Abstract
Medications for opioid use disorder (MOUD) after emergency department (ED) visits for overdose can reduce subsequent overdose deaths, but disparities in receiving MOUD persist in the US. Using national Medicaid claims data from the period 2016-20, we examined racial and ethnic disparities in MOUD initiation after ED visits for opioid overdose. Overall, 6.4 percent of Medicaid ED visits were associated with a claim for MOUD within thirty days. This rate was highest among non-Hispanic White (7.3 percent) patients and lowest among non-Hispanic Black (4.3 percent) and Hispanic (4.9 percent) patients. The adjusted rate of MOUD initiation was 2.5 percentage points lower among Black patients compared with White patients, and this disparity increased nearly twofold between 2016 and 2020. Although policy and clinical efforts to increase MOUD use in the Medicaid population are important, findings suggest that efforts targeting patients from racial and ethnic minority groups may be warranted.