ArticlePharmacoepidemiology and drug safety2026
Identifying Extended-Release Naltrexone Treatment for Opioid Use Disorder in US Medicaid Data.
Article in Pharmacoepidemiology and drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
purposeExtended-release naltrexone (XR-NTX, monthly injection) is used to treat opioid use disorder (OUD). In claims data, XR-NTX may be identified by drug or procedure codes. In the US, Medicaid is a predominant payer of OUD treatment and differences in state Medicaid policies may produce variation in XR-NTX coding. We aimed to describe documentation of XR-NTX in multi-state Medicaid data.
methodsUsing 2016-2019 National Medicaid data (TAF) from 26 states, we identified individuals with an XR-NTX specific drug or procedure code and evidence of OUD during ≥ 5 months continuous Medicaid enrollment (N = 26 169). At the individual's first observed XR-NTX treatment, we described state-level variation in the types of codes, file source, and presence of procedure codes for injection (including nonspecific codes).
resultsAn XR-NTX drug code was the first record of treatment for 98% of patients; this percentage was high in all states except one. Just 25% of patients had a procedure code for injection (XR-NTX specific code or non-specific injection code) during the first treatment with marked variation across states, ranging from 7% to 87%. The percentage of patients with evidence of a second XR-NTX treatment was higher among patients with an injection code at initial treatment (61%) than among patients without an injection code (49%).
conclusionsWe found inconsistent patterns of XR-NTX codes across states indicating claim-based definitions should consider both drug and procedure codes to fully capture XR-NTX service delivery. Multiple definitions should be considered in sensitivity analyses given substantial variability in coding practices across states.
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