FACT FILE: High dosages linked to surge in opioid use disorder

High-dosage opioid prescriptions, even for short durations, have been linked to higher rates of opioid use disorder diagnoses in a Blue Cross Blue Shield (BCBS) Association study released this week.

High dosages were defined as having a morphine equivalent daily dose of more than 100, and regimens were considered long duration if they exceeded 90 days. In a study of BCBS plan member data from 2015, an opioid use disorder diagnosis was found to be 40 times more likely in patients who filled high-dose, short-duration regimens versus those who filled low-dose, short-duration regimens.

By the numbers

• 21%: More than 1 in 5 BCBS members filled at least one opioid prescription in 2015.
• 493%: The increase in the percentage of members diagnosed with an opioid use disorder from 2010 to 2016.
• 45: Over the age of 45, women were found to have higher rates of opioid use disorder than men. Under 45, men had higher rates. More opioid prescriptions were filled by women across all age groups.
• 65%: The increase in the number of cases in which medication-assisted treatment (MAT) was used from 2010 to 2016.

Regional observations

• The highest rates of long-duration prescription opioid use and opioid use disorder diagnoses were found in the South and lower Midwest. Oklahoma, Alabama and Tennessee were among the highest ranked states in each category.
• Despite having fewer opioid use disorder diagnoses, the New England region led the nation in the use of MAT. More than 70% of patients diagnoses with opioid use disorder in Maine, New Hampshire, Vermont and Massachusetts received MAT therapy. In no other state did more than 57% of OUD patients receive MAT therapy.

Data used in the report comes from medical and pharmacy claims of more than 30 million BCBS commercially insured members from 2010 to 2016, with all eligible members under the age of 65 included. Pharmacy data was limited to 2015 and 29.2 million members, and dose and duration of opioid regimens were provided by an outside source.