{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:10:43Z","timestamp":1790014243925,"version":"4.0.1"},"reference-count":57,"publisher":"Weston Medical Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Objective: This narrative review aims to describe changes in naloxone dispensing and availability rates between states that have implemented Medicaid expansion compared to those that have not.Design: The review searched four databases (January 2014-March 2025), using predefined inclusion and exclusion criteria and dual independent screening with consensus resolution; data extraction included study design, population, data sources, metrics of naloxone access, main findings, and limitations.Results: Four articles met the inclusion criteria. Two studies found that Medicaid expansion was associated with an increase in naloxone prescriptions by 38-78 per state per quarter and Medicaid-paid prescriptions by 14.21-140.8 per 100,000 individuals per quarter. A third secret shopper study found that naloxone nasal spray availability was higher at pharmacies in states that implemented Medicaid expansion compared to those that did not. In contrast, one study found that Medicaid expansion was not significantly associated with an increase in naloxone prescriptions.Conclusions: Few studies have explored the association between Medicaid expansion and improved access to naloxone. Three of four studies found that expansion was associated with increased naloxone prescriptions and pharmacy availability. Future studies should incorporate standardized measures to assess the impact of Medicaid expansion on naloxone dispensing across a greater number of states and utilize longitudinal data to evaluate its impact over time.<\/jats:p>","DOI":"10.5055\/jom.1011","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:26:51Z","timestamp":1790011611000},"page":"415-424","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Medicaid expansion on naloxone dispensing: A narrative review"],"prefix":"10.5055","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7316-6879","authenticated-orcid":false,"given":"Suhanee","family":"Mitragotri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Marley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delesha","family":"Carpenter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3008","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"105702","unstructured":"CDC: Understanding the opioid overdose epidemic. 2024. 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J Pain Palliative Care Pharmacother. 2015; 29(2): 133-139. DOI: 10.3109\/15360288.2015.1037530.","DOI":"10.3109\/15360288.2015.1037530"},{"key":"105709","doi-asserted-by":"crossref","unstructured":"Ali SA, Shell J, Harris R, et al.: Naloxone prescriptions among patients with a substance use disorder and a positive fentanyl urine drug screen presenting to the emergency department. Harm Reduct J. 2023; 20(1): 144. DOI: 10.1186\/s12954-023-00878-8.","DOI":"10.1186\/s12954-023-00878-8"},{"key":"105710","doi-asserted-by":"crossref","unstructured":"Behar E, Rowe C, Santos GM, et al.: Acceptability of naloxone co-prescription among primary care providers treating patients on long-term opioid therapy for pain. J Gen Intern Med. 2017; 32(3): 291-295. DOI: 10.1007\/s11606-016-3911-z.","DOI":"10.1007\/s11606-016-3911-z"},{"key":"105711","unstructured":"CDC: Naloxone dispensing rate maps: Overdose prevention. 2024. 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DOI: 10.1111\/1475-6773.13920.","DOI":"10.1111\/1475-6773.13920"},{"key":"105719","doi-asserted-by":"crossref","unstructured":"Presskreischer R, Mojtabai R, Mauro C, et al.: Medicaid expansion and medications to treat opioid use disorder in outpatient specialty care from 2010 to 2020. J Subst Use Addict Treat. 2025; 168: 209568. DOI: 10.1016\/j.josat.2024.209568.","DOI":"10.1016\/j.josat.2024.209568"},{"key":"105720","doi-asserted-by":"crossref","unstructured":"Swartz N, Odayappan S, Chatterjee A, et al.: Impact of Medicaid expansion on inclusion of medications for opioid use disorder in homeless adults' treatment plans. J Subst Use Addict Treat. 2023; 152: 209059. DOI: 10.1016\/j.josat.2023.209059.","DOI":"10.1016\/j.josat.2023.209059"},{"key":"105721","doi-asserted-by":"crossref","unstructured":"Johnson NL, Choi S, Herrera CN: Black clients in expansion states who used opioids were more likely to access medication for opioid use disorder after ACA implementation. 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DOI: 10.1111\/1475-6773.13266.","DOI":"10.1111\/1475-6773.13266"},{"key":"105725","doi-asserted-by":"crossref","unstructured":"Frank RG, Fry CE: The impact of expanded Medicaid eligibility on access to naloxone. Addiction. 2019; 114(9): 1567-1574. DOI: 10.1111\/add.14634.","DOI":"10.1111\/add.14634"},{"key":"105726","unstructured":"Baptiste-Roberts K, Hossain M: Socioeconomic disparities and self-reported substance abuse-related problems. Addict Health. 2018; 10(2): 112-122. DOI: 10.22122\/ahj.v10i2.561."},{"key":"105727","doi-asserted-by":"crossref","unstructured":"Peet ED, Powell D, Pacula RL: Trends in out-of-pocket costs for naloxone by drug brand and payer in the US, 2010-2018. JAMA Health Forum. 2022; 3(8): e222663. DOI: 10.1001\/jamahealthforum.2022.2663.","DOI":"10.1001\/jamahealthforum.2022.2663"},{"key":"105728","doi-asserted-by":"crossref","unstructured":"Jiang X, Strahan AE, Zhang K, et al.: Trends in out-of-pocket costs for and characteristics of pharmacy-dispensed naloxone by payer type. JAMA. 2024; 331(8): 700-702. DOI: 10.1001\/jama.2023.26969.","DOI":"10.1001\/jama.2023.26969"},{"key":"105729","unstructured":"The Network for Public Health Law: Naloxone insurance coverage mandates. Available at https:\/\/www.networkforphl.org\/wp-content\/uploads\/2023\/05\/Naloxone-Insurance-Coverage-Mandates.pdf. Accessed April 1, 2025."},{"key":"105730","unstructured":"Addiction Policy Forum: Medicaid access to naloxone: A look at state policies to removing barriers to access. 2024. Available at https:\/\/www.addictionpolicy.org\/post\/medicaidaccess-to-naloxone-a-look-at-state-policies-to-removing-barriers-to-access. 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