Buprenorphine Dispensing Following Medicaid Expansion Amid Unwinding in North Carolina

Among Medicaid-insured adults in North Carolina with buprenorphine dispensing before the end of Medicaid continuous coverage requirement in June 2023, was Medicaid expansion in December 2023 associated with changes in buprenorphine dispensing?In this cross-sectional study of prescription dispensing among 15 064 patients, buprenorphine dispensing decreased between June and November 2023 among individuals in North Carolina and South Carolina, which did not expand Medicaid. Medicaid expansion was associated with slowing of this decline in North Carolina compared with South Carolina.The findings suggest that North Carolina’s Medicaid expansion may have partially mitigated the adverse changes in buprenorphine dispensing associated with the end of Medicaid continuous coverage requirement.

Corresponding Author: Joanne Constantine, PhD, Department of Health Policy and Management, School of Public Health, State University of New York (SUNY) Downstate Health Sciences University, 450 Clarkson Ave, MSC 43, Brooklyn, NY 11203 (Joanne.Constantin@downstate.edu).

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