In 2019, over 71,000 Americans died from a drug overdose and, with the onset of the COVID-19 pandemic in 2020, opioid-related deaths have climbed to a new high. As states grapple with the opioid epidemic amid a pandemic, the rising prevalence of other drug use is complicating efforts to treat opioid use disorder and prevent overdose deaths. Recent research suggests that more than 30% of opioid deaths also involved benzodiazepines. In addition, the concurrent use of methamphetamines and opioids doubled from 2011 to 2017. A study using 2016-2017 data reported that approximately half of Medicaid enrollees with opioid use disorder had a comorbid other substance use disorder. Yet, little is known about recent trends in multiple or polysubstance use disorders among Medicaid enrollees or the associated consequences for medical conditions including those common among people with injection drug use. Improving understanding of substance use disorder comorbidity burden can help states target interventions to reduce overdose deaths. With funding from the Medicaid and CHIP Payment and Access Commission (MACPAC), AcademyHealth, in collaboration with the University of Pittsburgh, Ohio State University, West Virginia University, and the University of Maryland, Baltimore County conducted an analysis of four states (MD, OH, WV, PA) participating in the Medicaid Outcomes Distributed Research Network (MODRN). This brief examines the prevalence of diagnoses of polysubstance use disorders, describes the characteristics of Medicaid enrollees with polysubstance use disorders and compares the mental health and medical comorbidities based on the number of unique substance use disorders.
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