1 in 5 Blue Cross Blue Shield members fill an opioid prescription annually, study shows

June 29--A new report on opioid use among people with commercial insurance reinforces a fact doctors and researchers often repeat: addiction to the drugs affects people of every income, age, race and place.

One in five people with a Blue Cross and Blue Shield commercial health plan filled an opioid prescription in 2015, according to a report Thursday from the Blue Cross Blue Shield Association, which includes Highmark Inc. and other large national insurers. Commercial insurance is the type of insurance most people get from their employers.

Not all the filled prescriptions were addiction-related, but addictions jumped 493 percent from 2010 through 2016, according to the study. Treatment rates increased just 65 percent over the same period.

"It touches everyone; we're all affected some way," said Dr. Rhonda Johnson, senior medical director in the clinical services area at Highmark.

Common surgeries, for which opioids are legitimately prescribed to control pain, can lead to addictions in some people, Johnson said. High doses and extended-release prescriptions were more likely to trigger addiction than lower doses and shorter-duration pills, the report found.

Dr. Karen Hacker, director of the Allegheny County Health Department, said her department has found that the demographics of opioid use defy stereotypes. Predominantly middle-class white communities are some of the hardest-hit in the region -- places like Shaler, Millvale, Etna and the South and North Hills have been affected along with places like Penn Hills and Sharpsburg, she said.

Thursday's study follows a Pennsylvania Health Care Cost Containment Council report released earlier this week that showed hospital admissions for heroin and pain pill overdoses had dramatically increased in the state from 2014 to 2016. About 1,800 people were hospitalized for pain medication overdoses in 2016 and about 1,500 for heroin overdoses, according to the report.

Among people admitted for pain medications, 43 percent had Medicare, 34 percent had Medicaid and 19 percent had private insurance, Joe Martin, the council's executive director, wrote in an email. Among people admitted for heroin, 61 percent had Medicaid, 21 percent had private insurance and 10 percent had Medicare, he wrote.

Pain pills were often prescribed for chronic diseases, according to the Blue Cross report. Appendicitis, kidney stones, dental diseases and gall bladder problems were among the most common short-term problems for which opioids were prescribed in 2015, the report showed.

Osteoarthritis, back disorders and other bone and joint disorders were among the most common long-term chronic conditions for which the drugs were prescribed.

Researchers found that women older than 45 had higher rates of opioid use disorder than men, but among people younger than 45, men had higher rates of the disorder.

Patients with the disorder were more likely to get treatment in New England than they were in the South and parts of the Midwest, according to the study.

In Pennsylvania, the rate of opioid prescriptions filled was slightly lower than the national average, at 15 percent to 18 percent.

The study included 6.3 million patients younger than 65 with commercial insurance. It excluded people with cancer diagnoses and those receiving palliative or hospice care. The Blue Cross Blue Shield Association is a federation of insurance plans that cover about 106 million Americans.

Highmark analyzes prescriptions to spot signs of addiction, Johnson said.

"The doses are higher, the duration of use is longer, you have refills that are multiple and earlier than what they should be," she said.

The insurer then intervenes through the patient's doctor, pharmacist or a case manager, steering the patient toward treatment.

"This is a chronic condition where relapse is common, and we need to encourage people to seek treatment for this disorder," she said.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676, [email protected] or via Twitter @wesventeicher.

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