According to a recent study that analyzed insurance records, health care claims for people with opioid dependence diagnoses rose more than 3,000 percent – from 217,000 to 7 million medical services – between 2007 and 2014. The study also suggested that 1) across all age groups, men were more likely than women to be diagnosed with dependency and 2) women were more likely than men to overdose. These findings also suggested that prevention and treatment should be more widely available.
The findings illustrate that the opioid problem is “in the general mainstream,” says Robin Gelburd, president of Fair Health, a nonprofit that analyzes health care costs and conducted the study. The researchers used de-identified claims data from insurers representing 150 million patients who either have insurance through work or buy coverage on their own. They looked for diagnosis codes related to opioid dependency and abuse, adverse effects of heroin use or problems caused by the misuse or abuse of other types of opiates, including prescription drugs.
The study found that health care costs related to opioid dependence increased most sharply since 2011, a period marked by increased attention to the problem and a growing pressure on physicians to reduce the number of opioid prescriptions. Younger patients ages 19 to 35 were most likely to be diagnosed as opioid dependent. Those younger patients were also more likely than older ones to overdose on heroin. The reverse was true for overdoses related to other types of opioids, which were more common in people in their mid-40s to mid-50s.
Still, basing an analysis solely on insurance claims data, while common, may not paint a complete picture. The accuracy of billing codes may be poor, for example. In this case, increased attention to the opioid problem may have also resulted in an increased use of related codes. Some research studies also pair claims data with medical record information, which includes doctors’ notes. This study did not.
Other findings include:
Data from IMS Health, which tracks prescription drug sales, shows the number of prescriptions for opioid-based drugs have ticked down, falling 11.8 percent from 2012 to 2015. That decline, however, followed a huge increase: The number of opioid prescriptions more than doubled between 2000 and 2012, when more than 282 million prescriptions were written.
The data from Fair Health truly shows the scope of the problem; this is not limited to a problem of the poor and unemployed, this is a problem that is cutting right across society. In mid-July, President Obama signed the Comprehensive Addition and Recovery Act of 2016, which aims to make prevention and treatment more widely available. Supporters say the legislation will help, but criticized lawmakers for not including more funding.
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