As opioid addiction skyrockets, treatment for addicts lags far behind, insurance data shows

July 3, 2017 by Melissa Healy, Los Angeles Times
Credit: CC0 Public Domain

A new report on opioid use among privately insured Americans has found that diagnoses of opioid addiction increased almost fivefold between 2010 and 2015, ticking up dramatically in 2014.

During the same period, the delivery of medication-assisted addiction treatment - the method most likely to result in successful abstinence - grew by just 65 percent.

Exacerbating that gap was a geographic mismatch. The use of treatments that wean addicts off opiates with drugs such as buprenorphine, naloxone and suboxone was least common in states across the American South and Midwest, where addiction rates were highest. By contrast, such treatments were common in states where the opiate addiction epidemic is less severe, including Pennsylvania, New York and New England.

Roughly 30,000 American adults last year died from an opioid drug overdose. That's on par with the number of Americans killed in motor vehicle crashes each year and more than died from HIV/AIDS at the height of that epidemic. The National Institutes of Health estimate that prescribed opiates were the gateway to addiction for close to three-quarters of new heroin users.

The new report was prepared by Blue Cross Blue Shield, which combed the medical and pharmacy records of 30 million of its members to glean trends in the opiate addiction epidemic. By 2016, BCBS reported, nearly 1 percent of its members had been diagnosed with opioid use disorder.

In addition to providing insight into the extent of the opioid crisis - and the anemic response to treating the afflicted - the insurance giant's records yielded insights into which are most likely to become addicted, and how.

It found that in 2015, roughly one in five privately insured adults in the United States filled at least one prescription for a prescription narcotic painkiller.

Close to half of those patients - 45 percent of those prescribed prescription opioids - received high doses of narcotic painkillers, which were most likely to result in a later diagnosis of addiction disorder.

Pharmacy and medical records showed that the highest rate of addiction disorders was seen in patients who had been prescribed high doses of prescription pain relief medicine for short periods - fewer than 90 days. Fully 6.2 percent of those patients would go on to be diagnosed with an opioid addiction disorder.

Many of those patients got hooked after a physician prescribed a relatively short course of pain medication for appendicitis, osteoarthritis, back or joint pain, or kidney or gallstones.

Right behind them, in terms of addiction risk, were patients who were prescribed high doses of painkillers for more than 90 days, typically for chronic conditions such as arthritis and back pain. Of those patients, 4 percent would eventually be diagnosed with opioid addiction.

Lower doses of opioids, even over a long period, were found to be far less addictive than high doses. But the length of a patient's treatment with painkillers also escalated the risk of addiction.

The Blue Cross Blue Shield report suggests that the spurt in addiction disorder diagnoses that started in 2014 may have been driven in part by growing recognition of opioid addiction among physicians.

But prescribing practices clearly played a key role too. In 2015, the highest density of patients filling prescriptions for opioid narcotics lay in an arc of states spanning Oklahoma, Arkansas, Louisiana, Mississippi and Alabama, with slightly lower rates in Georgia, Tennessee, North and South Carolina, West Virginia and Indiana.

In 2016, physicians in those same states were diagnosing opioid use disorder at extremely high rates.

Blue Cross Blue Shield called opiate addiction "the fifth most impactful condition affecting the health of commercially insured members in the U.S."

"It will take a collaborative effort of health providers, insurers, communities and all levels of government working together to develop solutions that effectively meet community needs," the insurance giant said.

The Trump administration has called the epidemic a top priority, and the president has named his former advisor, New Jersey Gov. Chris Christie, to head a commission investigating the matter. In a June meeting, experts said that Medicaid expansion - a key target of the GOP's proposed healthcare revision - is key to the delivery of effective treatment.

Christie's panel was expected to provide draft recommendations this week. But it has postponed further meetings, and a release of recommendations, until July.

Explore further: Americans favor treatment, not enforcement, to address opioid crisis

Related Stories

Americans favor treatment, not enforcement, to address opioid crisis

May 23, 2017
Many Americans have been directly touched by the opioid crisis—more than a quarter of Americans and more than a third of millennials, report knowing someone who has been addicted to opioids or prescription painkillers. ...

Ohio sues five drugmakers over role in opioid crisis

May 31, 2017
The US state of Ohio on Wednesday sued five major producers of prescription opioid medications, accusing them of lying about the deadly risks the painkillers—at the center of a nationwide addiction crisis—posed to public ...

When is an opioid safe to take?

June 26, 2017
(HealthDay)—Many people in pain are apprehensive about taking an opioid painkiller to ease their suffering, and rightfully so.

Deaths among patients with opioid disorders may be cut by one-third by better care

June 27, 2017
Following three possible recommendations in providing medical care to people with an opioid addiction may cut deaths among such patients by as much as one-third, according to a new RAND Corporation study.

More access to opioid treatment programs needed in Southeast, says study

March 30, 2017
In 2015, more than 30,000 Americans died from overdosing on opioids, and a new study led by the University of Georgia shows that one of the hardest hit populations-low-income Americans on Medicaid-isn't getting the help it ...

Many patients receive prescription opioids during treatment for opioid addiction

February 23, 2017
More than two in five people receiving buprenorphine, a drug commonly used to treat opioid addiction, are also given prescriptions for other opioid painkillers - and two-thirds are prescribed opioids after their treatment ...

Recommended for you

In most surgery patients, length of opioid prescription, number of refills spell highest risk for misuse

January 17, 2018
The possible link between physicians' opioid prescription patterns and subsequent abuse has occupied the attention of a nation in the throes of an opioid crisis looking for ways to stem what experts have dubbed an epidemic. ...

Patients receive most opioids at the doctor's office, not the ER

January 16, 2018
Around the country, state legislatures and hospitals have tightened emergency room prescribing guidelines for opioids to curb the addiction epidemic, but a new USC study shows that approach diverts attention from the main ...

FDA bans use of opioid-containing cough meds by kids

January 12, 2018
(HealthDay)—Trying to put a dent in the ongoing opioid addiction crisis, the U.S. Food and Drug Administration on Thursday slapped strict new restrictions on the use of opioid-containing cold and cough products by kids.

Taking ibuprofen for long periods found to alter human testicular physiology

January 9, 2018
A team of researchers from Denmark and France has found that taking regular doses of the pain reliever ibuprofen over a long period of time can lead to a disorder in men called compensated hypogonadism. In their paper published ...

Nearly one-third of Canadians have used opioids: study

January 9, 2018
Nearly one in three Canadians (29 percent) have used "some form of opioids" in the past five years, according to data released Tuesday as widespread fentanyl overdoses continue to kill.

Growing opioid epidemic forcing more children into foster care

January 8, 2018
The opioid epidemic has become so severe it's considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

BubbaNicholson
1 / 5 (2) Jul 04, 2017
250mg of healthy adult male facial skin surface lipid taken by mouth alleviates opioid addiction without withdrawal symptoms. Extreme care should be taken handling the pheromone. Use oscillating fans to break up plumes of the airborne sub-pheromone evaporating from the skin surface liquid pheromone. Freeze the skin surface pheromone, contain in barrier containers with activated charcoal dunnage. Wear supplied air respirators at all time.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.