Opioid Use by the Numbers

20,101.

The number of overdose deaths due to prescription painkiller abuse in 2015.

650,000.

The number of opioid prescriptions written each day in the U.S.

100,000,000.

The number of Americans who report suffering from chronic pain.

Artemis Health regularly hears from employers who are concerned that the opioid epidemic is affecting their employees. They want to know if it’s a problem for their population for a few key reasons:

• They’re concerned about overall population health
• They’re worried about risk and potential safety issues on the job
• They want to offer and promote programs that address substance abuse 

It’s a difficult problem for Artemis to track because benefits data comes from medical/Rx claims and wellness program vendors, not from illegal sales of opioids. We can’t give employers insight into transactions happening in parking lots, but we can give them a look at legal opioid use. Artemis built a custom Story within our platform for one customer focused on opioids, and we’ll use this limited data set to explore this topic. 

For this employer, roughly 5% of their total Rx claims were for opioids and this accounted for 2% of their spend:

So for this population, a relatively small number of employees are taking opioids, and it’s not a large percentage of spend either (about $200,000 of $12.8 million in annual Rx spend).

We can also see that these members aren’t necessarily taking a large number of drugs - those within our Opioid Cohort are taking an average of 2.67 prescriptions, in line with national averages.

The customer wanted to see how their population who had major orthopedic procedures corresponded with opioid use.

This data does indicate a potential problem: following a major orthopedic procedure, members are filling an average of 6 opioid prescriptions.

6 refills sounds high, so we did a little exploration to see how many pills over how long a period this would be. Doing the math, if these members are taking the prescribed quantity of 4 pills per day with about 63 pills in the bottle, they’ll be on opioids for about 3 months. Studies have shown that dependence develops from prolonged use due to the patient developing a tolerance for the drug. The longer they use a drug like fentanyl, the higher the dose necessary to achieve the same pain relief and the higher the risk of misuse. Some experts say that tolerance can occur after just 30 days of use.

Employers could use this information to conduct employee education campaigns around transitioning to other pain relief methods, like the RICE method, physical therapy, and non-addictive pain medications. As we saw above for this employer, less than 7 of those in our opioid/major orthopedic procedure Cohort were also in physical therapy, which some studies are showing to be the most effective long-term solution for back pain.

Now let’s look at which drugs are prescribed (the top 15):

This Visualization provides a view how many members are taking certain drugs, and it provides the insight employers need to develop messaging around the use of high-risk medications. You may also find substitutions that allow for cost savings with the same outcomes for patients.

Artemis analysts found that “cross-walking,” or looking at data across different vendors and feeds, is the key to actionable insights. Medical and Rx claims give us an overall picture, but we also analyzed the opioid Cohort’s behavior around absenteeism.

Employees within the opioid Cohort are absent on disability for a longer period of time than those who aren’t (30.2 vs. 26.7 days). Absenteeism is a big concern for employers, and considering the unpredictability of short-term disability claims, it could cost companies more than they would spend on prevention programming. Artemis customers have used similar analyses to make the business case for new wellness programs.

This data reflects just one employer using the Artemis Platform, and the overall insight here is limited. It looks from the data like most employees are using opioids as directed, and we can’t see obvious cause for alarm in these numbers. However, this is only reflective of the legal, medical means of obtaining opioids. So what can an employer do?

Many Artemis customers find the best way to address substance abuse is through robust benefits programs that enable members to seek help quickly and at a low out-of-pocket cost. They take a proactive approach, paired with a targeted communication strategy, to reach members who may need help with opioid abuse. This is one way to meet members’ needs and minimize risk to the organization when employee well-being is difficult to analyze.