Executive Summary

Background

The opioid addiction epidemic is one of America’s foremost health crises. According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), opioids (including prescription opioids and heroin) kill more than 33,000 people annually, which is more than any year on record and more than at the peak of the human immunodeficiency virus (HIV) epidemic.1 Opioid abuse/overdose is considered a leading cause of shortened life expectancy in the U.S.2



The nation’s opioid epidemic reflects a complex set of circumstances. The pattern of opioid prescribing—including dose and duration-—and the patient’s risk factors of age, gender and condition are major determinants of whether a patient becomes dependent.3 As cases of opioid use disorder skyrocket among the commercially insured, this data shed new light on the specific prescribing practices and use that pose a significant threat to patient health.

The Analysis

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. The report analyzes medical claims from BCBS commercially-insured members diagnosed with opioid abuse disorder from 2010 through 2016.4 Specifically, it looks at the degree of prescription opioid use—in terms of the dose and duration of opioid prescriptions—and how this relates to opioid dependence.

