Objective: This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain.
Method: The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life.
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The participant will interpret the association found between individuals dying of opioid-related causes and receipt of services related to drug use and mental disorders in the last year of life.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: June 1, 2018
End Date: May 31, 2020
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Service Use Preceding Opioid-Related Fatality
Authors: Mark Olfson, M.D., M.P.H., Melanie Wall, Ph.D., Shuai Wang, Ph.D., Stephen Crystal, Ph.D., Carlos Blanco, M.D., Ph.D.
Affiliations: From the Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York (M.O., M.W.); Quartet Health, New York (S.W.); the Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick (S.C.); and the Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Md. (C.B.).
Disclosures: Dr. Wang is currently employed by Quartet, which is not related to the subject of the article. Dr. Blanco owns stock in Eli Lilly, Sanofi, and General Electric. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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