The Economic Burden of Opioid Abuse: Updated Findings

Kirson, Noam Y.; Scarpati, Lauren M.; Enloe, Caroline J.; Dincer, Aliya P.; Birnbaum, Howard G.; Mayne, Tracy J.

doi:10.18553/jmcp.2017.16265

Cited by 51 publications

(44 citation statements)

References 12 publications

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“…Additionally, several matched cohort studies reported direct healthcare costs over a 12-month follow-up period that consisted of a 6-month period prior to and a 6-month period following a patient’s index date, which was defined as the date of the first formal abuse diagnosis. The total healthcare cost difference between abusers and matched non-abuser controls began to increase prior to the index date, with excess costs of more than US$3000 per person in the pre-index period [ 17 , 18 , 21 , 22 , 25 ]. Following the initial diagnosis of abuse, this cost difference increased substantially to US$7971–US$12,727 per person in the post-index period [ 17 , 18 , 21 , 22 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Reinhart

Scarpati

Kirson

et al. 2018

Appl Health Econ Health Policy

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BackgroundAbuse of prescription opioids [opioid use disorder (OUD), poisoning, and fatal and non-fatal overdose] is a public health and economic challenge that is associated with considerable morbidity and mortality in the USA and globally.ObjectiveTo systematically review and summarize the health economics literature published over the last 5 years that describes the economic burden of abuse of prescription opioids.MethodsFindings from searches of databases including MEDLINE, Embase, and Cochrane CENTRAL as well as hand searches of multiple conference abstracts were screened against predefined inclusion criteria to identify studies reporting cost and healthcare resource utilization (HRU) data associated with abuse of prescription opioids.ResultsA total of 49 unique studies were identified. Most of the studies examined direct costs and HRU, which were substantially higher for abusers of prescription opioids than non-abuser controls in several matched cohort analyses (US$20,343–US$28,718 vs US$9716–US$14,079 for mean direct combined annual healthcare costs reported in 6 studies). Although only a small number of studies reported indirect costs, these findings suggest a high societal burden related to productivity losses, absenteeism, morbidity, and mortality among those who abuse opioids. Studies of medication-assisted treatment demonstrated that factors such as adherence, dose, formulation (film or tablet), and relapse during treatment, were associated with direct costs and HRU among treated patients.ConclusionsThis systematic literature review shows that abuse of prescription opioids is characterized by substantial direct healthcare costs, medical utilization, and related societal costs. Future research should further investigate the indirect costs of opioid abuse.Electronic supplementary materialThe online version of this article (10.1007/s40258-018-0402-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Reinhart

Scarpati

Kirson

et al. 2018

Appl Health Econ Health Policy

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“…Opioid abuse leads to an estimated additional $14,810 in per-patient annual health care costs due to higher health care utilization. 7 In patients undergoing plastic and reconstructive surgery, risks for persistent (between 90 and 180 days after surgery) and prolonged (more than 180 days after surgery) use include being prescribed an opioid in the perioperative setting, procedure type, number of medical comorbidities, and history of mental health disorders or substance abuse. 8 Although work has been done to characterize rates of perioperative opioid use after radical prostatectomy, data on persistent and prolonged opioid use are limited.…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy Associated with Decreased Persistent Postoperative Opioid Use

Shkolyar

Shih

et al. 2020

Journal of Endourology

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Introduction: Minimally invasive surgery offers reduced pain and opioid use postoperatively compared with open surgery, but large-scale comparative studies are lacking. We assessed the incidence of persistent opioid use after open and robot-assisted radical prostatectomy (RARP). Materials and Methods:We performed a retrospective claims database cohort study of opioid-naive (i.e., no opioid prescriptions 30-180 days before index surgery) adult males who underwent radical prostatectomy for prostate cancer from July 2013 to June 2017. For patients who filled a perioperative opioid prescription (30 days before to 14 days after surgery), we calculated the incidence of new persistent postoperative opioid use ( ‡1 prescription 90-180 days after surgery). Multivariable logistic regression was performed to investigate the association between the surgical approach, patient risk factors, and persistent opioid use. Results: Twelve thousand two hundred seventy-eight radical prostatectomy patients filled an opioid prescription perioperatively (1510 [12%] open and 10,768 [88%] robot assisted). Of these, 846 (6.9%) patients continued to fill opioid prescription(s) 90 to 180 days after surgery. Patients undergoing RARP were 35% less likely to develop new persistent opioid use compared with those undergoing open radical prostatectomy (6.5% vs 9.7%; adjusted odds ratio 0.65; 95% confidence interval 0.54, 0.79). Other independent risk factors included living in the southern, western, or north central United States; preoperative comorbidity; and tobacco use.Conclusions: Approximately 6.9% of opioid-naive patients continued to fill opioid prescriptions 90 days after radical prostatectomy. The risk of persistent opioid use was significantly lower among patients undergoing a robot-assisted vs open approach. Further efforts are needed to develop postoperative opioid prescription protocols for patients undergoing radical prostatectomy.

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“…Alarmingly, illicit fentanyl products are increasingly identified in products sold as heroin [3]. As more people are affected by this crisis, many eventually interact with the healthcare system, often for acute care needs [4,5].…”

Section: Introductionmentioning

confidence: 99%

Agreement between self-reported psychoactive substance use and urine toxicology results for adults with opioid use disorder admitted to hospital

Moreno

Duprey

Hayes

et al. 2019

Toxicology Communications

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Hospitals often perform urine drug screens (UDS) upon inpatient admission to confirm selfreported psychoactive substance use for patients with opioid use disorder (OUD). We sought to evaluate the agreement between UDS and patient self-report for psychoactive substances detected with UDS for adults with OUD admitted to hospital. For 11 substance categories, we evaluated agreement between the UDS and the documented history over a 5-year period for consecutive adults admitted to one academic center with a history of OUD. Among the 153 patients, overall agreement across the 1683 different history/UDS pairs (i.e. either historyþ/ UDS þ or history-/UDS-) was high (81.3%) but varied (from lowest to highest) by substance [opiates (56.9%), benzodiazepines (66.0%), 6-acetylmorphine (67.3%), cocaine (81.0%), cannabinoids (81.0%), methadone (83.7%), buprenorphine (85.0%), amphetamine (94.8%), barbiturates (95.4%), and phencyclidine (98.7%)]. Historyþ/UDS-pair mismatches were most frequent for 6-acetylmorphine (32.7%), methadone (14.3%) and oxycodone (12.4%); history-/UDS þ pair mismatches were most frequent for opiates (43.1%), benzodiazepines (24.8%) and cannabinoids (18.3%). The change in agreement over time of self-reported heroin use may reflect an increasing number of patients unknowingly using illicit fentanyl products. Among hospitalized patients with OUD, agreement between reported psychoactive substance use history and UDS results is strong with the exception of opiates, heroin, and benzodiazepines.

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The Economic Burden of Opioid Abuse: Updated Findings

Cited by 51 publications

References 12 publications

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

The Economic Burden of Abuse of Prescription Opioids: A Systematic Literature Review from 2012 to 2017

Robot-Assisted Radical Prostatectomy Associated with Decreased Persistent Postoperative Opioid Use

Agreement between self-reported psychoactive substance use and urine toxicology results for adults with opioid use disorder admitted to hospital

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