Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012 #177

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Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012 #177

Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012

Pamela L Owens, Ph.D., Marguerite L. Barrett, M.S., Audrey J. Weiss, Ph.D., Raynard E. Washington, Ph.D., and Richard Kronick, Ph.D.

Highlights

The rate of hospital stays involving opioid overuse among adults increased more than 150 percent between 1993 and 2012. By 2012, there were 709,500 total opioid-related hospital stays representing a rate of 295.6 stays per 100,000 population. In 1993, the national rate of hospital stays involving opioid overuse among adults was 116.7 per 100,000 population, with the highest rates in select subgroups: men (144.0 per 100,000 population), people aged 25-44 years (188.6 per 100,000 population), and people living in the Northeast (264.0 per 100,000 population). By 2012, hospital stays involving opioid overuse had increased by approximately 150 percent, with the largest rates of increase among subgroups with relatively lower rates in 1993 (women, people aged 85 years and older, and people living in the Midwest). In 2012, rates for various age groups were much more similar, the Northeast was no longer a notable outlier, and rates for men and women were nearly equal. Medicaid had the largest proportion of stays involving opioid overuse (43 percent) in 1993, but Medicare had the largest annual increase over time. By 2012, Medicaid and Medicare each were billed about one-third of all opioid-related stays.

Introduction

Opioids, or pain medications, are commonly used to manage pain associated with injury, illness, or following surgery. Opioids include both prescription pain medications, such as morphine, codeine, fentanyl, oxycodone, and hydrocodone, as well as illegal drugs such as heroin.¹ A variety of negative side effects can occur from opioid use, including vomiting, severe allergic reactions, and overdose.² In 2010, opioids, predominantly prescription medications, were estimated to be nonmedically used by more than 12 million people,³ resulted in 425,000 emergency department visits,⁴ and were related to approximately 17,000 deaths.^5,6

Opioid overdose can occur for a variety of reasons, including accidental and deliberate misuse of a prescription (e.g., taking more doses than prescribed), taking medication prescribed for someone else, and combining opioids with other substances such as alcohol. The U.S. Department of Health and Human Services has recognized opioid misuse and abuse as a significant public health issue.^8,9,10

This HCUP Statistical Brief presents data on adult inpatient hospitalizations involving overuse of opioids, including opioid dependence, abuse, poisoning, and adverse effects. Hospitalizations that involved illegal drug use were excluded from this analysis. Trends in hospital inpatient stays related to opioid overuse among adults are presented along with characteristics of these types of stays. Differences between group rate estimates noted in the text are statistically significant at the 0.05 level or better and differ by at least 10 percent.

Findings

Trends in inpatient hospitalizations involving opioid overuse, 1993-2012
The trend in the rate of hospital inpatient stays involving opioid overuse from 1993 to 2012 is presented in Figure 1. The rate is calculated per 100,000 population aged 18 years and older.