{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:57:42Z","timestamp":1784329062529,"version":"3.55.0"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"Importance<\/jats:title>Federal emergency authorities were invoked during the COVID-19 pandemic to expand clinical telehealth for opioid use disorder (OUD).<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the association of the receipt of telehealth services and medications for OUD (MOUD) with fatal drug overdoses before and during the pandemic.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study used exploratory longitudinal data from 2 cohorts (prepandemic cohort: September 1, 2018, to February 29, 2020; pandemic cohort: September 1, 2019, to February 28, 2021) of Medicare Fee-for-Service beneficiaries aged 18 years or older initiating an episode of OUD-related care using Medicare Fee-for-Service data from the Centers for Medicare &amp;amp; Medicaid Services and National Death Index data from the Centers for Disease Control and Prevention. Data analysis was performed from September 19 to October 17, 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Prepandemic vs pandemic cohort demographic, medical, substance use, and psychiatric characteristics.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Receipt of OUD-related telehealth services, receipt of MOUD, and fatal drug overdose.<\/jats:p><\/jats:sec>Results<\/jats:title>The prepandemic cohort comprised 105\u202f162 beneficiaries (58.1% female; 67.6% aged 45-74 years). The pandemic cohort comprised 70\u202f479 beneficiaries (57.1% female; 66.3% aged 45-74 years). The rate of all-cause mortality was higher in the pandemic cohort (99.9 per 1000 beneficiaries; 7041 deaths) than in the prepandemic cohort (76.8 per 1000; 8076 deaths) (P<\/jats:italic>\u2009&amp;lt;\u2009.001). The rate of fatal drug overdoses was higher in the pandemic cohort (5.1 per 1000 beneficiaries; n\u2009=\u2009358) than in the prepandemic cohort (3.7 per 1000; n\u2009=\u2009391) (P<\/jats:italic>\u2009&amp;lt;\u2009.001). The percentage of deaths due to a fatal drug overdose was similar in the prepandemic (4.8%) and pandemic (5.1%) cohorts (P<\/jats:italic>\u2009=\u2009.49). In multivariable analysis of the pandemic cohort, receipt of OUD-related telehealth was associated with a significantly lower adjusted odds ratio (aOR) for fatal drug overdose (aOR, 0.67; 95% CI, 0.48-0.92) as was receipt of MOUD from opioid treatment programs (aOR, 0.41; 95% CI, 0.25-0.68) and receipt of buprenorphine in office-based settings (aOR, 0.62; 95% CI, 0.43-0.91) compared with those not receiving MOUD; receipt of extended-release naltrexone in office-based settings was not associated with lower odds for fatal drug overdose (aOR, 1.16; 95% CI, 0.41-3.26).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cohort study found that, among Medicare beneficiaries initiating OUD-related care during the COVID-19 pandemic, receipt of OUD-related telehealth services was associated with reduced risk for fatal drug overdose, as was receipt of MOUD from opioid treatment programs and receipt of buprenorphine in office-based settings. Strategies to expand provision of MOUD, increase retention in care, and address co-occurring physical and behavioral health conditions are needed.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2023.0310","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T16:53:01Z","timestamp":1680108781000},"page":"508","source":"Crossref","is-referenced-by-count":42,"title":["Association of Receipt of Opioid Use Disorder\u2013Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic"],"prefix":"10.1001","volume":"80","author":[{"given":"Christopher M.","family":"Jones","sequence":"first","affiliation":[{"name":"National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"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":"Centers 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":[{"key":"ybr230001r4"},{"issue":"10","key":"ybr230001r7","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1001\/jamapsychiatry.2022.2284","article-title":"Receipt of telehealth services, receipt and retention of medications for opioid use disorder, and medically treated overdose among beneficiaries before and during the COVID-19 pandemic.","volume":"79","author":"Jones","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"ybr230001r10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00952990.2018.1546862","article-title":"Development of a Cascade of Care for responding to the opioid epidemic.","volume":"45","author":"Williams","year":"2019","journal-title":"Am J Drug Alcohol Abuse"},{"key":"ybr230001r11","volume-title":"Medications for Opioid Use Disorder Save Lives","year":"2019"},{"key":"ybr230001r13","author":"Hedegaard","year":"2021"},{"key":"ybr230001r1","unstructured":"Public health emergency. Determination that a public health emergency exists. US Department of Health and Human Services. January 31, 2020. Accessed February 17, 2023. https:\/\/www.phe.gov\/emergency\/news\/healthactions\/phe\/Pages\/2019-nCoV.aspx"},{"key":"ybr230001r2","unstructured":"COVID-19 disaster declarations. Federal Emergency Management Agency (FEMA). Accessed February 17, 2023. https:\/\/www.fema.gov\/disaster\/coronavirus\/disaster-declarations"},{"key":"ybr230001r3","unstructured":"Medicare payment policies during COVID-19. Centers for Medicare and Medicaid Services. Accessed February 17, 2023. https:\/\/telehealth.hhs.gov\/providers\/billing-and-reimbursement\/medicare-payment-policies-during-covid-19\/"},{"key":"ybr230001r5","unstructured":"Opioid treatment program (OTP) guidance. March 16, 2020. Substance Abuse and Mental Health Services Administration (SAMHSA). Accessed February 17, 2023. https:\/\/www.samhsa.gov\/sites\/default\/files\/otp-guidance-20200316.pdf"},{"key":"ybr230001r6","unstructured":"U.S. Department of Justice\/Drug Enforcement Administration. Dear Registrant: [This letter only addresses the topic of prescribing buprenorphine for maintenance and detoxification treatment.]. Accessed February 17, 2023. https:\/\/www.deadiversion.usdoj.gov\/GDP\/(DEA-DC-022)(DEA068)%20DEA%20SAMHSA%20buprenorphine%20telemedicine%20%20(Final)%20+Esign.pdf"},{"key":"ybr230001r8","unstructured":"Master Beneficiary Summary File (MBSF) Base. Centers for Medicare & Medicaid Services. Research Data Assistance Center. Accessed February 17, 2023. https:\/\/resdac.org\/cms-data\/files\/mbsf-base"},{"key":"ybr230001r9","unstructured":"Master Beneficiary Summary File (MBSF): 27 CCW Chronic Conditions Segment. Centers for Medicare & Medicaid Services. Research Data Assistance Center. Accessed February 17, 2023. https:\/\/resdac.org\/cms-data\/files\/mbsf-27-cc"},{"key":"ybr230001r12","unstructured":"Medications for Opioid Use Disorder: Treatment Improvement Protocol (TIP) 63. Substance Abuse and Mental Health Services Administration (SAMHSA). Updated 2021. Accessed February 17, 2023. https:\/\/store.samhsa.gov\/sites\/default\/files\/pep21-02-01-002.pdf"},{"key":"ybr230001r14","unstructured":"CMS Behavioral Health Strategy. Centers for Medicare and Medicaid Services (CMS). Last modified May 5, 2022. Accessed February 17, 2023. https:\/\/www.cms.gov\/cms-behavioral-health-strategy"},{"key":"ybr230001r15","unstructured":"Overdose Prevention Strategy. US Department of Health and Human Services. Accessed February 17, 2023. https:\/\/www.hhs.gov\/overdose-prevention\/"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2802946\/jamapsychiatry_jones_2023_br_230001_1682621924.80762.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T15:18:38Z","timestamp":1683127118000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2802946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2023.0310","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}