Study: Opioid Dependence Leads to 3000% Rise in Medical Services

In one of the largest data studies ever conducted, Fair Health looked at claims data for 150 million privately insured patients to measure the difference in medical service utilization for the opioid addicted population vs the non-addicted group. The results were staggering- click here to read CNN’s report on the study.

Looking only at data from 2007-2014, researchers found a 3,000% increase in medical service utilization in the opioid addicted population, with a disproportionate amount of that coming since 2011 as opioid awareness increased dramatically. Interestingly, younger patients (19-35 years old) were more likely to have a diagnosis of opioid addiction and more likely to overdose on heroin. When looking at other legal prescribed opioids, the older age bracket from mid-forties to mid-fifties had the highest overdose rate. These statistics certainly seem to confirm use of the term ‘opioid epidemic.”

While the presence of this higher spend among opioid addicted patients is no real surprise, the magnitude is shocking.  The other statistics seem to be in line with what we’ve witnessed for years. Younger patients become addicted due to illicit use or overprescribing, and end up turning to illicit heroin use when their supply of opioids dries up from other sources. They tend to be the overdose cases that present to ERs as heroin is now commonly laced with fentanyl, which is much more potent than newer forms of heroin.

At axialHealthcare, we have been identifying this cost difference for years and positively impacting it through our various products we offer clients. While the over-utilization from doctor shopping, advanced imaging, and ER visits can be curbed, the next costly issue to tackle is in treating these patients with addiction. Medication assisted treatment clinics are springing up all over the country and federal funding is stepping in the support these efforts.  Unfortunately, there is a lack of consensus around standardized protocols and many providers are taking advantage of this by providing less than evidence based care to these patients.





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