Abuse of opioids is on the rise. The widespread abuse of heroin and opioid prescription painkillers over the years is often dubbed “The Opioid Crisis.” The epidemic is disproportionately affecting white, middle-class people in non-urban settings, but are we seeing a rise in the abuse of these drugs in U.S. cities?
Using private insurance claim lines, or individual services or procedures listed on an insurance claim, FAIR Health found an increase in claim lines with opioid abuse and dependence diagnoses in Illinois of 329 percent from 2007 to 2014. Within Chicago alone, the increase was 382 percent, compared to 322 percent for the rest of the state.
While investigating the national opioid crisis’s impact in Illinois, FAIR Health, an independent nonprofit organization dedicated to transparency in healthcare costs and health insurance information, found the trend to be upward, but with twists and turns. Chicago had a steeper increase than the rest of the state in claim lines with opioid abuse and dependence diagnoses from 2010 to 2012, with a dip from 2012 to 2013 and a steep rise the following year.
But Chicago represented only 14 percent in the statewide distribution of private insurance claim lines associated with an opioid abuse or dependence diagnosis from 2007 to 2015. This was despite the fact that Chicago represents 21 percent of the total population in Illinois, according to July 2016 U.S. Census figures.
There may be several reasons why Chicago has a disproportionately smaller share of the private insurance claim lines with opioid-related diagnoses. It could be that, at least among the privately insured, the opioid epidemic is affecting the rest of Illinois more severely than Chicago.
It also could be that, in Chicago, a greater share of patients with opioid-related diagnoses are receiving their healthcare under Medicaid than in the rest of Illinois. Data collected by FAIR Health do not show Medicaid utilization. And it could be that in Chicago there are a greater number of higher-income individuals who are not using insurance to cover their mental health or opioid-related treatment.
There is a similar picture in New York City when comparing it with the rest of New York State. New York City contains 43 percent of the state’s population, but only 13 percent of the private insurance claim lines for opioid abuse and dependence diagnoses.
The opioid epidemic continues its spread across the nation, and robust, reliable data to study it are crucial. Such data can lead to a better understanding of the complexities of the issues, and providers, payors, educators, policy makers and other healthcare stakeholders can use that understanding to inform strategies to address the crisis.
Robin Gelburd, JD, is the president of FAIR Health, a national, independent nonprofit with the mission of bringing transparency to healthcare costs and insurance reimbursement. FAIR Health oversees the nation’s largest collection of healthcare claims data, which includes a repository of over 23 billion billed medical and dental procedures that reflect the claims experience of over 150 million privately insured individuals, and separate data representing the experience of more than 55 million individuals enrolled in Medicare. Certified by the Centers for Medicare & Medicaid Services (CMS) as a Qualified Entity, FAIR Health receives all of Medicare Parts A, B and D claims data for use in nationwide transparency efforts.