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A brand new research has discovered that extending state Medicaid protection didn’t improve the chance of prescription opioid or benzodiazepine misuse amongst individuals who use medication.
Individuals who inject medication and expertise poverty are at an elevated danger of well being situations reminiscent of HIV and tuberculosis, in addition to overdose. Whereas this inhabitants stands to profit from well being companies supplied via Medicaid enlargement, prior reviews have claimed that extending Medicaid protection to this group encourages misuse of opioids.
A brand new research led by researchers at Boston College Faculty of Public Well being (BUSPH) and Emory College Rollins Faculty of Public Well being (Rollins SPH) vigorously refutes this declare.
Printed within the Journal of Substance Use and Dependancy Remedy, the research examined federal information on well being and drug use amongst practically 20,000 individuals who inject medication and are low-income within the US, and located no affiliation between Medicaid enlargement and misuse of prescription opioids or benzodiazepines, medication usually prescribed for anxiousness or insomnia.
Importantly, these findings current real-world information that disprove narratives claiming that Medicaid enlargement has fueled the longstanding opioid disaster in America by rising entry to low-cost prescription opioids diverted for non-prescribed use.
The brand new research takes under consideration state-level opioid traits and individual-level traits—reminiscent of race, well being standing, and insurance coverage protection—that may have an effect on how and to what extent individuals might entry and make the most of opioids. The researchers noticed no improve in non-prescribed opioid use amongst low-income individuals who use medication, a clinically and socially susceptible inhabitants for which expanded Medicaid protection might fulfill unmet and dear well being wants.
If Congress advances a price range blueprint that cuts funding to Medicaid—which serves greater than 1 in 5 individuals within the US—these important wants might stay unmet.
“Our findings provide strong empirical data that indicate there is no link between Medicaid expansion and non-prescribed use of opioids and benzodiazepines,” says research lead and corresponding writer Dr. Danielle Haley, assistant professor of group well being sciences at BUSPH. “This insight allows us to focus on what we do know from the literature about Medicaid expansion—that there are potential life-saving benefits for people who use drugs.”
Whereas the sooner phases of the opioid disaster had been pushed by an overprescribing of opioid ache treatment, the US has made concerted efforts to handle this drawback, Dr. Haley provides.
“The timing of the opioid overdose crisis far predates the expansion of Medicaid, which began in 2014 under the Affordable Care Act,” she says. “What has really driven overdose deaths over the last several years are synthetic opioids, such as fentanyl. We need to support policies that ensure individuals have access to appropriate pain medication while advancing best practices for prescribing these drugs.”
For the research, Dr. Haley and colleagues from Rollins SPH, Johns Hopkins Bloomberg Faculty of Public Well being, and the Florida State College Faculty of Nursing utilized three waves of federal well being information in 2012, 2015, and 2018, amongst 19,728 individuals who inject medication ages 18–64 who had been enrolled in Medicaid with an earnings of 138 p.c of the federal poverty line or beneath. The members resided in 13 states, together with 10 that expanded Medicaid and three that didn’t increase Medicaid.
After accounting for quite a few components, reminiscent of race/ethnicity, earnings, employment, well being situations, and entry to drug monitoring applications, they noticed no connection between Medicaid enlargement and non-prescribed use of opioids or benzodiazepines amongst all the members—nor any affiliation primarily based particularly on race/ethnicity or HIV standing.
The researchers hope the brand new findings assist scale back persistent stigmas and structural inequities related to opioid use amongst individuals who inject medication.
“FDA-approved medications for opioid use disorder are very effective in treating opioid use disorder, and also reducing overdose,” Dr. Haley says. “There are multiple issues that still need to be addressed, but having health insurance is a critical gateway for people to access these life-saving services. It is important to address the barriers that Medicaid enrollees who inject drugs encounter in actually receiving the treatment and services their insurance provides.”
Extra data:
Danielle F. Haley et al, Medicaid enlargement shouldn’t be related to prescription opioid and benzodiazepine misuse amongst individuals who inject medication: A serial cross-sectional observational research utilizing generalized difference-in-differences fashions, Journal of Substance Use and Dependancy Remedy (2025). DOI: 10.1016/j.josat.2025.209639
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Research: Medicaid enlargement doesn’t result in improve in non-prescribed drug use (2025, March 11)
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