Opioid Use Disorder Increased 493% Between 2010-2016, Reports BCBS
In a report by the Blue Cross Blue Shield insurance company, data was culled from 30 million of its own customers, and reveals a staggering 493% increase in patients diagnosed with an opioid use disorder from 2010-2016.
And yet, there was just a 65% rise in the number of patients receiving medication-assisted treatment, such as buprenorphine and naltrexone – drugs used to relieve cravings for opioids and an approach that addiction professionals typically deem necessary to treat opioid dependence.
So, this leaves us with a startling, but undeniable fact: the rate of diagnosed opioid use disorder has increased by almost eight times that of what is considered to be among the most effective treatments.
And There’s More…
But that’s not all. More statistics revealed by BCBS are worrisome. Take for example, in 2016, almost 1% of the company’s commercial insured clients received a diagnosis for an opioid use disorder. And in 2015, more than one in five (21%) clients filled at least one prescription for opioids. This number did not include cancer patients or those in palliative care.
And of those who filled a prescription for opioids, 6% were prescribed a high dosage for more than 3 months. As it turns out, patients with prescriptions for high-dosage opioids have significantly higher rates of opioid use disorder than those who receive low-dose prescriptions.
However, the fact that opioid use and use disorder has increased so much, and yet medication-assisted treatment has increased so little reveals something about how the U.S. health care system is responding to the crisis. Regarding people receiving painkillers, we line them up and knock them down, but we sure don’t want to pick them back up again.
And what’s being done? Well, physicians are beginning to limit access to opioids for many patients, thanks to urging from the Centers for Disease Control and Prevention (CDC) and others. But those patients on opioid long-term for chronic pain (a condition for which they are not indicated) this move can be devastating.
Many are dependent upon the drugs, and by canceling prescriptions, doctors risk encouraging their patients to find another medication to help them with their dependence and/or pain – and often, this “medication” is heroin. In fact, the CDC estimates that as many as 4 in 5 new heroin users initiated their habit after first becoming addicted to prescription painkillers.
Also, a 2015 analysis found that people who become addicted to prescription opioids are 40 times more likely to be addicted to heroin.
And what’s worse is that there are few effective alternatives to opioids. Many are still in the study phase, and are based on substances such as spider venom, cayenne pepper, and everything in between. But it will likely be years before any of these alternatives become widely accessible.
Treatment facilities are also lacking. Many people of low economic status have poor insurance coverage, and many centers don’t take Medicaid, because of how little it pays. And if you live in a very rural area, the chance of finding treatment is even lower, unless you can travel far and wide and pay for expenses to do as much.
Moreover, another finding stated in the report that the southern and lower mid-westerns states have the greatest rates of diagnoses for opioid use disorders, and often the lowest rates of prescribed medication-assisted treatment.
And finally, there is still a huge stigma attached to addiction. One of the most disparaging remarks I’ve heard lately is this:
“Why should people in pain suffer just because of a bunch of dopeheads?”
I calmly explained that those “dopeheads” were middle-aged parents or grandparents who had become dependent on opioid prescriptions for exactly that reason – they were prescribed long-term for some type of pain. My point is this: despite evidence that addiction is a disease, or at least involves a certain amount of uncontrollable behavior, addicts are marginalized and symbolically chained to their addiction.
An addict is no longer a person – he or she is just a burden to society, someone whom others would rather just sweep under the rug and would rather not deal. And yet, just like diabetes and multiple sclerosis, it’s a disease that is no fault of their own.
The Treatment Conundrum
And so many people who become opioid dependent face few choices. If they want to get off drugs, they can do it cold turkey and without help, which is extremely difficult. Once withdrawal symptoms kick in, many people give into their desires in an attempt to take away the pain, discomfort, and mental anguish.
Or, the person can try to seek help in a treatment center, if one is even nearby, he or she can afford it, or it is primarily covered by insurance. When treatment is unavailable or not viable, this is when many people succumb to the habit and stop fighting it. Addiction re-wires the brain, and after its onset, often people simply have no other choice than to conform.
According to a 2016 report by the surgeon general, only about 1 in 10 patients with drug use disorders receive specialty treatment. While the epidemic continues to grow, we as a country have simply not stepped up to the plate and made treatment more easily accessible from either a monetary perspective or a local one.
The Big Picture
According to the CDC, in 2015, more than 33,000 people in the U.S. died from overdoses related to opiates or opioid prescription or illicit drugs. That’s about 91 Americans every day, and that number is expected to rise when the final tally comes in for 2016. Also, an estimated two million are addicted to painkillers.
~ G. Nathalee Serrels, M.A., Psychology