"Natl Health Stat Report"},{"issue":"3","key":"ioi240032r7","doi-asserted-by":"publisher","first-page":"137","DOI":"10.7326\/M17-3107","article-title":"Medication for opioid use disorder after nonfatal opioid overdose and association mortality: a cohort study.","volume":"169","author":"Larochelle","year":"2018","journal-title":"Ann Intern Med"},{"key":"ioi240032r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106820","article-title":"Naloxone dispensing among the commercially insured population in the United States from 2015 to 2018.","volume":"153","author":"Dunphy","year":"2021","journal-title":"Prev Med"},{"issue":"29","key":"ioi240032r22","doi-asserted-by":"publisher","first-page":"940","DOI":"10.15585\/mmwr.mm7129e2","article-title":"Vital signs: drug overdose deaths, by selected sociodemographic and social determinants of health characteristics - 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