title: The prevalence of diagnosed opioid abuse in commercial and Medicare managed care populations.
abstract: OBJECTIVE
  To measure the prevalence of diagnosed opioid abuse and prescription opioid use in a multistate managed care organization.
  
  
  METHODS
  This retrospective claims data analysis reviewed the prevalence of diagnosed opioid abuse and the parallel prevalence of prescription opioid use in half-year intervals for commercial and Medicare members enrolled with Humana Inc., from January 1, 2008 to June 30, 2010. Diagnosis of opioid abuse was defined by ≥ 1 medical claim with any of the following ICD-9-CM codes: 304.0 ×, 304.7 ×, 305.5 ×, 965.0 ×, excluding 965.01, and opioid use was defined by ≥ 1 filled prescription for an opioid. The prevalence of opioid abuse was defined by the number of members with an opioid abuse diagnosis, divided by the number of members enrolled in each 6-month interval.
  
  
  RESULTS
  The 6-month prevalence of diagnosed opioid abuse increased from 0.84 to 1.15 among commercial and from 3.17 to 6.35 among Medicare members, per 1,000. In contrast, there was no marked increase in prescription opioid use during the same time period (118.0 to 114.8 for commercial members, 240.6 to 256.9 for Medicare members, per 1,000). The prevalence of diagnosed opioid abuse was highest among members younger than 65 years for both genders in commercial (18- to 34-year-olds) and Medicare (35- to 54-year-olds) populations.
  
  
  CONCLUSIONS
  Despite a stable rate of prescription opioid use among the observed population, the prevalence of diagnosed opioid abuse is increasing, particularly in the Medicare population.
authors.affiliation: Comprehensive Health Insights, Inc., Louisville, Kentucky, U.S.A.
authors.forename: Robert
authors.initials: R
authors.lastname: Dufour
authors.forename: Ashish V
authors.initials: AV
authors.lastname: Joshi
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Pasquale
authors.forename: David
authors.initials: D
authors.lastname: Schaaf
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
authors.forename: George A
authors.initials: GA
authors.lastname: Andrews
authors.forename: Nick C
authors.initials: NC
authors.lastname: Patel
mesh_terms: D000701:Analgesics, Opioid / Q000191:economics; D016208:Databases, Factual; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics; D008329:Managed Care Programs; D006278:Medicare / Q000191:economics*; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: medical claims data analysis; medicare managed care; opioid abuse; opioid use; prevalence