Even as claims for opioid addiction and dependence soared almost 500 percent between 2010 and 2016, a report from Blue Cross and Blue Shield indicates more than 1 out of 5 people insured by the company were prescribed an opioid painkiller at least once in 2015.
An NBC News report says the company’s figures on claims and prescriptions—based on coverage of 30 million people with Blue Cross and Blue Shield insurance in 2015—bear out expert opinions that “much, if not most, of the opioid overdose epidemic is being driven by medical professionals who are prescribing the drugs too freely.”
It cites the BCS report saying, “Twenty-one percent of Blue Cross and Blue Shield (BCBS) commercially insured members filled at least one opioid prescription in 2015. Data also show BCBS members with an opioid use disorder diagnosis spiked 493 percent over a seven year period.”
And that’s not counting patients with cancer or terminal illnesses. The report’s findings are comparable with similar surveys of people with Medicare, Medicaid or other government health insurance, according to Dr. Trent Haywood, chief medical officer for the Blue Cross and Blue Shield Association.
Sadly, the report also says epidemic hotspots are the least likely places for people fighting addiction and dependence to be able to get medication-assisted treatment, a package of counseling coupled with drugs such as buprenorphine that help patients to get off opioids.
The CDC has been pushing doctors to prescribe opioids less and for shorter periods, and to rely more on less dangerous painkiller options—acetaminophen, ibuprofen, even ice or relaxation techniques—rather than the highly addictive opioids. It says in the report, “Opioids (including prescription opioids and heroin) killed more than 33,000 people in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid.”
Insurance companies have a role to play in fighting the epidemic, according to Haywood, in part by tracking statistics on opioid prescriptions and also by encouraging doctors to downplay the role opioids play in treatment regimens—as well as by keeping track of doctors that are prescribing at considerably higher rates than their peers.
The BCBSA report identified a number of trends point toward women suffering more in the epidemic than men, with women 45 and older having higher rates of opioid use disorders than men and women of all ages are filling more opioid prescriptions than men.
A separate report, from the Agency for Healthcare Research and Quality, finds hospital stays to treat opioid disorders rose between 2005 and 2014, with men being treated in a hospital at a higher rate than women in 2005—although, it says, “by 2014 the rate was the same for both sexes.”
In addition, the BCBSA report says while the highest rates of long-term opioid prescriptions are seen in the South and Appalachia, when it comes to treatment, those states do not use medications to treat opioid abuse. Instead, medication-assisted treatment is found farther north.
The report says, “For example, New England leads the nation in use of medication-assisted treatments but it has lower levels of opioid use disorder than other parts of the country.” Also, the rate of treatment is far below that of addiction; it continues, “The 65 percent rate of increase in the use of medication-assisted treatments lags behind the 493 percent rate of increase in opioid use disorder diagnoses from 2010 through 2016.”
And, predictably enough, patients with high-dose prescriptions are more likely to misuse or abuse opioids than those on lower doses.