America's Opioid Epidemic and its Effect on the Nation's Commercially-Insured Population
The opioid addiction epidemic is one of America’s foremost health crises. According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), opioids (including prescription opioids and heroin) kill more than 33,000 people annually, which is more than any year on record and more than at the peak of the human immunodeficiency virus (HIV) epidemic.1 Opioid abuse/overdose is considered a leading cause of shortened life expectancy in the U.S.2
The nation’s opioid epidemic reflects a complex set of circumstances. The pattern of opioid prescribing—including dose and duration—and the patient’s risk factors of age, gender and condition are major determinants of whether a patient becomes dependent.3 As cases of opioid use disorder skyrocket among the commercially insured, this data sheds new light on the specific prescribing practices and use that pose a significant threat to patient health.
Twenty-one percent of Blue Cross and Blue Shield (BCBS) commercially insured members filled at least one opioid prescription in 2015. Data also shows BCBS members with an opioid use disorder diagnosis spiked 493% over a seven-year period. The report analyzes medical claims from BCBS commercially insured members diagnosed with opioid abuse disorder from 2010 through 2016.4 Specifically, it looks at the degree of prescription opioid use—in terms of the dose and duration of opioid prescriptions—and how this relates to opioid dependence.
Key Findings
Patients who fill high-dosage opioid prescriptions have much higher rates of opioid use disorder than patients who fill low-dose prescriptions across both short and long duration regimens.
Key Findings
Women aged 45 and older have higher rates of opioid use disorder than men. Males younger than 45 have higher rates of opioid use disorder than females. Females fill more opioid prescriptions than males across all age groups.
Key Findings
Long-duration prescription opioid use and opioid use disorder align geographically, with the highest rates in the South and the Appalachian Region.
Key Findings
The 65% rate of increase in the use of medication assisted treatments does not match the 493% rate of increase in opioid use disorder diagnoses from 2010 through 2016.
Key Findings
While opioids are more likely to be prescribed for select acute short-term conditions, prescriptions for chronic conditions are twice as likely to extend past 45 days and three times as likely to reach a “high dose” level which, as noted above, leads to higher levels of opioid use disorder.
ENDNOTES
- Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016.
- http://www.npr.org/sections/health-shots/2016/12/08/504667607/life-expectancy-in-u-s-drops-for-first-time-in-decades-report-finds.
- Dose and duration was calculated from claims data by Axial Healthcare. See Methodology Notes.
- Members diagnosed with cancer or who were undergoing palliative or hospice care were excluded from this analysis.
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