Published: June 22, 2013
The Soaring Cost of the Opioid Economy
U.S. EMERGENCY ROOM COSTS
INSURANCE CLAIMS FOR TIME LOST
MONITORING “DOCTOR SHOPPING”
PHYSICIAN DISPENSING
SPENDING ON OPIOIDS
PILL MILLS
PATIENTS IN ADDICTION TREATMENT
OVERDOSE DEATHS
DRUGS FOR OPIOID ADDICTION
DRUG-SCREENING TESTS
Up 33%
Up 110%
240.9 million
181.7 million
2012
2001
$8.34 billion
$3.97 billion
2012
2001
OPIOID PRESCRIPTIONS
SALES OF OPIOIDS
A Decade of Rising American Use
The cost of four to six weeks of
inpatient treatment at a private
facility can range from $20,000 to
$32,000.
At a Hazelden drug treatment facility
in Minnesota that specializes in
adolescents and young adults, the
portion of patients treated for
painkiller or heroin addiction nearly
tripled, to 41 percent in 2011 from
15 percent in 2001.
Number of patients in a one-day
survey at facilities that use
methadone or buprenorphine to treat
addiction to pain pills or heroin.
(Does not include all patients treated
at doctors’ offices.)
’02
’07
’12
8 MILLION PRESCRIPTIONS
6
4
2
0
2011 PRICE
PER PILL:
+54%
–10%
+66%
–2%
Pharmacy
Physician sold
37¢
$1.43
53¢
$1.44
Connecticut
Illinois
IN 2012:
46 states; Georgia, Maryland and
New Hampshire are setting up
monitoring programs. Missouri and
the District of Columbia lack systems.
More Legal Expenses …
The opioid boom produced an explosion of pill mills, or supposed pain clinics, that handed out painkiller prescriptions with few questions asked.
Florida became a hotbed; dozens of doctors have been arrested. A 2010 law led to a crackdown. In fiscal 2009, the state had 921 registered pain clinics; two years later, only 441.
Most states have databases of prescriptions to flag patients trying to get additional opioids.
IN 2002:
16 states with monitoring.
Between 2001 and 2008, narcotics prescriptions as a share of all drugs used to treat workplace injuries jumped 63 percent, according to insurance industry data.
In California, workplace insurers spent $252 million on opioids in 2010, which represented about 30 percent of all prescription costs; in 2002, opioids accounted for 15 percent of drug expenditures
Workers’ compensation costs include treatment expenses and lost wages. The stronger the opioid, the higher the expense.
Cost with short-acting opioid like Percocet:
Cost with long-acting opioid like OxyContin:
Average claim cost without use of opioids:
$13,000
$39,000
$117,000
More Workplace Costs
16,651
4,030
2010
1999
Where prescription opioids
were involved:
885,348
299,498
2011
2004
Cases in which an opioid other than heroin was cited as a reason for an emergency-room treatment:
313,460
228,140
2011
2002
More Hospitalizations …
$2 billion
$800 million
2013
2000
More Pills, More Business …
Some 20 states let doctors both prescribe and sell drugs, sometimes at very big markups. Cases often involve workers’ comp and opioids.
Here’s how prices for physician-sold Vicodin spiked in two states between 2007 and 2011. In the same period, pharmacy prices dropped.
The number of prescriptions dispensed for two drugs increasingly given to treat opioid addiction — buprenorphine and naltrexone — has soared along with opioid use.
Many of these tests check the urine of patients taking opioids, looking for abuse of those drugs. In 2013, workers’ compensation insurers in California will spend about $100 million on tests, up 200-fold since 2002.
Estimated size of the U.S. screening industry: