Opioid-Related ER Visits, Hospitalizations on the Rise

In a decade, opioid-related inpatient stays rose 64 percent across the nation, while emergency room visits nearly doubled.

The nation’s epidemic of opioid abuse is sending Americans to the hospital at an alarming rate.

Between 2005 and 2014, the number of people visiting emergency departments and hospitalized for opioid misuse and dependence increased dramatically, according to data released in June 2017 by the U.S. Department of Health and Human Services.

In that 10-year span, opioid-related inpatient stays rose 64 percent across the nation, while emergency room visits nearly doubled. The numbers include treatment related to prescription opioid painkillers as well as heroin.

These increases played out differently according to gender, age and residence.

Gender

  • Women had a higher cumulative increase in opioid-related hospitalizations (75.3 percent) than men (54.5 percent).
  • The hospitalization rates among men and women were nearly equal by 2014 – about 225 per 100,000 people.

Age

  • People ages 25 to 44 were most likely by far to visit an ER in 2014 because of opioid abuse – 336.2 per 100,000 compared with 187.9 per 100,000 for people ages 45 to 64. The rate of hospitalizations was roughly equal across those cohorts – 321 per 100,000 for the younger group and 317.4 per 100,000 for the older group.
  • However, people 65 and older saw the highest cumulative increases in opioid-related inpatient stays (85 percent increase) and ER visits (112.1 percent increase) compared with any other age group over the 10-year period.

States

  • By 2014, Maryland and Massachusetts had the highest rates of opioid-related hospitalizations (403.8 stays per 100,000 people in Maryland and 393.7 stays per 100,000 people in Massachusetts). Those states also had the highest rates of ER visits (450.2 visits per 100,000 people in Massachusetts and 300.7 per 100,000 people in Maryland).
  • Iowa—which had the lowest rates that year—had 72.7 inpatient stays per 100,000 people and 45.1 ER visits per 100,000 people.

How health insurers and providers can help

More than 12 million Americans misused prescription opioids in 2015, according to to data from the Substance Abuse and Mental Health Services Administration.

The scope of the opioid crisis demands a coordinated response from all health care stakeholders, says Dr. Trent Haywood, senior vice president and chief medical officer of Blue Cross and Blue Shield Association.

A recent review of medical claims by the Association showed a 493 percent increase in opioid use disorder from 2010 to 2016.

“Opioid use disorder is a complex issue, and there is no single approach to solving it,” he said. “It will take a collaborative effort among medical professionals, insurers, employers, communities and all levels of government working together to develop solutions that effectively meet community needs.”

Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, which are operated by the same company, implemented a Controlled Substance Integration Program to collaborate with pharmacists, doctors, case managers and behavioral health specialists to develop a plan of action for members who need help.

In 2016 the program was expanded to monitor medical claims to identify and work with doctors who prescribe more opioid painkillers than most of their peers.

And in early 2017, the company’s plans eliminated the requirement for doctors to get prior authorization for medication-assisted treatment, which combines behavioral therapy with drugs such as buprenorphine that ease an addict’s cravings for opioids.

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