Hospitalizations for opioid abuse double, costs quadruple in 10 years

A study published by Health Affairs has found that hospitalizations related to opioid abuse/dependence both with and without associated serious infection doubled while inpatient charges almost quadrupled over the same time period.

In recent years, data have indicated a shift from the exclusive use of prescription opioids to simultaneous abuse of both heroin and prescription opioids, where almost half of patients with opioid dependence report abuse of both drugs. Some states have gone as far as no longer prescribing opiates to combat the rate of these ever increasing hospitalizations and increased rate of heroin use.

Along with the increase of opioid and heroin misuse comes the inevitable risk of contracting a serious infection through the use of needles, further increasing the rates of morbidity and mortality.

While the mortality rate associated with opioid use has steady increased since the 1990s, no research has been gathered about the definitive number of hospitalizations related to opioid use and the cost of these visits.

The Health Affairs study conducted a cohort study using data from 2002 to 2012 of the Nationwide Inpatient Sample, developed for the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality; the largest publicly available, all-payer, national inpatient database that represents 20 percent of all inpatient hospitalizations.

The data showed the number of hospitalizations as a result of opioid abuse/dependence and the number of individuals with an associated infection increased dramatically between 2002 and 2012. Hospitalizations related to opioid abuse/dependence and resulting infections were 3,421 out of 301,707 in 2002 and 6,535 out of 520,275 in 2012. The number of hospitalizations with infections but without opioid abuse/dependence was 121,776 out of 36,222,124 in 2002 and 166,405 out of 35,964,571 in 2012. These results indicate that infections occur at a higher rate in those with opioid abuse/dependence.

Total inpatient charges for the hospitalization related to opioid abuse/dependence more than tripled between 2002 ($4.57 billion) and 2012 ($14.85 billion) while the charges for opioid abuse/dependence with infection also tripled in that time frame (from $190.68 million to $700.66 million).

As for who was paying for the charges, Medicaid was the most common primary payer in both 2002 and 2012, where the total charge per hospitalization related to opioid abuse/dependence was $28,543 and for opioid abuse/dependence with infection was $107,217.

In the cases of hospitalization where there was opioid abuse/dependence with infection, the patients were more likely to die during hospitalization, less likely to be sent home and more likely to be discharged to a second medical facility compared to hospitalizations with just opioid abuse/dependence.

In the span of 10 years, total inpatient charges almost quadrupled for hospitalizations of opioid abuse/dependence, amounting to almost $15 billion while the total cost of hospitalizations related to opioid abuse/dependence and infection was more than $700 million. The risk of infection made each hospitalization four times more costly and patients discharged were more likely to be uninsured, more likely to die during their visit and more likely to require placement in a drug rehabilitation facility after hospitalization.

“The rise in associated inpatient charges is outpacing the increase in number of hospitalizations and places a significant financial burden on the healthcare system as a whole,” concluded Dr. Matthew V. Ronan, MD, and colleagues. “Downstream consequences of opioid abuse/dependence, such as related infections, are particularly costly, and a continued focus on decreasing access to opioids, early treatment and preventive strategies is necessary to decrease the burden of disease and cost to the healthcare system and society.”