Study: Opioid dependence claims increased by 3,200% among privately insured

Between 2007 and 2014, private insurance claims which included a diagnosis of opioid dependence increased by more than 3,200 percent, according to a new study released by nonprofit group FAIR Health.

The group said the “tsunami of services” being ordered by people with employer-sponsored or other private health coverage illustrates how the problem of opioid abuse has entered “the general mainstream.”

“Because the demographics of opioid abuse have changed from earlier epidemics, the effects of the current wave can be traced not only in records related to the uninsured and those on Medicaid, but in private health insurance claims,” the study said. “Indeed, while heroin use has increased across most demographic groups, it has grown particularly sharply among the privately insured, a group that historically had relatively low rates of heroin use.”

Using data from ICD-9 diagnostic codes, the study said the claims related to opioid dependence or a heroin overdose occurred “overwhelmingly” among patients between the ages of 19 and 35. 69 percent of the claim lines for opioid dependence came from within that age group. When the diagnosis was related to opioid abuse (such as the ICD-9 code of 305.51, opioid abuse, continuous), the 19-35 group was less dominant, representing 50 percent of all claims, with 31 percent coming from the 36-55 age group, and 12 percent from teenagers 13 to 18.

Heroin overdose was also more prevalent among the 19-35 age group, accounting for 78 percent of all claims between 2009 and 2014. Non-heroin opioid overdoses, however, were more spread out, and in the age groups above 36, those types of overdoses were more common.

In one alarming statistic, claim lines with a pregnancy drug dependence diagnosis—which includes opioid dependence—rose 511 percent between 2007 and 2014.

“This is especially serious because abuse of opioids by pregnant women can put an infant at risk for the group of problems known as neonatal abstinence syndrome (NAS), which grew by nearly 300 percent between 2000 and 2009,” the study said.

Men are more likely to be diagnosed as opioid dependent, according to the study, though the gap between genders narrowed among older age groups.

Efforts to combat the rise in opioid abuse and dependence have been a frequent topic among federal lawmakers this year. A comprehensive package aimed at fighting the opioid epidemic was passed by Congress and signed into law by President Barack Obama in July, and there will likely be more legislation coming trying to involve physicians in reducing opioid abuse, like requiring prescribers in all states to check prescription drug monitoring databases to clamp down on “doctor shopping.”