Costly Opioid-Related Hospital Stays Soar Nationwide, But Vary Widely Among States

Opioid-related hospital stays increased nationwide by 64 percent from 2005 to 2014, according to an AHRQ report offering new insights into the nation’s costly opioid epidemic. Trends in opioid-related hospital stays varied widely among states, with rates increasing more than 70 percent in North Carolina, Oregon, South Dakota and Washington, for example, while declining in Illinois, Kansas, Louisiana and Maryland. The report, Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009–2014, features data from AHRQ’s Fast Stats, an online resource that provides inpatient and emergency department data from AHRQ’s Healthcare Cost and Utilization Project. The rise in overdoses linked to opioids, including prescription painkillers and heroin, has been declared an epidemic by HHS. The department initiated several strategies to help Americans struggling with opioid addiction, including AHRQ’s series of grants totaling $12 million to address delivering medication-assisted treatment for opioid abuse in rural primary care practices. Access a press release on AHRQ’s report, a new AHRQ infographic that shows state variations in opioid-related hospital stays, and Director Andy Bindman’s AHRQ Views blog post on efforts to reduce opioid misuse.

Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014

Audrey J. Weiss, Ph.D., Anne Elixhauser, Ph.D., Marguerite L. Barrett, M.S., Claudia A. Steiner, M.D., M.P.H., Molly K. Bailey, and Lauren O'Malley

Highlights

Between 2005 and 2014, the national rate of opioid-related inpatient stays increased 64.1 percent and the national rate of opioid-related emergency department (ED) visits increased 99.4 percent.

Across States, the rate of opioid-related inpatient stays in 2014 varied eight-fold.
- The highest hospitalization rates occurred in Maryland (362.1 stays per 100,000 population), the District of Columbia (339.0), and New York (335.3).
- The lowest rates occurred in Iowa (44.2), Nebraska (46.1), and Texas (70.9).

The rate of opioid-related inpatient stays increased in most States between 2009 and 2014, with the greatest increases in Oregon (88.9 percent), North Carolina (81.8 percent), and South Dakota (74.1 percent).

Across States, the rate of opioid-related ED visits in 2014 varied 14-fold.
- The highest rates occurred in Massachusetts (441.6 visits per 100,000 population), Rhode Island (288.6), and Maryland (288.4).
- The lowest rates occurred in Iowa (31.1), Nebraska (39.9), and South Dakota (47.1).

The rate of opioid-related ED visits increased in almost all States between 2009 and 2014, more than doubling in Ohio (119.1 percent), South Dakota (106.4 percent), and Minnesota (102.3 percent).

Introduction

The opioid epidemic has reached alarming levels in many parts of the United States, affecting the lives of thousands of individuals and families. Between 2000 and 2014, the rate of overdose deaths involving opioids in the United States increased 200 percent.¹ Between 2013 and 2014 alone, the rate of opioid overdose deaths increased 14 percent, from 7.9 to 9.0 per 100,000 population.² Hospitalizations related to opioid misuse and dependence also have increased dramatically, with the rate of adult hospital inpatient stays per 100,000 population nearly doubling between 2000 and 2012.³ The substantial increase over the past decade in the misuse of opioids, which include prescription opioids and illicit opioids such as heroin, has been declared an "opioid epidemic" by the U.S. Department of Health and Human Services (HHS).⁴

In March 2015, HHS launched its Opioid Initiative to help reverse the increasing trend in opioid misuse, use disorder, and overdoses, and to support State efforts to address the opioid crisis.⁵ In response to HHS initiatives, in December 2016 the Agency for Healthcare Research and Quality released statistics on opioid-related hospital use by State in the interactive, online tool for the Healthcare Cost and Utilization Project (HCUP), HCUP Fast Stats.⁶

This HCUP Statistical Brief presents data from HCUP Fast Stats on the national rate of opioid-related hospital inpatient stays and emergency department (ED) visits from 2005 to 2014. Rates for more than 40 individual States and the District of Columbia are provided for 2014 along with changes in rates for the 6-year period from 2009 to 2014. Identification of opioid-related stays and visits is based on all-listed diagnoses and includes events associated with prescription opioids or illicit opioids such as heroin. Differences greater than 10 percent between estimates are noted in the text.

Findings

National rate of opioid-related inpatient stays and ED visits, 2005-2014
Figure 1 presents the national rate per 100,000 population of opioid-related inpatient stays and ED visits from 2005 through 2014.