title: High mortality rate of unintentional poisoning due to prescription opioids in adults enrolled in Medicaid compared to those not enrolled in Medicaid in Montana.
abstract: BACKGROUND
  Unintentional death due to prescription drug-related poisoning has been a growing problem nationally. Some sub-populations have been shown to be at higher risk than others.
  
  
  METHODS
  In 2014, we matched death records to Medicaid eligibility files to determine enrollment status at the time of unintentional death from prescription opioid poisoning from 2003 to 2012 in Montana. Medicaid prescription claims for decedents were used to assess prescribing patterns and time between refills.
  
  
  RESULTS
  The age-adjusted mortality rate per 100,000 from opioid poisoning for adults aged 18-64 years and enrolled in Medicaid at the time of death was eight times higher than the rate for non-Medicaid Montana adults (38.2 [95% CI (30.7-45.7)] vs. 4.7 [95% CI (4.1-5.3)]). Twenty-eight percent of unintentional poisoning deaths during this time frame were among Medicaid members. Only 33% of the Medicaid decedents had a claim for an opioid prescription during the month before their death.
  
  
  CONCLUSIONS
  Our findings suggest that more needs to be done to address prescription opioid use in Montana. Adults enrolled in Medicaid continue to be at high risk for prescription opioid unintentional poisoning deaths. Data on prescribing practices suggest that there are opportunities to intervene and provide education on use of opioid medications for Medicaid members and prescribing providers.
authors.affiliation: Injury Prevention Program, Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Jessie C
authors.initials: JC
authors.lastname: Fernandes
authors.affiliation: Montana Medicaid Program, Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: David
authors.initials: D
authors.lastname: Campana
authors.affiliation: Injury Prevention Program, Montana Department of Public Health and Human Services, Helena, MT, United States. Electronic address: tharwell@mt.gov.
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
authors.affiliation: Injury Prevention Program, Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000506:poisoning*; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009009:Montana / Q000453:epidemiology; D011041:Poisoning / Q000401:mortality*; D055553:Prescription Drugs / Q000506:poisoning*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs
keywords: Deaths; Epidemiology; Medicaid; Opioid; Prescription drug