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Tuesday, September 13, 2016

Opioid Use Disorder: A Heavy Cost

opioid use disorder
Opioid use disorder in the United States has taken its toll on both individuals and families alike. It is a problem that is both unprecedented in America and the entire world. The U.S. only accounts for about 5 percent of the total world population, Americans use the vast majority of the world’s opioid supply. Rampant over prescribing and subsequent heroin abuse has resulted in skyrocketing death rates linked to opioid overdoses, making that class of drug the most dangerous on the planet.

While health experts and lawmakers continue to work together in putting a stop to the insidious problem, it is worth pointing out that there are other serious costs associated with the epidemic—such as the burden that it has put on the healthcare system. Insurance providers in this country have long had a bad rap when it comes to paying for claims related to mental health. Up until the Mental Health Parity and Addiction Equity Act and the Affordable Care Act, it was extremely difficult for people with a history of addiction to get insurance and/or coverage for mental illness.

There are still a number of kinks to workout with regard to providing coverage for addiction treatment services, but insurance companies can no longer turn their back on people suffering with addiction. And it turns out that the American opioid epidemic has racked up costs with insurance companies as a result. The Impact of the Opioid Crisis on the Healthcare System report shows a more than thirteen-fold increase in spending by health insurers on patients with opioid dependence or abuse problems over a four year period, NPR reports. Insurance companies went from paying $32 million in 2011 to $446 million in 2015, for covering:
  • Hospitals
  • Laboratories
  • Addiction Treatment Centers
  • Other Medical Providers
Between 2007 and 2014, there was a thirty-fold increase in insurance claims related to opioid use disorder diagnoses, according to the article. The average patient costs insurance companies $3,435 per year, compared to $19,333 for patients with opioid problems. "That really shows the stress on the health system and the impact on the individuals," said Robin Gelburd, president of Fair Health, a nonprofit databank that provides cost analysis to the health industry and consumers. Gelburd points out that this "is a societal issue," one that require significant changes be made.

"Are medical school curricula adjusting to recognize the growing need for these services? Are insurers increasing the number of providers in their networks to ensure sufficient access? Are consumers being educated? It's an issue that has to be dealt with in all quadrants."

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