Opioid Epidemic Grows as Alabama Ranks First Nationally Having More Opioid Prescriptions than People

BIRMINGHAM – Blue Cross and Blue Shield of Alabama is taking action to help address the opioid epidemic in Alabama.

According to the Centers for Disease Control and Prevention (CDC), Alabama ranks highest in the nation as having more opioid prescriptions than people with Alabama physicians writing an alarming 5.8 million prescriptions for opioids in 2015. Alabama also ranks number one as the highest prescribing state in the nation for opioid pain reliever prescriptions, according to the CDC.

A new national report, “America’s Opioid Epidemic and Its Effect on the Nation’s Commercially Insured Population,” represents a comprehensive study of national medical claims from Blue Cross and Blue Shield (BCBS) members using opioid painkillers, as well as those diagnosed with opioid use disorder over a seven-year period.*

This new study by the Blue Cross Blue Shield Association (BCBSA) reports that:

In Alabama,

  • 26 percent of Blue Cross and Blue Shield of Alabama’s commercially insured members filled at least one opioid prescription in 2015, compared to 21 percent nationally.
  • 6.5 percent of our members were on a long-duration opioid regimen in 2015, compared to 3.8 percent nationally.
  • 16.4 per 1,000 members were diagnosed with opioid use disorder in Alabama in 2016, double that of 8.3 nationally.
  • 29 percent of our members with opioid use disorder received medication-assisted therapy in 2016, compared to 37 percent nationally.


  • Opioid use disorder diagnoses among BCBS commercially insured members spiked 493 percent from 2010 through 2016.
  • Among those 45 and older, women have a higher rate of opioid use disorder than do men. Among people younger than 45, men have higher rates of opioid use disorder than women. Women fill more opioid prescriptions than males across all age groups.
  • Long-duration prescription opioid use and opioid use disorder overlap by region, with the highest rates in the South and the Appalachian Region.
  • The 65 percent rate of increase in the use of medication-assisted treatments lags behind the 492 percent rate of increase in opioid use disorder diagnoses from 2010 through 2016.
  • States that have experienced the greatest growth in the use of medication-assisted treatments are not necessarily the areas most impacted by opioid use disorders. High rates of treatment relative to opioid use disorder occur in New England, and lower rates occur in the South and parts of the Midwest.

“We recognize that it’s crucial for us to be a proactive partner in the fight against the opioid epidemic in Alabama,” said Dr. Anne Schmidt, Medical Director for Blue Cross and Blue Shield of Alabama. “We strongly support best practices and are collaborating with primary care doctors to appropriately apply recommendations and guidelines from the CDC.”

Blue Cross and Blue Shield of Alabama is taking action to prevent opioid misuse by working in three primary areas:

  1. Promoting the health and safety of Alabamians through public awareness and education of opioid risk by partnering with local and state agencies including the Governor’s Council on Opioid Misuse and Addiction, the Alabama Department of Public Health, and local awareness groups and coalitions.
  2. Supporting appropriate prescribing of opioids for pain management by providing CDC treatment guidelines to primary care physicians and offering medication-assisted treatment options for members with opioid use disorder.
  3. Encouraging and supporting public outreach initiatives to prevent prescription opioid misuse, abuse, fraud and diversion. This also includes supporting and promoting “National Drug Take-Back Day” which provides free, anonymous collection of unwanted and expired medications.

The BCBS Health IndexSM identifies substance use disorder as the fifth most impactful condition affecting the health of commercially insured members in the U.S. In Alabama, the results are similar with substance use disorder ranked as the fifth most prevailing health condition.

This is the thirteenth study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care. For more information, visit www.bcbs.com/healthofamerica.

*Members diagnosed with cancer or who were undergoing palliative or hospice care were excluded from this analysis.

About Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama has insured Alabamians for 81 years. Blue Cross offers coverage plans to corporations, individuals and the senior market. For more information about Blue Cross, visit AlabamaBlue.com. Connect with us on Facebook, check out our videos on YouTube and follow us on Twitter for more up-to-date information.

Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.

About BHI
Health Intelligence Company is the nation’s premier health intelligence resource, delivering data-driven insights about healthcare trends and best practices, resulting in healthier lives and more affordable access to safe and effective care. HIC accesses healthcare claims data from more than 140 million individuals nationwide, collected over nine years, in a safe, HIPAA compliant and secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Health Intelligence Company, LLC operates under the trade name Blue Health Intelligence (BHI) and is an Independent Licensee of BCBSA. For more information, visit http://www.bluehealthintelligence.com/.


The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.