Direct Costs of Opioid Abuse in an Insured Population in the United States

White, Alan G.; Birnbaum, Howard G.; Mareva, Milena N.; Daher, Maham; Vallow, S.; Schein, Jeff; Katz, Nathaniel

doi:10.18553/jmcp.2005.11.6.469

Cited by 169 publications

(157 citation statements)

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“…In a population of mentally ill‐addicted patients at risk for “Adverse Selection” phenomena,14 PDMP monitoring showed that addiction and dual diagnosis treatment involving INTX objectively produced a significant decrease in exposure to prescribed opioids. This decrement was likely accompanied, to some extent that we did not measure, by reductions in costs associated with doctor's visits, medical diagnostic tests, pharmacy costs, and diversion of prescription drugs that often accompany iatrogenic opioid prescribing 7, 30, 31. These findings thus suggest a remarkable, if indirect effect of addiction treatment, beyond individual patients, on the practices of outside physicians and health care systems that may inadvertently be contributing to addictions and overdose deaths.…”

Section: Discussionmentioning

confidence: 85%

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

et al. 2016

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Background and ObjectivesFourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university‐affiliated integrated mental health‐addiction treatment clinic.MethodsRepeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long‐acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders.ResultsThere were no group differences post‐injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol‐only patients. Post‐first injection, UDS's positive for opioids declined (p < .05) along with PDMP measures of opioid prescriptions (p < .001), doses (p < .01), types (p < .001), numbers of dispensing prescribers (p < .001) and pharmacies (p < .001). Opioid patients without alcohol disorders showed the best outcomes with 50% to 80% reductions in PDMP‐measures of opioids, down to levels of alcohol‐only patients.ConclusionsThis study shows PDMP utility for measuring opioid addiction treatment outcomes, supporting the routine use of PDMPs in clinical and research settings.Scientific SignificanceThese findings demonstrate that opioid addiction in patients with complex addictions and mental illnesses comorbidities can show effective treatment responses as measured by PDMP tracking of decreases in opioid prescriptions to those patients. (Am J Addict 2016;25:557–564)

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Section: Discussionmentioning

confidence: 85%

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

et al. 2016

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“…[9,14] Individuals who abuse prescription opioid analgesics have higher rates of both HIV and hepatitis infection than non-abusers (1.4% vs 0.3% for HIV infection and 6.5% vs 0.2% for hepatitis A, B, and C). [72] Abuse routes associated with the highest morbidity are injection and inhalation. [15] Abuse of prescription opioid analgesics has been independently related to risky injection behaviors, such as sharing syringes.…”

Section: Differences In Routes Of Abuse Between Populationsmentioning

confidence: 99%

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Gąsior

Bond

Malamut

2015

Postgraduate Medicine

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Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

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“…Studies also evaluated opioid abuse in the insured population of the USA [131]. Opioid abuse was determined to be present in 6.7-8 per 10,000 persons insured; however, opioid abusers presented with multiple comorbidities and expenses eight-times higher than for nonabusers (US$15,884 vs 1830).…”

Section: Opioid Abuse In Chronic Painmentioning

confidence: 99%

Opioids in chronic noncancer pain

Manchikanti

Benyamin

Datta

et al. 2010

Expert Review of Neurotherapeutics

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Direct Costs of Opioid Abuse in an Insured Population in the United States

Abstract: The high costs of opioid abuse were driven primarily by high prevalence rates of costly comorbidites and high utilization rates of medical services and prescription drugs.

Cited by 169 publications

References 0 publications

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Opioids in chronic noncancer pain

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