- Veterans enrolled in both the Veterans Administration (VA) health system and Medicare Part D who receive opioids from both sources are 2 to 3 times more likely to die from an unintentional opioid overdose than those who received opioids from a VA or non-VA provider alone.
Why this matters
- Many VA enrollees use both VA and non-VA providers, a dual-system care approach that complicates the monitoring of potential unsafe opioid use.
- This nested case-control study evaluated all veterans enrolled in VA health system and Medicare Part D who filled ≥1 opioid prescription from either system.
- 215 case patients who died of a prescription opioid overdose in 2012 or 2013 were matched with 833 living control patients.
- Funding: US Department of Veterans Affairs.
- Dual users (aOR, 3.53; P<.001 or part d only users p>=.002) vs those who received opioids from VA only had significantly higher odds of death from prescription opioid overdose.
- Dual users vs part D only users had significantly higher odds of death from prescription opioid overdose (aOR, 1.83; P=.005).
- Reliance on death certificate data.
- Findings not generalizable to patients whose overdose deaths were intentional or a result of illicit opioids.
Coauthored with Antara Ghosh, PhD