Is the opioid crisis a major plague involving millions of drug-addicted Americans? Not so, says new research presented by Castlight Health.

The benefits platform provider studied data from medical and pharmacy insurance claims and unearthed a trove of insightful information about the use and abuse of opioids. While Castlight characterized opioid abuse as a severe crisis, its data suggests that the actual number of people who account for most of the opioid abuse is a small one. Yet that small number has created a serious problem.

The big-picture finding: Just 4.5 percent of those who have received a prescription for an opioid drug are opioid abusers, and they account for nearly a third of total opioid prescriptions and 40 percent of spending on opioid scripts in the U.S.

Digging deeper, Castlight found that this abuser population costs employers nearly twice the total medical spending per year as do non-abusers. Castlight estimated that opioid abusers take a nearly $8 billion chunk out of employers’ budgets each year. It estimated the total number of abusers at two million, and said abuse drains about $65 billion a year from the American economy.

Some of the findings were less than surprising. Examples:

Baby boomers are four times more likely to abuse opioids as Millennials, perhaps because they are older and experience more chronic pain.

Patients with a behavioral health diagnosis of any kind are three times more likely to abuse opioids than those without one.

Opioid abusers have twice as many pain-related conditions as non-abusers.

Yet other findings may open new paths to addressing opioid abuse. For instance:

States that have legalized marijuana at least for medical purposes report a significantly lower instance of abuse than states where pot continues to be illegal (2.8 percent compared to 5.4 percent).

The nation’s lowest-income geographic areas have twice the opioid abuse as do the highest-income areas.

The South is home to more opioid abusers as a percent of the population than any other part of the country. Of the cities with the highest incidence of opioid abuse, the first 13 were south of the Mason-Dixon line, with four Alabama cities in that group.

What’s to be done? Castlight said a very good starting point would be more research like this report, to better define the scope of the crisis and to create a targeted response where taxpayers and employers could get better bang for their buck.

“Harnessing powerful data and analytics can help employers better understand which employee populations have potentially higher rates of opioid abuse, and engage them with the right information at the right time so they can make better health choices,” the report concluded.

Instant Insights /

Small percentage of opioid abusers driving a crisis

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