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Opioid addiction rates far exceed growth of medically assisted treatment, report finds

July 3, 2017 at 6:40 PM EDT
A new report offers striking revelations about opioid use in the U.S. When insurance giant Blue Cross Blue Shield analyzed 30 million medical records, it found that roughly 20 percent of patients filled at least one prescription for opioid painkillers in 2015. William Brangham talks with Dr. Trent Haywood, chief medical officer of Blue Cross Blue Shield, about their findings.
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JUDY WOODRUFF: Now: A new study by one of the nation’s biggest health insurance companies provides a startling look at the toll that prescription opioids are taking on its policy-holders.

William Brangham has that.

WILLIAM BRANGHAM: The insurance giant Blue Cross Blue Shield analyzed medical records for 30 million of its customers. And it found some striking results.

In 2015, roughly 20 percent of their customers, one in five, filled at least one prescription for opioid painkillers. Almost half of those patients were prescribed high doses of those drugs, which are more likely to cause dependence.

And, indeed, between 2010 and 2016, the rate of abuse or addiction to those painkillers shot up dramatically by almost 500 percent, this while the rate of medically assisted treatment, considered the most successful way to curb those addictions, grew by just 65 percent in the same time frame.

The report also detailed differences in opioid abuse between men and women and among different parts of the country.

For more on this, I’m joined now by Dr. Trent Haywood. He’s the chief medical officer for the Blue Cross Blue Shield Association.

Welcome to the NewsHour.

This is a very, very interesting set of data that you have produced from your patients’ records. We have said one in five have had a prescription for these painkillers, obviously, most of them for very legitimate pain-suppression needs. But we have also discovered here that the rate of addiction has shot up.

Why do you think that has been happening?

DR. TRENT HAYWOOD, Chief Medical Officer, Blue Cross Blue Shield Association: Well, one of the things, the reason why we wanted to focus on this particular issue is just what you just alluded to, the escalation in the opioid addiction from physicians prescribing these particular opioids.

Starting in the ’90s, we really went aggressive as physicians making sure that we address pain. Unfortunately, it was found out later, as we are starting to see unfold now, we underestimated the risk related to that particular high doses of prescribing those particular opioids. And now we are suffering the consequences of that.

WILLIAM BRANGHAM: Some of this data that you guys have put together, it is not necessarily new news. Why hasn’t the message seemingly gotten out to the medical community just how serious these drugs really are?

DR. TRENT HAYWOOD: Well, one of the things that we know when it comes to medicine and the practice of medicine is that it really requires a substantial amount of time for it to change.

We’re headed into the independence holiday, and so people are moving off to make sure that they enjoy times with their friends and family, but as this report highlights, all of us won’t necessarily be independent this particular day, because whether it be your family, whether it be your neighbor’s family or whether it be someone down the block, we’re all struggling with this issue of opioid addiction.

Over two million Americans each year are suffering from this opioid addiction. And what is key about that particular aspect is that it’s not one specific demographic.

WILLIAM BRANGHAM: The treatments, the best-known treatments for these addictions have barely kept up with the pace. Why do you think that is?

DR. TRENT HAYWOOD: We’re talking about someone moving from what would normally would be an acute situation to a chronic condition.

And so this opioid addiction is a chronic condition and we need to treat it that way. We need to make certain these people are not only in treatment, but they have the necessary support for the chronic condition that they have.

WILLIAM BRANGHAM: If I am a policy holder of Blue Cross Blue Shield and I recognize that I have a substance problem, and I come and I try to get treatment for that, will my policy cover that addiction treatment?

DR. TRENT HAYWOOD: Yes.

So, one of the reasons why we’re highlighting this is because you — actually make certain that you follow up at your local plan level to get that treatment. So, this is something that is actually covered in most members’ policies. And so you absolutely should be following up to get that treatment.

WILLIAM BRANGHAM: One of the things I was also struck by in your report is the gender differences.

It seemed that younger — when the genders are younger, when men and women are younger, men seem to be more vulnerable. But as we age, women seem to become more vulnerable to addiction. Do you have a sense of why that is?

DR. TRENT HAYWOOD: One of the reasons why we think women are being impacted as we get into an older age group is the fact that they’re appropriately following up with their physicians.

If you think about it, the more that you are following up, the more likely that you’re going to be prescribed an opioid. And so we’re seeing women are actually at an accelerated pace the more that we get into the older age groups. And so that’s the correlation that you’re seeing, why women would necessarily be higher, because they are more predisposed to actually getting that prescribed opioid.

WILLIAM BRANGHAM: At the very moment we’re talking, the Senate is debating a health care bill that could eliminate hundreds of billions of dollars from Medicaid. Medicaid itself pays for much of addiction treatment around the country.

Do you share concern of many that, if this bill were to become law, that this — those cuts to Medicaid could only worsen an already awful epidemic?

DR. TRENT HAYWOOD: From every indication, this particular issue is not partisan at all.

So, whether you’re on the right or on the left, what we have understood is, as relates to the opioid epidemic, both sides of the aisle are eager to be able to address that particular concern.

And so, while there may be broader implications as it relates to health care reform, on this particular topic, I think we all stand together as Americans.

WILLIAM BRANGHAM: All right, Dr. Trent Haywood, chief medical officer of Blue Cross Blue Shield, thank you so much.

DR. TRENT HAYWOOD: Thank you.

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