A recent analysis report published on the University of Pennsylvania’s Leonard Davis Institute of Health Economics website and authored by Julia Hinckley discussed a recently published research study comparing overdose risk, hospitalization, and use of substance use disorder treatment among those enrolled in Medicaid, with and without autism.
Specifically, the study was published in the peer-reviewed journal Autism Research and examined Medicaid claims from 2016 to 2020 for more than 50,000 people diagnosed with autism and substance use disorder (SUD) and compared them with a control group of beneficiaries with SUD only. Currently in the U.S., Medicaid covers care for people with both autism and substance use disorder, but states often administer the two types of services separately.
The study found that among people with SUD, those with autism had significantly higher rates of overdose, hospitalization, and concurrent benzodiazepine and opioid use than those without autism. Over four years, about 13% of the autistic group experienced an overdose, compared with 9% of the comparison group; 49% were hospitalized, compared with 29%. Benzodiazepine use was also nearly twice as common in the autistic group. The researchers suggest that these disparities may be related to benzodiazepine use, barriers to effective SUD treatment, or the life stressors autistic people experience.
In addition, it was found that Medicaid enrollees with both autism and SUD used nearly all types of SUD services less often than enrollees with SUD alone. Medication-assisted treatment was used more than three times as often in the group without autism, although psychotherapy was among the few services used more often by the autistic group. The authors suggest that the gap may reflect a lack of treatments adapted for autistic people, limited clinician training, and the separate administration of autism and SUD services.
“Rising rates of SUD among people with autism, along with high rates of overdose and hospitalization, highlight the need to develop evidence-based treatment options that address the complex needs of people with co-occurring autism and SUD,” wrote Hinckley.
According to the study’s authors, these research findings demonstrate the need for integrative, evidence-based autism-tailored SUD service solutions.