27 Jul

Map of the Week: How Opioid Misuse is Costing Health Systems

By Sara Ryan



Opioids are a category of drugs that simulate natural substances found in the opium poppy plant and include both prescription pain medicine and illegal drugs. Along with effects such as pain relief, opioids often create a feeling of euphoria or a sense of heightened well-being among their users. Experiencing euphoria after taking opioids (even ones prescribed by a medical practitioner) is often a warning sign of vulnerability to opioid addiction. Opioid use disorder (OUD) is characterized by compulsive use or need for opioid drugs. 

This map by Axios depicts the share of emergency department inpatients treated for opioid use disorder, by state. The physical and emotional distress that comes with Opioid use disorder causes many sufferers to frequently end up in hospital emergency rooms. Although most hospitals only provide an assessment and then connect the patient to treatment centers, some hospitals may admit someone with a significant medical problem due to or in addition to the opioid use disorder.  The treatment of opioid use disorder (OUD) costs US hospitals more than $95 billion a year (7.86% of all hospital expenditures). Last fall, the Joint Economic Committee Democrats released a report estimating the opioid epidemic cost the U.S. nearly $1.5 trillion in 2020 (up 37% from 2017). In addition, the proliferation of the synthetic opioid fentanyl (which is attracting more people 40 and under) has caused the crisis to worsen further. New Mexico led all states with 7.09% of emergency department inpatient stays associated with OUD diagnoses, followed by New Jersey with 5.54%. Arkansas and Iowa had the lowest percentage of ER inpatient stays associated with OUD.

Although hospital treatments, such as Naloxone for opioid overdoses, are a quick fix for the opioid epidemic, they do not address the underlying opioid use disorder the way a specialized addiction treatment center would. Studies show that 87% of people with OUD do not receive evidence-based treatment. As a result, Federal health officials have begun to lay out guidelines for prescribing opioids for chronic pain, emphasizing they should not be used as the first line of therapy.

Economic and social disparities mean many opioid users cannot afford to receive any OUD care until they have reached life threatening levels, hence relying on emergency department care. Investments in making health care more affordable, in conjunction with an increased level of accessible opioid addiction education, can better overall social infrastructure for at risk communities and help reduce the amount of OUD emergency department admissions in the first place. 

Initiatives such as HEAL aim to increase the amount of aid opioid users can receive before they develop OUD. Initiatives like this have decreased the frequency of patients discharged from emergency department visits with an opioid prescription in 2020, compared to 2017-2018. However, the excessive cost and strain OUD places on the US healthcare system highlights how social injustice and a lack of primary care will inevitably affect all corners of a population.