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The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013-.
Background: There has been a significant increase in hospitalizations for opioid misuse in recent years. Identifying patterns of post-discharge treatment is an important step in helping patients receive appropriate care following an opioid-related hospitalization. Method: Using 2010–2014 data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database, this report identifies the types of services individuals with private insurance receive following hospitalization for opioid misuse. Results: Forty percent of patients do not receive any follow-up services within 30 days after an opioid-related hospitalization. Only 10.7 percent of patients received the recommended combination of both medication and a therapeutic service. Conclusion: Developing strategies to link patients to resources that can provide the recommended treatment options is an important goal in supporting treatment and recovery efforts.
Opioid misuse is a growing public health concern.1 Nearly 2.4 million people in the United States have a substance use disorder (SUD) related to prescription opioids. Approximately a half million people have an SUD related to heroin.2 There has been a significant increase in hospitalizations for opioid misuse.3,4 The U.S. Food and Drug Administration has approved three different medications to treat opioid addiction: methadone, naltrexone, and buprenorphine.5 Research shows a combination of medications and therapy is often the most successful approach to treating opioid addiction.6,7
The Truven Health Analytics MarketScan® Commercial Claims and Encounters Database includes insurance claims from employees and their dependents covered by large, self- insured employers and by regional health plans. The MarketScan Database captures all billed services, including prescription drugs, outpatient services, and inpatient services. This report uses data from 2010 to 2014. Information on MarketScan is available online at http://truvenhealth.com/your-healthcare-focus/analytic-research/marketscan-research-databases
In 2014, more than 67 percent of Americans aged 18 to 64 had private insurance, making it the most common form of health care coverage in the United States.8 Data on privately insured individuals aged 18 to 64 from the 2010 to 2014 Truven Health Analytics MarketScan® Commercial Claims and Encounters Database show that 40.0 percent of patients did not receive any follow-up services within 30 days following an opioid- related hospitalization (Figure 1). Within 30 days of discharge for an opioid-related hospitalization, 6.0 percent of patients received medications only, and 43.3 percent received therapy only. A small percentage (10.7 percent) of patients received the recommended combination of both medication and a therapeutic service.
Given the increasing rates of hospitalization for opioid misuse, identifying patterns of post-discharge treatment is an important step in developing targeted prevention, intervention, and treatment options for patients with an SUD related to prescription opioids. More research is needed to understand the barriers that patients with an SUD related to prescription opioids have in trying to access services after hospitalization, as well as the barriers that health care providers have in making the optimal referral.
Ali, M. M., & Mutter, R. Patients Who Are Privately Insured Receive Limited Follow-up Services After Opioid-Related Hospitalizations. The CBHSQ Report: February 11, 2016. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Rockville, MD. [PubMed: 27054227]
Volkow, N. (2014). America's addiction to opioids: Heroin and prescription drug abuse. National Institute on Drug Abuse. Retrieved from http://www
Center for Behavioral Health Statistics and Quality. (2014, September 4). Table 5.14A—Substance dependence for specific substances in the past year, by age group: Numbers in thousands, 2012 and 2013 [Table]. In Results from the 2013 National Survey on Drug Use and Health: Detailed tables. Retrieved from http://www
Coben J. H., Davis S. M., Furbee P. M., Sikora R. D., Tillotson R. D., Bossarte R. M. (2010). Hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers. American Journal of Preventive Medicine, 38(5), 517–524. 10.1016/j.amepre.2010.01.022 [PubMed: 20409500] [CrossRef]
Owens, P. L., Barrett, M. L., Weiss, A. J., Washington, R. E., & Kronick, R. (2014). Hospital inpatient utilization related to opioid overuse among adults, 1993–2012 (Statistical Brief #177). Retrieved from http://www
Office of National Drug Control Policy. (2012). Medication-assisted therapy for opioid addiction. Retrieved from https://www
Fullerton C. A., Kim M., Thomas C. P., Lyman D. R., Montejano L. B., Dougherty R. H., Delphin-Rittmon M. E. (2014). Medication-assisted treatment with methadone: Assessing the evidence. Psychiatric Services, 65(2), 146–157.10.1176/appi.ps.201300235 [PubMed: 24248468] [CrossRef]
Liebschutz J. M., Crooks D., Herman D., Anderson B., Tsui J., Meshesha L. Z., Stein M. (2014). Buprenorphine treatment for hospitalized, opioid- dependent patients: A randomized clinical trial. JAMA Internal Medicine, 174(8), 1369–1376. 10.1001/jamainternmed.2014.2556 [PMC free article: PMC4811188] [PubMed: 25090173] [CrossRef]
Ward, B., Clarke, T., Freeman, G., & Schiller, J. (2015). Early release of selected estimates based on data from the 2014 National Health Interview Survey. Retrieved from http://www
Post-discharge services provided within 30 days following an opioid-related hospitalization among the privately insured: 2010 to 2014
SUD = substance use disorder.
Source: Truven Health Analytics MarketScan® Commercial Claims and Encounters Database, 2010-2014
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