Opioid Addiction on the Rise
Updated: Jun 12, 2018
By Nadia Kounang - CNN- A new study finds that the number of Americans being diagnosed with opioid addiction continues to skyrocket, but still very few receive any treatment. This is in line with the rising trend documented in previous reports.
An analysis from Blue Cross Blue Shield of its members found that from 2010 to 2016, the number of people diagnosed with an addiction to opioids -- including both legal prescription drugs like oxycodone and hydrocodone, as well as illicit drugs -- climbed 493%. In 2010, there were just 1.4 incidences of opioid use disorder among every 1000 members. By 2016, that rate had climbed to 8.3 incidences for every 1000 members. Yet, at the same time, there was only a 65% increase in the number of people getting medication-assisted treatment to manage their addiction.
MAT: "gold standard"of treatment
Medication-assisted treatment, MAT, includes the prescribing of medications like buprenorphine or methadone, along with behavioral therapy. MAT is considered the gold standard of treatment amongst doctors and there are a number of studies to back it up - one found that Suboxone, a combination of buprenorphine and naloxone could at least double a persons chances of remaining drug free after 18 months; another found that increased buprenorphine use was accompanied by a reduction in the number of overdose deaths. Other treatments may include detox programs such as Narcotics Anonymous.
"Opioid use disorder is a complex issue, and there is no single approach to solving it," Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA said in a statement. "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," he added.While the rates of opioid addiction treatment have increased more than 6 fold since 1999, few individuals struggling with addiction actually receive treatment. In fact, a 2016 Surgeon General's Report found that only one in 10 people receive any specialized treatment to manage their addiction. At the same time 40% of those who are addicted do not seek treatment. Of the 20 million Americans that had a substance abuse addiction in 2015, about 10% of them were addicted to opioids. In addition to that, few places provide MAT. According to the Pew Charitable Trusts, less than half of private sector treatment programs offered any medications approved by the Food and Drug Administration for substance use disorders, and just 23% of publicly funded treatment centers offered them.
More people die from drugs than from guns
These numbers illustrate the continued difficulty of trying to get control of this public health epidemic. According to the US Centers for Disease Control and Prevention, 91 people die every day from an opioid overdose. In 2015, more than 33,000 lives were lost to opioids. In fact, drug overdoses - most of them from opioids - kill more people than guns or car accidents. The deaths from prescription drugs alone have more than quadrupled since 1999. Added to that is the threat of heroin and synthetic drugs like illicitly made fentanyl. Deaths from synthetic opioids alone, such as illicit fentanyl, jumped 72% from 2014 to 2015. According to the National Institutes of Health, three in four new heroin users start by abusing prescription drugs.
Who's becoming addicted
The BCBS analysis found that longer-duration prescriptions were associated with higher incidences of opioid use disorder. A CDC study from earlier this year found that an opioid prescription lasting for eight or more days increased the likelihood of using the drug a year laterto 13.5%. A prescription of 31 days or more increased chances of long-term opioid use to 29.9%.In an effort to reign in the problem, a handful of states -- Connecticut, Massachusetts, Rhode Island, New York, and Maine - have adopted legislation that limits opioid prescriptions to seven days. This year, New Jersey became the strictest, limiting painkiller prescriptions to just five days.The BCBS analysis also found that women 45 and older had higher rates of abuse then men.According to the CDC, the overdose deaths for women due to prescription painkillers have jumped more than 400%, while for men it has increased by 265% Part of that may be due to the fact that women in general are more likely to be diagnosed with chronic pain and be prescribed painkilling narcotics at higher dosages and durations.
"BCBS companies are already undertaking initiatives to help families and communities address opioid use disorder by forging partnerships with the medical community to promote best practices in prescribing and providing critical education to the public to raise awareness of the risks of opioid use," said Kim Holland, vice president of state affairs for BCBSA.President Trump has said that the opioid epidemic is a top priority for his administration and established a commission, headed by New Jersey Governor Chris Christie to look at how to combat the epidemic. The commission was set to have their second meeting and provide a draft of recommendations this past Monday, but the meeting was postponed till July. And while the commission has no law making abilities, during the commission's first meeting in June, commission members and panelists alike testified to the need to maintaining Medicaid expansion in the health care proposals. Commission member Bertha Madras, of Harvard Medical School, has said "We need more time because it's a massive task." CNN reached out to Madras - as well as the other members of the commission and the White House for further comment on the status of the draft of recommendations and has not received any comment.